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A New Serological Method for the Differential Diagnosis of Hashimoto's Thyroiditis and Graves' Disease

23 Pages Posted: 8 Nov 2018

See all articles by Biao Huang

Biao Huang

Zhejiang Sci-tech University

Yi Zhang

Nanjing Medical University - Jiangsu Institute of Nuclear Medicine

Liang Wang

Nanjing Medical University - Wuxi Children’s Hospital

Xue Yang

Nanjing Medical University - Wuxi Children’s Hospital

Jue Zhang

Nanjing Medical University - Jiangsu Institute of Nuclear Medicine

Jun Dai

Jiangsu Jiangyuan Hospital

Yun Gao

Jiangsu Jiangyuan Hospital

Jiandong Bao

Jiangsu Jiangyuan Hospital

Zhigang Hu

Nanjing Medical University - Wuxi Children’s Hospital

More...

Abstract

Background: Although Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) have overlapping symptoms, the treatment of these conditions is different, making the differential diagnosis of these disorders crucial for optimal patient outcomes. Therefore, we developed and evaluated a novel serological method for the differential diagnosis of HT and GD.

Methods: We developed a highly sensitive, time-resolved fluoroimmunoassay for measuring serum concentrations of anti-phospholipase A2 receptor (PLA2R)-IgG antibody; other thyroid health indicators such as thyroid-stimulating hormone (TSH), free T3, free T4; and antibodies against thyroglobulin (TGAb), thyroperoxidase (TPOAb), and TSH receptor (TRAb). We analyzed the differences in the concentrations of these indicators among healthy controls, patients with HT, and patients with GD. Serum anti-PLA2R-IgG, TGAb, TPOAb, TRAb, and other indicator concentrations were used to differentially diagnose HT and GD.

Results: In the control, GD, and HT groups, the average concentrations (±standard deviation) of anti-PLA2R-IgG were 0.49 ± 0.24 mg/L, 0.47 ± 0.11 mg/L, and 3.23 ± 1.89 mg/L, respectively, and the percentages of patients above the threshold of 1.1 mg/L were 0%, 0%, and 95% respectively. The positive results obtained in both the TPOAb and anti-PLA2R-IgG tests were good diagnostic indicators of HT, with a sensitivity of 90% and specificity of 100%.

Conclusions: The serum anti-PLA2R-IgG antibody concentration was significantly elevated in the sera of HT patients compared with that in healthy controls and GD patients. Measurement of serum anti-PLA2R-IgG concentrations in conjunction with the TPOAb test provides a reliable method for the differential diagnosis of HT and GD.

Funding Statement: Funding was provided by the Clinical Medical Science fund of Jiangsu Province (No. BL2014022), the Directive Planning Project of Wuxi Science and Technology Bureau(No. CSE31N1302), the Key Subject of Wuxi’s Hospital Administration Center (No. YGZXM14013), Wuxi Key Medical Talents (zdrc006), Jiangsu Province Science and Education Project (CXTDB2017016), Wuxi Technology Development Fund (Medical and public health project) (WX18IIAN027) and Medical and Public Health Project of Wuxi Sci-Tech Development Fund (WX18IIAN647).

Declaration of Interests: The authors declare they have no competing financial interests.

Ethics Approval Statement: The institutional review board of Jiangyuan Hospital and Wuxi People’s Hospital approved the study, and written informed consent was obtained from all the study subjects. Patients treated at Jiangyuan Hospital (China) and Wuxi People’s Hospital (China) between January 2015 and May 2017 were selected as the subjects for this study.

Keywords: Time-resolved fluoroimmunoassay (TRFIA), phospholipase A2 receptor (PLA2R), Hashimoto thyroiditis, Graves’ disease

Suggested Citation

Huang, Biao and Zhang, Yi and Wang, Liang and Yang, Xue and Zhang, Jue and Dai, Jun and Gao, Yun and Bao, Jiandong and Hu, Zhigang, A New Serological Method for the Differential Diagnosis of Hashimoto's Thyroiditis and Graves' Disease (February 11, 2018). Available at SSRN: https://ssrn.com/abstract=3279191

Biao Huang

Zhejiang Sci-tech University ( email )

Hangzhou
China

Yi Zhang

Nanjing Medical University - Jiangsu Institute of Nuclear Medicine ( email )

Jiangsu
China

Liang Wang

Nanjing Medical University - Wuxi Children’s Hospital ( email )

Jiangsu
China

Xue Yang

Nanjing Medical University - Wuxi Children’s Hospital ( email )

Jiangsu
China

Jue Zhang

Nanjing Medical University - Jiangsu Institute of Nuclear Medicine ( email )

Jiangsu
China

Jun Dai

Jiangsu Jiangyuan Hospital ( email )

Jiangsu, 214063
China

Yun Gao

Jiangsu Jiangyuan Hospital ( email )

Jiangsu, 214063
China

Jiandong Bao

Jiangsu Jiangyuan Hospital ( email )

Jiangsu, 214063
China

Zhigang Hu (Contact Author)

Nanjing Medical University - Wuxi Children’s Hospital ( email )

Jiangsu
China

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