Thyroglobulin (Tg) is a dimeric protein produced by the follicular cells of the thyroid and accounts for approximately half of the protein content of the thyroid gland. It is the precursor for the thyroid hormones T3 and T4 and each Tg molecule forms approximately 10 thyroid hormone molecules.
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Thyroglobulin is normally produced at low levels by the thyroid gland. Certain autoimmune disease such as Graves’ disease, Hashimoto thyroiditis, and other diseases including subacute thyroiditis and thyroid cancer cause high levels of thyroid hormone. Anti-thyroglobulin antibody tests are used to measure antibodies produced in response to thyroid autoimmune disease and the thyroglobulin assay is mostly used as a tumor marker test to monitor patients with well differentiated thyroid cancers (particularly papillary or follicular thyroid cancer) and to determine metastasis. Tg assays can also be used to detect deficient thyroglobulin synthesis in infants with goitrous hypothyroidism, which is a preventable cause of mental retardation.
Tg serum levels are measured by two-site sandwich immunoassays. However, quantitative Tg serum assays are prone to interference from endogenous circulating autoantibodies (anti-Tg) and can cause inappropriately low Tg results in about 20% to 30% of patients. In suspected cases of interference, a confirmatory test detecting the presence of anti-Tg should be carried out.
Anti-thyroglobulin antibody tests are generally used in combination with other tests such as anti-thyroid peroxidase (anti-TPO) to examine thyroid function for autoimmune thyroid disorders and distinguish it from other forms of thyroiditis.
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