Detection of thyroid disorders by use of basal thyrotropin values determined with an optimized "sandwich" enzyme immunoassay.

To measure the concentrations of thyrotropin (thyroid-stimulating hormone), we used the components of a commercially available two-step "sandwich" enzyme immunoassay (Enzymun-Test TSH, Boehringer Mannheim) based on the specific binding of the beta-subunit of thyrotropin by monoclonal antibodies coated on polystyrene tubes. By modifying the original assay protocol, we lowered the limit of detection to 0.18 milli-int. units/L, using a total incubation period of 22 h. With this modification we could differentiate between patients responsive to administration of thyroliberin (thyrotropin-releasing factor) and those who were non-responders, by measuring only the basal concentration of thyrotropin. Furthermore, we demonstrated a correlation between the basal concentration of thyrotropin and its increase after administration of thyroliberin (r = 0.77, n = 48).