Upper Limit of TSH Reference Range Disputed

2007 ◽  
Vol 2 (10) ◽  
pp. 24
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Reference Range ◽  
Upper Limit

scholarly journals TSH reference range in older adults: a Brazilian study

2014 ◽  
Vol 58 (4) ◽  
pp. 389-393 ◽  
Author(s):  
Pedro Weslley Rosario ◽  
Maria Regina Calsolari
Keyword(s):  
Older Adults ◽  
Thyroid Dysfunction ◽  
Elderly Population ◽  
Thyroid Nodules ◽  
Reference Range ◽  
Adult Population ◽  
Free T4 ◽  
Upper Limit ◽  
Thyroperoxidase Antibodies ◽  
Serum Tsh

Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 older adults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population.

scholarly journals Assessment of the Effects of SARS-Cov-2 Infection on Multiple Organs Using Laboratory Indices

2021 ◽  
Vol 17 (2) ◽  
pp. 73-78
Author(s):  
Jianwei Zhou ◽  
Yu Li ◽  
Cui Kong ◽  
Yizhao Li ◽  
Yao Liang
Keyword(s):  
Reference Range ◽  
Normal Range ◽  
Causative Mechanism ◽  
Gamma Glutamyltransferase ◽  
Multiple Organs ◽  
Upper Limit ◽  
Laboratory Results ◽  
Heart Injury ◽  
Beta 2 Microglobulin ◽  
Biochemical Indices

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is still a severe threaft for human health currently, and the researches about it is a focus topic worldwide. Aim of the study: In this study, we will collect some laboratory results of the patients with coronavirus disease (COVID-19) to assess the function of liver, heart, kidney and even pancreas.  Subjects and Methods: Laboratory results of the patients with COVID-19 are collected. The biochemical indices are classified and used to assess the according function of liver, heart, kidney; meantime, and blood glucose is also observed and taken as an index to roughly evaluate pancreas. Results: There were some indices exhibited abnormal. For patient 1, the ratio of albumin and globulin slightly was lower than the down-limit of reference range. For patient 2, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatine kinase (CK), creatinine kinase-MB isoenzyme (CK-MB), lactate dehydrogenase (LDH), alpha-hydroxybutyric dehydrogenase (HBDH), and beta-2 microglobulin (β2-MG) were respectively higher than the according upper limit of the reference range, while prealbumin (PA) was lower than the down limit. For patient 3, GGT, CK, PA were high than normal range. For patient 4, CK, LDH, HBDH were higher than the upper range. Conclusion: Infection of SARS-Cov-2 could cause liver and heart injury, and it is suggested that clinicians and researchers should pay more attention on the prevention, treatment and causative mechanism of such an injury.

scholarly journals An adolescent girl with coexisting ovarian mature cystic teratoma and HAIR-AN syndrome, an extreme subtype of polycystic ovarian syndrome

2021 ◽  
Vol 2021 ◽  
Author(s):  
Jin Hui Ho ◽  
Ana Vetriana Abd Wahab ◽  
Yin Khet Fung ◽  
Serena Sert Kim Khoo
Keyword(s):  
Insulin Resistance ◽  
Testosterone Level ◽  
Acanthosis Nigricans ◽  
Polycystic Ovarian Syndrome ◽  
Reference Range ◽  
Cystic Teratoma ◽  
Serum Testosterone ◽  
Total Serum ◽  
Upper Limit ◽  
Ovarian Syndrome

Summary Polycystic ovarian syndrome (PCOS) is associated with menstrual irregularities, ovulatory dysfunction, hirsutism, insulin resistance, obesity and metabolic syndrome but is rarely associated with severe hyperandrogenaemia and virilisation resulting in male pattern baldness and clitoromegaly. Total serum testosterone greater than twice the upper limit of the reference range or free androgen index of over five-fold elevated suggests a diagnosis other than PCOS. We reported a case of a 15 years old obese girl presented with secondary amenorrhoea, virilising signs: frontal baldness, clitoromegaly and prominent signs of insulin resistance and marked acanthosis nigricans. Her total testosterone level was markedly elevated at 9.4 nmol/L (0.5–1.7 nmol/L) and MRI pelvis revealed a right ovarian mass with fat and cystic component and a left polycystic ovary. The patient underwent laparoscopic right ovarian cystectomy and histologically confirmed mature cystic teratoma. Post-operatively, her testosterone level declined but did not normalise, menses resumed but remained irregular. Her fasting insulin was elevated 85.2 mIU/L (3–25 mIU/L) and HOMA-IR was high at 13.1 (>2) with persistent acanthosis nigricans suggesting co-existing HAIR-AN syndrome, an extreme phenotype of polycystic ovarian syndrome. Learning points Rapid onset of hyperandrogenic symptoms, especially if associated with signs of virilisation must raise the suspicion of an androgen-secreting tumour. Total serum testosterone greater than twofold the upper limit of the reference range or free androgen indices over fivefold suggest a diagnosis other than polycystic ovarian syndrome (PCOS). High levels of testosterone with normal levels of the DHEA-S suggest an ovarian source. Ovarian androgen-secreting tumour and HAIR-AN syndrome, an extreme spectrum of PCOS can co-exist.

scholarly journals The evolution of clot strength in critically-ill COVID-19 patients: a prospective observational thromboelastography study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Colette Neethling ◽  
Gregory Calligaro ◽  
Malcolm Miller ◽  
Jessica J. S. Opie
Keyword(s):  
Critically Ill ◽  
Reference Range ◽  
Maximum Amplitude ◽  
Clot Lysis ◽  
Clot Strength ◽  
Mechanically Ventilated ◽  
Time Points ◽  
Normal Platelet ◽  
Upper Limit ◽  
Intravascular Coagulopathy

Abstract Background Few studies detail the evolution of COVID-19 associated coagulopathy. We performed serial thromboelastography (TEG) and laboratory coagulation studies in 40 critically-ill, mechanically ventilated COVID-19 patients over a 14-day period and analysed differences between 30-day survivors and non-survivors. Methods Single-center prospective, observational study including 40 patients with severe COVID-19 pneumonia admitted to the intensive care unit (ICU) for mechanical ventilation. TEG analysis was performed on days 1, 7 and 14 of ICU admission and laboratory coagulation studies were performed on days 1 and 14. Coagulation variables were evaluated for change over the 14-day observation period. Differences between survivors and non-survivors at 30-days were analysed and compared. Results On admission, TEG maximum amplitude (MA) with heparinase correction was above the upper limit of the reference range in 32 (80%) patients while 33 (82.5%) presented with absent clot lysis at 30 min. The functional fibrinogen MA was also elevated above the upper limit of the reference range in 37 (92.5%) patients. All patients had elevated D-dimer and fibrinogen levels, mildly prolonged prothrombin times (PT), normal platelet counts and normal activated partial thromboplastin times (aPTT). The heparinase MA decreased significantly with time and normalised after 14 days (p = < 0.001) while the increased fibrin contribution to clot strength persisted with time (p = 0.113). No significant differences in TEG analysis were noted between 30-day survivors and non-survivors at all time points. No patients developed disseminated intravascular coagulopathy (DIC) after 14-days, however thrombosis and bleeding were each reported in 3 (7.5%) patients. Conclusion Critically-ill patients with COVID-19 present in a hypercoagulable state characterised by an increased clot strength. This state normalises after 14 days despite a persistently increased fibrin contribution to clot strength. We were unable to demonstrate any significant differences in TEG parameters between 30-day survivors and non-survivors at all time points.

Discrepancies in measurement of aspartate aminotransferase by continuous-flow analysis.

1983 ◽  
Vol 29 (12) ◽  
pp. 2086-2088
Author(s):  
P West
Keyword(s):  
Quality Control ◽  
Aspartate Aminotransferase ◽  
Continuous Flow ◽  
Reaction Rate ◽  
Reference Range ◽  
Flow Analysis ◽  
Independent Data ◽  
Positive Bias ◽  
Upper Limit ◽  
Continuous Flow Analysis

Abstract I compared results for aspartate aminotransferase (EC 2.6.1.1) obtained with a reaction-rate analyzer (LKB 2086 Mark Two), based on IFCC methodology, and a continuous-flow analyzer (the Technicon SMA 2) for 115 patients' sera and seven commercial quality-control sera. The data from the SMA 2 showed a clear positive bias in those sera with activities exceeding 40 U/L (the upper limit of the reference range). Independent data to support the bias of the SMA 2 and other continuous-flow analyzer systems are presented. Application of a correction factor to the SMA 2 data above the upper limit of the range significantly decreased this bias. Failure to apply such a factor to data obtained from continuous-flow analyzers could lead to serious clinical misinterpretation.

Low-Level Alanine Aminotransferase Elevations in Osteoarthritis Patients within Approximately 2 Weeks of Treatment Initiation with Daily Acetaminophen: A Retrospective Analysis Evaluating Subsequent Alanine Aminotransferase Activity on Continued Acetaminophen Therapy

2013 ◽  
Vol 5 ◽  
pp. CMT.S11120
Author(s):  
Edwin K. Kuffner ◽  
Kimberly M. Cooper ◽  
Jeffrey S. Baggish ◽  
Joseph M. Lynch ◽  
Brenda A. Zimmerman ◽  
...  
Keyword(s):  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Treatment Initiation ◽  
Reference Range ◽  
Aminotransferase Activity ◽  
Upper Limit ◽  
Therapy Initiation ◽  
Almost All ◽  
Alanine Aminotransferase Activity ◽  
Alt Activity

Published analyses have noted elevated alanine aminotransferase (ALT) activity in patients taking up to 4000 mg/day of acetaminophen. Data from 3 osteoarthritis trials of acetaminophen 3900–4000 mg/day in which ALT and aspartate aminotransferase (AST) were recorded within approximately 2 weeks of therapy initiation were retrospectively analyzed. Patients with baseline ALT or AST above the upper limit of the reference range (ULRR) were excluded. Among 466 patients, 376 (80.7%) had no ALT elevations within approximately 2 weeks of treatment initiation. Elevations >1.5 and >3.0 times ULRR occurred in 4.5% and 0.9% of patients, respectively. Elevations were transient as most resolved (72.9%) or declined (22.4%) with continued treatment beyond 2 weeks. Within approximately 2 weeks of therapy initiation, no patient had ALT > 5 times ULRR or ALT > 3 times ULRR combined with bilirubin >2 times ULRR. ALT elevations were transient and asymptomatic; almost all resolved or declined while on continued therapy and appear not to be clinically important. Clinical trials.gov ID numbers: NCT00240799, NCT00240786

Upper Limit of TSH Reference Range Debated

2008 ◽  
Vol 41 (4) ◽  
pp. 18
Author(s):  
SHERRY BOSCHERT
Keyword(s):  
Reference Range ◽  
Upper Limit

Reflotron assays of alanine aminotransferase and gamma-glutamyltransferase in whole-blood samples evaluated.

1987 ◽  
Vol 33 (6) ◽  
pp. 826-829 ◽  
Author(s):  
D R James ◽  
C P Price
Keyword(s):  
Alanine Aminotransferase ◽  
Reference Range ◽  
Blood Rheology ◽  
Sample Volume ◽  
Routine Laboratory ◽  
Laboratory Practice ◽  
Blood Samples ◽  
Gamma Glutamyltransferase ◽  
Upper Limit ◽  
Whole Blood Samples

Abstract We evaluated the Reflotron (Boehringer Mannheim) system for measuring activities of alanine aminotransferase (EC 2.6.1.2) and gamma-glutamyltransferase (EC 2.3.2.2). Within- and between-day precision were comparable with conventional analytical methods. The linear range of the methods extended to more than 40-fold the upper limit of the reference range. The methods were not influenced by moderate changes in blood rheology and also tolerated some variation in sample volume applied. We consider these methods to be suitable for use in satellite or physicians' office laboratories (with appropriate training of operators), and they can produce results that agree satisfactorily with those determined in routine laboratory practice.

scholarly journals Macroprolactinaemia: Contribution to Hyperprolactinaemia in a District General Hospital and Evaluation of a Screening Test Based on Precipitation with Polyethylene Glycol

1997 ◽  
Vol 34 (3) ◽  
pp. 252-258 ◽  
Author(s):  
M N Fahie-Wilson ◽  
S G Soule
Keyword(s):  
Polyethylene Glycol ◽  
Screening Test ◽  
Reference Range ◽  
Gel Filtration ◽  
District General Hospital ◽  
Serum Prolactin ◽  
Common Phenomenon ◽  
Common Cause ◽  
Upper Limit ◽  
Polyethylene Glycol 6000

For a period of 12 months all samples submitted for serum prolactin (PRL) assay and with PRL>700mU/L were examined by gel filtration chromatography. In 17 (25%) of 69 samples we found macroprolactin. The Delfia and Immuno 1 immunoassay systems gave similar PRL results with samples containing macroprolactin whereas the ACS 180 system gave lower results. With the Delfia and Immuno 1 systems samples containing substantial quantities of macroprolactin showed low recovery of PRL after precipitation with polyethylene glycol 6000 (PEG 6000) and this technique can be used as a screening test for macroprolactinaemia. We conclude that macroprolactinaemia is a common phenomenon and, in assays which detect this species, is a common cause of hyperprolactinaemia. Macroprolactinaemia may contribute to the difficulty in establishing an upper limit of the reference range for serum PRL. In our experience, patients with macroprolactinaemia do not exhibit features of the hyperprolactinaemia syndrome and it is important to recognize macroprolactin as the cause of hyperprolactinaemia to avoid unnecessary investigation and treatment.

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