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Thyrotropin as measured by a sensitive immunoradiometric assay.

An immunoradiometric assay (Boots-Celltech's "Sucrosep"; IRMA) for thyrotropin (TSH) was evaluated and results were compared with those of our in-house RIA procedure. The IRMA had a sensitivity of 0.02 milli-int. unit/L. In addition it displayed excellent intra- and inter-batch precision, cross-reacted negligibly with other pituitary hormones, and appeared to be relatively free of matrix effects (although deionized water did give an apparent TSH concentration of 0.13 milli-int. unit/L). Over the range 1.2 to 64 milli-int. units/L, correlation between the IRMA (y) and RIA (x) was excellent: y = 1.16x - 1.69 (r = 0.98). The normal reference interval for the IRMA was 0.4 to 4.2 milli-int. units/L. For patients suspected of hyperthyroidism who had been subjected to the thyroliberin test, the IRMA more effectively differentiated between euthyroidism and hyperthyroidism. During testing with thyroliberin, all nonresponding hyperthyroid patients had initial baseline TSH concentrations of less than 0.02 milli-int. unit/L by IRMA. This sensitive assay represents an important advance in the ability to differentiate between euthyroidism and hyperthyroidism.