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  • TSH receptor blocking antibodies x
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Bengt Hallengren Departments of Endocrinology, Skåne University Hospital, Malmö
Department of Clinical Sciences, Lund University, Lund, Sweden

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Tereza Planck Departments of Endocrinology, Skåne University Hospital, Malmö
Department of Clinical Sciences, Lund University, Lund, Sweden

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Peter Åsman Departments of Ophthalmology, Skåne University Hospital, Malmö
Department of Clinical Sciences, Lund University, Lund, Sweden

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Mikael Lantz Departments of Endocrinology, Skåne University Hospital, Malmö
Department of Clinical Sciences, Lund University, Lund, Sweden

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positive for TSH receptor blocking antibodies, followed by hyperthyroidism positive for TSH receptor-stimulating antibodies, after an episode of SAT. This was similar to our patient who developed TSH receptor antibodies and hypothyroidism, which remained

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Solène Castellnou Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d’Endocrinologie, Bron, France

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Patricia Bretones Service d’Endocrinologie Pédiatrique, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron, France

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Juliette Abeillon Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d’Endocrinologie, Bron, France

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Myriam Moret Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d’Endocrinologie, Bron, France

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Pauline Perrin Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, LBMMS, Bron, France

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Karim Chikh Centre de Biologie et de Pathologie Sud, Hospices Civils de Lyon, Groupement Hospitalier Sud, LBMMS, Saint Genis Laval, France

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Véronique Raverot Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, LBMMS, Bron, France

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Established Facts Maternal TSH receptor-blocking antibodies (TBAbs) are a known cause of transient congenital hypothyroidism. Novel Insights Congenital hypothyroidism due to TBAbs can occur in case of a normal concentration

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Tanja Diana Molecular Thyroid Research Laboratory, Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Christian Wüster Endocrine Laboratory Prof. Wüster, Mainz, Germany

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Paul D. Olivo Department of Microbiology, Washington University, St. Louis, Missouri, USA

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Angelica Unterrainer Molecular Thyroid Research Laboratory, Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Jochem König Endocrine Laboratory Prof. Wüster, Mainz, Germany

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Michael Kanitz Molecular Thyroid Research Laboratory, Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Artur Bossowski Department of Pediatrics, Endocrinology, and Diabetology, Medical University of Byalistok, Bialystok, Poland

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Brigitte Decallonne Division of Clinical and Experimental Endocrinology, UZ Leuven, Leuven, Belgium

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George J. Kahaly Molecular Thyroid Research Laboratory, Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Introduction Antibodies (Ab) to the thyroid-stimulating hormone receptor (TSHR) may mimic [ 1 - 3 ] or block [ 4 ] the action of TSH or be functionally neutral [ 5 ]. TSHR stimulating Ab (TSAb) are responsible for many of the clinical

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Bernard Goichot Department of Internal Medicine, Endocrinology and Nutrition, Hôpitaux Universitaires de Strasbourg
FMTS, Faculté de Médecine, Université de Strasbourg, Strasbourg

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Stéphane Bouée CEMKA, Bourg La Reine

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Claire Castello-Bridoux Medical Affairs Department, Merck Serono, Lyon

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Philippe Caron Department of Endocrinology, Metabolic Diseases and Nutrition, Pôle Cardio-Vasculaire et Métabolique, CHU Larrey
Inserm U1037, Université Paul Sabatier, Toulouse, France

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etiologies Laboratory Investigations A complete blood count was requested for the majority of patients, most likely with the idea to treat with antithyroid drugs. Anti-TSH receptor antibodies (TRAb) were tested in slightly less than 60% of the

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria ‘S. Maria della Misericordia', Udine

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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determination would be repeated by 68.5 and 66.5%, respectively. TSH receptor antibodies (TRAb), peroxidase antibodies (TPOAb), and thyroglobulin antibodies (TgAb) would be requested by 93.9, 76.8, and 58%, respectively. Complete blood count (CBC) is considered

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Mikael Lantz Department of Endocrinology and Ophthalmology, Skåne University Hospital Malmö, Malmö
Department of Clinical Sciences, Lund University, Lund

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Jan Calissendorff Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset

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Frank Träisk Department of Clinical Neurosciences, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden

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Leif Tallstedt Department of Clinical Neurosciences, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden

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Tereza Planck Department of Endocrinology and Ophthalmology, Skåne University Hospital Malmö, Malmö
Department of Clinical Sciences, Lund University, Lund

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Ove Törring Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset

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Bengt Hallengren Department of Endocrinology and Ophthalmology, Skåne University Hospital Malmö, Malmö
Department of Clinical Sciences, Lund University, Lund

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Peter Åsman Department of Endocrinology and Ophthalmology, Skåne University Hospital Malmö, Malmö
Department of Clinical Sciences, Lund University, Lund

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, plasma concentrations of TSH <0.2 mIU/l, and increased plasma levels of free T 4 and/or free T 3 . The patients were classified as having GD on the basis of clinical signs, the presence of TSH receptor antibodies (TRAb) and/or a diffuse uptake on thyroid

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Christiaan F Mooij Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands

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Timothy D Cheetham Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
Department of Pediatric Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Frederik A Verburg Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, the Netherlands

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Anja Eckstein Department of Ophthalmology, University Duisburg Essen, Essen, Germany

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Simon H Pearce Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK
Endocrine Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Juliane Léger Department of Pediatric Endocrinology and Diabetes, Reference Center for Rare Endocrine Growth and Development Diseases, Endo-ERN HCP, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, University of Paris, NeuroDiderot Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France

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A S Paul van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands

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. ATD, antithyroid drug; CBZ, carbimazole; FT3, free triiodothyronine; FT4, free thyroxine; kg, kilogram; MMI, methimazole; TSH, thyrotropin; TSHRAb, TSH receptor antibodies. Table 4 Framework for managing patients with block and replace

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Mahdi Kamoun Endocrinology and Metabolism Department

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Michèle d'Herbomez Department of Nuclear Medicine, Lille University Hospital, Lille

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Christine Lemaire Department of Endocrinology, Regional Hospital of Béthune, Béthune

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Armelle Fayard Endocrinology and Metabolism Department

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Rachel Desailloud Endocrinology and Metabolism Department, Amiens University Hospital, Amiens, France

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Damien Huglo Department of Nuclear Medicine, Lille University Hospital, Lille

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Jean-Louis Wemeau Endocrinology and Metabolism Department

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/ml; radioimmunometric and immunoenzymatic methods). Assay interference from anti-TSH antibodies was suspected; however, not proven. TSH measurements were repeated after sample incubation in heterophile-blocking tubes (Scantibodies Laboratory). The results did not

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Susanne Neumann Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Bethesda, Bethesda, Maryland, USA

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Christine C. Krieger Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Bethesda, Bethesda, Maryland, USA

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Marvin C. Gershengorn Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health Bethesda, Bethesda, Maryland, USA

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) . 2010 Sep ; 73 ( 3 ): 404 – 12 . 10.1111/j.1365-2265.2010.03831.x 20550534 0300-0664 21 Furmaniak J , Sanders J , Rees Smith B . Blocking type TSH receptor antibodies . Auto Immun Highlights . 2012 Mar ; 4 ( 1 ): 11 – 26 . 10

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Sandrine Donadio-Andréi Siamed'Xpress, Hôtel Technologique Morandat, Gardanne

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Karim Chikh Hospices Civils de Lyon, Lyon
CARMEN-INSERM U1060, Université Claude Bernard Lyon 1, Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Oullins
Société Française de Médecine Nucléaire, Groupe de Biologie Spécialisée, Centre Antoine Béclère, Paris

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Christine Heuclin BioSIMS Technologies, Seine Biopolis II, Rouen

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Elisabetta Kuczewski Hospices Civils de Lyon, Lyon

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Anne Charrié Hospices Civils de Lyon, Lyon
CARMEN-INSERM U1060, Université Claude Bernard Lyon 1, Faculté de Médecine et de Maïeutique Lyon Sud - Charles Mérieux, Oullins
Société Française de Médecine Nucléaire, Groupe de Biologie Spécialisée, Centre Antoine Béclère, Paris

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Anne-Sophie Gauchez Société Française de Médecine Nucléaire, Groupe de Biologie Spécialisée, Centre Antoine Béclère, Paris
Laboratoire du Service de Médecine Nucléaire, Centre Hospitalier de Chambéry, Chambéry
Pôle de Biologie, Centre Hospitalier et Universitaire de Grenoble
UMR-S INSERM 1037, Grenoble, France

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Catherine Ronin Siamed'Xpress, Hôtel Technologique Morandat, Gardanne

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-Aldrich), pH 7.4. Cyclic AMP released from the cells was measured by RIA (Immunotech, Marseille, France). The negative sera of pooled TSH-receptor antibodies (normal sera) were used to measure cAMP basal production. Results were expressed as the ratio of

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