Clinical relevance of thyroid-stimulating autoantibodies in pediatric graves' disease-A multicenter study

T. Diana, R. S. Brown, A. Bossowski, M. Segni, M. Niedziela, J. König, A. Bossowska, K. Ziora, A. Hale, J. Smith, S. Pitz, M. Kanitz, G. J. Kahaly

Research output: Contribution to journalArticlepeer-review


Context and Objective: The incidence of TSH receptor (TSHR) stimulating autoantibodies (TSAbs) in pediatric Graves' disease (GD) is controversial. This large, multicenter study evaluated the clinical relevance of TSAbs in children with GD both with Graves' orbitopathy (GO) and without orbital disease. Design: We conducted a cross-sectional retrospective study. Setting: Sera were collected in seven American and European academic referral centers and evaluated in a central laboratory. Patients and Samples: A total of 422 serum samples from 157 children with GD, 101 control individuals with other thyroid and nonthyroid autoimmune diseases, and 50 healthy children were studied. Main Outcome Measures: TSAbs were measured using a novel, chimeric TSHR bioassay and a cAMP response element-dependent luciferase. TSH binding-inhibitory Ig (TBII) and parameters of thyroid function were also determined. Results: In 82 untreated children with GD, sensitivity, specificity, and positive and negative predictive values for TSAb and TBII were: 100 and 92.68% (P = .031), 100 and 100%, 100 and 100%, and 100 and 96.15%, respectively. TSAb and TBII were present in 147 (94%) and 138 (87.9%) of the 157 children with GD (P <.039), respectively; and in 247 (94%) and 233 (89%) of the 263 samples from this group (P <.0075), respectively. In children with GD and GO, TSAb and TBII were noted in 100 and 96% (P <.001), respectively. Hyperthyroid children with GD and GO showed markedly higher TSAb levels compared to those with thyroidalGDonly (P

Original languageEnglish
Pages (from-to)1648-1655
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number5
Publication statusPublished - 2014

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism


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