TPO Antibody

Alternative Names
  • Antimicrosomal Antibody
  • Antithyroid Microsomal Antibody
  • Thyroid Peroxidase Antibody
  • Thyroid Microsomal Ab
  • Thyroid Microsomal Antibodies
  • Antithyroid Antibodies

Test Code: 4023

CPT: 86376
Tests Included TPOAb
Use Disorders of the thyroid gland are frequently caused by autoimmune mechanisms with the production of autoantibodies. The determination of TPOAb levels is the most sensitive test for detecting autoimmune thyroid disease.
Clinical Utility The highest TPOAb levels are observed in patients suffering from Hashimoto's thyroiditis. In this disease, the prevalence of TPOAb is about 90% of cases confirming the autoimmune origin of the disease. These autoantibodies also frequently occur (60-80%) in the course of Graves' disease.

There is a good association between the presence of autoantibodies against TPO and histological thyroiditis. However, in view of the extensive regenerative capacity of the thyroid under the influence of TSH, chronic thyroid disease may be present for years before the clinical manifestation of hypothyroidism becomes evident, if ever.
Intended Patient Population 18+ and Older Adult Males & Females
Patient Preparation None Specified
Sample Serum, Plasma
Tube Red, Green, Tiger
Volume 4mL Whole Blood (1mL Serum/Plasma)
Min Sample Volume 0.5 mLs
Reference Ranges M & F ≥ 18 yrs old;  ≤ 9 IU/mL
Analytical Measurement Range 0.25-1000.00 IU/mL
Units IU/mL
Test Methodology Immunoassay
Test Turnaround Time 4 Days
Limitations Moderately increased levels of TPO antibody may be found in patients with non-thyroid autoimmune disease such as pernicious anemia, type I diabetes mellitus, or other disorders which activate the immune system. 3, 6, 7
Shipping Requirements Refrigerated
Specimen Stability 7 Days RF
Reject Criteria Gross Hemolysis, Gross Lipemia
Laboratory Developed Test (LDT) Yes
CMS Guidance NCD 190.22
  1. Kimura S, Kotani T, McBride OW, Umeki K, Hirai K, Nakayama T, Ohtaki S. Human thyroid peroxidase: complete cDNA and protein sequence, chromosome mapping and identification of two alternately spliced mRNAs. Proc Natl Acad Sci 1987; 84:5555-5559.
  2. DeGroot LJ, Niepomniszcze H. Biosynthesis of thyroid hormone: basic and clinical aspects. Metabolism 1977; 26: 665-718
  3. Mariotti S, Caturegli P, Piccolo P, Barbesino G and Pinchera A. Antithyroid peroxidase autoantibodies in thyroid diseases. J Clin Endocrinol Metab 1990; 71: 661-9.
  4. Toda S, Koike N, Sugihara H. Cellular integration of thyrocytes and thyroid folliculogenesis: a perspective for thyroid tissue regeneration and engineering. Endocrine Journal 2001; 48 (4): 407-425.
  5. Demers LM, Spencer CA. Laboratory medicine practice guidelines -- Laboratory support for the diagnosis and monitoring of thyroid disease. The National Academy of Clinical Biochemistry.
  6. Feldt-Rasmussen U, Høier-Madsen M, Bech K, Blichert-Toft M, Bliddal H, Date J, Danneskiold-samsøe B, Hegedüs L, Hippe E, Hornnes PJ, Kriegbaum NJ, Müller, Perrild H, Rasmussen NG, Rasmusson B, Schouboe, A. Anti-thyroid peroxidase antibodies in thyroid disorders and non-thyroid autoimmune diseases. Autoimmunity 1991; 9: 245-253.
  7. Thomas, L. Clinical laboratory diagnostics. TH-Books Verlagsgesellschaft mbH, Frankfurt/Main, Germany, 1998.

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