From the Guidelines
Yes, it is possible to have both positive Thyroid-Stimulating Hormone (TSH) receptor antibody and Thyroid Peroxidase (TPO) antibody.
Relevant Tests
- Thyroid stimulating hormone receptor antibody (TRAb)
- Thyroid stimulating immunoglobulin (TSI)
- TPO
Clinical Context
These tests are undertaken when thyroiditis is suspected, primarily to rule out other causes of thyrotoxicosis such as Graves’ disease 1.
Disease Association
Graves’ disease is associated with the presence of TSH receptor antibody, while thyroiditis and autoimmune thyroid disease can be associated with the presence of TPO antibody.
Management
Conservative management during the thyrotoxic phase of thyroiditis is sufficient, with non-selective beta blockers and thyroid hormone replacement initiated at the time of hypothyroidism diagnosis 1.
From the Research
Presence of Both TSH Receptor Antibody and Thyroid Peroxidase Antibody
- It is possible for an individual to have both positive Thyroid-Stimulating Hormone (TSH) receptor antibody and Thyroid Peroxidase (TPO) antibody, as indicated by studies on autoimmune thyroid disease 2, 3, 4.
- The presence of TPO antibody is often used to indicate thyroid autoimmunity, and it can be found in patients with Hashimoto's thyroiditis or Graves' disease 3.
- TSH receptor antibodies, on the other hand, are specific biomarkers for Graves' disease and can also be found in patients with Hashimoto's thyroiditis, where they may contribute to hypothyroidism 2, 4.
Clinical Relevance and Utility
- The measurement of TSH receptor antibodies, including both stimulating and blocking antibodies, is recommended for the diagnosis and management of autoimmune thyroid disease, particularly in patients with Graves' disease or Hashimoto's thyroiditis 2, 3, 4.
- The presence of both TSH receptor antibody and TPO antibody can provide valuable information for the diagnosis and treatment of thyroid disorders, and clinicians should be aware of the different tests available and how to interpret the results 3, 4.
- Studies have shown that patients with positive TSH receptor antibody and TPO antibody can have varying clinical presentations, including hypothyroidism, hyperthyroidism, or euthyroidism, and the measurement of these antibodies can help guide treatment decisions 2, 3.