Hyperthyroidism in Graves' disease (autoimmune hyperthyroidism) is typically caused by autoantibodies to the thyroid stimulating hormone receptor (TSHR), and measurement of these TSHR antibodies (TRAb) can
be useful in disease diagnosis and management.
TSH autoantibodies can be classified as stimulating, blocking or neutral depending on their mechanism of action. Despite having actions similar to TSH, TSHR stimulating antibodies are not subject to the negative feedback mechanisms associated with TSH, leading to prolonged activation of the TSHR. This results in the elevated thyroid hormone levels and clinical thyrotoxic state associated with Graves’ disease.
Manufacturer’s reagent package insert, Elecsys Anti-TSHR, 2019-01,V.14, Roche Diagnostics GmbH, D68305 Mannheim.