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1090: Thyrotropin Receptor Autoantibody with TSH Print View
TBII RIA  < 17  %Inhibition 
TSH IA    mIU/L 

PRIMARY
1 Serum 2 (1) mL   Refrigerated - 4 Day(s)/Frozen - 2 Month(s)  
ALTERNATE

Used in diagnosis of hyperthyroidism and Graves' disease. The Thyrotropin Receptor Autoantibody (TRAB) Assay has utility in the differential diagnosis of Graves disease versus toxic nodular goiter. A low-positive TRAB (15-60) upon initial diagnosis is indicative of a high likelihood that a 6-18 month course of anti-thyroid drug medication will result in remission of Graves disease. Conversely, a high-positive TRAB (>80) upon initial diagnosis indicates a low likelihood of disease remission following anti-thyroid therapy. Studies show that 83% of patients with detectable receptor antibody activity (i.e., an elevated TRAB) at the end of a twelve month course of anti-thyroid drug therapy subsequently relapse. Non-elevated TRAB concentrations after twelve months of drug treatment predict remission in 89% of patients at 1 year and in 81% at 3 years after drug withdrawal. In the most current studies, the frequency of an elevated TRAB in patients with confirmed Graves disease ranges from 94-100%.

Patient Preparation:
Specimen collection after fluorescein dye angiography should be
delayed for at least 3 days. For patients on hemodialysis, specimen
collection should be delayed for 2 weeks. According to the assay
manufacturer Siemens: "Samples containing fluorescein can produce
falsely depressed values when tested with ADVIA Centaur TSH3 Ultra
assay."
Setup Schedule
Monday

Reported (Analytical Time)
Same day

CPT Codes
83519,84443

The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.

Notes
Also available Thyrotropin Receptor Autoantibody without TSH, #1093. According to the assay manufacturer Siemens: "In general, the fluorescein clearance (requires) about 48 to 72 hours." For patients in "end stage renal disease on hemodialysis, the elimination will be delayed likely by several cycles of hemodialysis. Assuming the dialysis cycle serves as one half-life (and) using the rule of thumb that 5 half-lives are required to completely eliminate a compound, two weeks is conservative (if) dialysis is performed 3 times per week."






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