The Dilemma of Abnormal Thyroid Function Tests — Is Thyroid Disease Present or Not?

1985 ◽  
Vol 289 (2) ◽  
pp. 76-88 ◽  
Author(s):  
James E. Griffin
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Disease Present

scholarly journals The Characteristics of Children with Abnormalities Detected in Thyroid Function Tests, and Distribution of Diagnoses

2020 ◽  
Author(s):  
Elif Çelik ◽  
Ayşe Anık
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Correct Diagnosis ◽  
Thyroid Function Test ◽  
Hashimoto Thyroiditis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Test Results ◽  
Function Tests ◽  
Function Test

INTRODUCTION: Thyroid function tests are among the most frequently implemented laboratory tests in primary, and secondary healthcare institutions. The aim of the present study was to investigate the demographic and clinical characteristics and final diagnosis of children referred by primary and secondary healthcare institutions with the suspicion of an abnormality in thyroid function test and/or with the initial diagnosis of specific thyroid disease. METHODS: A total of two hundred eighty-nine pediatric patients, aged between 4 and 18 years admitted to the outpatient clinics of Behçet Uz Children’s Health and Diseases Hospital between January 2018 and January 2020, were included in the study. The patient data were obtained retrospectively from the hospital records. RESULTS: A total of 66% of the patients who were included in the study were female with a median age of 12 years (8.7-14.4), while 64% of them were pubertal; and 78% of the cases were referred by secondary healthcare institutions. The most common reason for referral was isolated elevation of thyroid stimulating hormone (TSH). A total of 56% of the patients were asymptomatic at the time of admission, and thyroid function test results of 75% of them were within normal limits. When evaluated according to their final diagnoses, the children were normal/healthy (64%), diagnosed with Hashimoto thyroiditis (30%), nodular thyroid disease (3%), Graves disease (2%) and isolated increase of TSH was related to obesity in 5 patients (1%). DISCUSSION AND CONCLUSION: It is essential to evaluate children with abnormal thyroid function test results with detailed history and physical examination. Besides, the thyroid function tests should be performed with reliable and sensitive methods in standardized laboratories to reach the correct diagnosis in these children.

scholarly journals Postpartum Thyroid Abnormalities and Systemic Lupus Erythematosus: Is There a Link?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A948-A949
Author(s):  
Jordan Albrecht ◽  
Moeed Ahmed ◽  
Sudha Nandala ◽  
Saad Farooqi ◽  
Robert J Anderson
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Thyroid Function ◽  
Lupus Erythematosus ◽  
Thyroid Disease ◽  
Postpartum Period ◽  
Thyroid Function Tests ◽  
Systemic Lupus ◽  
Free T4 ◽  
Postpartum Thyroiditis ◽  
Function Tests

Abstract Introduction: Postpartum Thyroiditis (PPT) is an autoimmune disorder characterized by destruction of the thyroid gland within the first year after delivery. Systemic Lupus Erythematosus (SLE), another autoimmune disease, has been associated with a spectrum of thyroid disorders. While the prevalence of thyroid diseases in patients with SLE is increased, the association between SLE and PPT is not well known. The infrequency of encountering SLE and PPT makes abnormal thyroid tests in the postpartum period a diagnostic challenge. Clinical Case: A 27-year-old G1P1001 who was five months postpartum and not breast feeding was referred to Endocrinology clinic for evaluation of abnormal thyroid function tests. Past medical history was significant for SLE with renal and pericardial involvement. SLE was well controlled, treated with hydroxychloroquine. Family history was significant for hypothyroidism in her mother. She was asymptomatic and appeared clinically euthyroid. Vitals were stable and physical exam was negative for goiter, nodule or orbitopathy. Lab results at two months postpartum showed an elevated TSH of 3.87 UIU/mL (Normal 0.40-3.8 UIU/mL) and at four months postpartum TSH was low at 0.012 UIU/mL. Repeat labs at five months postpartum continued to show a low TSH at 0.007 UIU/mL with mildly elevated Free T4 at 1.7 ng/dL (Normal 0.6-1.6 ng/dL) and elevated Free T3 of 6.0 pg/mL (Normal 2.1-3.8 pg/mL). Anti-thyroid peroxidase antibodies (TPO), thyroid stimulating antibodies (TSI) and TSH receptor antibodies (TRAb) were negative. Thyroid Ultrasound with Doppler was within normal limits. Radioactive Iodine Uptake and Scan, obtained at 6 months postpartum, showed high normal uptake (17% and 32% at 4 hours and 24 hours respectively), suggestive of recovery phase of PPT. The most recent TSH was elevated at 8.5 UIU/mL and Free T4 was low at 0.7 ng/dL. Disease course was consistent with PPT. Conclusion: The Th1 (T-helper) lymphocyte immune predominance in autoimmune thyroid disease and SLE is the immune-pathogenetic base of the association between both diseases. Postpartum thyroiditis is a variant of chronic autoimmune thyroiditis. Serum anti-TPO antibodies vary during pregnancy and tend to increase early and may decline later. Immunologic tolerance increases during pregnancy, fades in the postpartum period and makes interpretation of thyroid function tests and disease process challenging. Pregnant and postpartum patients who have SLE have increased prevalence of thyroid disease. Causes are multifactorial with a higher prevalence of hypothyroidism and thyroid autoantibodies. Hyperthyroidism is much less likely. One comparable study found 6 of 43 (14%) women with SLE developed PPT and only one of these patients had positive thyroid antibodies. These reports and our patient illustrate the variability of thyroid function tests in patients with SLE.

scholarly journals Thyroid profile in women with menstrual disorders

2017 ◽  
Vol 6 (8) ◽  
pp. 3300
Author(s):  
Madhu Digra ◽  
Ravinder Kumar ◽  
Dinesh Kumar
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Thyroid Function Tests ◽  
Age Group ◽  
Menstrual Disorders ◽  
Hormone Levels ◽  
Function Tests ◽  
Menstrual Irregularities ◽  
Menstrual Patterns ◽  
Thyroid Profile

Background: Thyroid dysfunction influences both menstrual flow and fertility, likely through changes in sex hormone levels, gonadotrophin release and possibly ovarian function. Objectives of this work were to study thyroid related complaints and thyroid function tests in patients with menstrual irregularities like menorrhagia, oligomenorrhoea, amenorrhoea, hypomenorrhoea and ploymenorrhoea, to study menstrual patterns in women with diagnosed thyroid disease-hypothyroidism/hyperthyroidism and to study changes in menstrual patterns, if any in these patients during the course of treatment of thyroid disease, who receive correct treatmentMethods: This study was conducted in the Department of Obstetrics and Gynecology in Government L.D. Hospital, Government Medical College, Srinagar during the period from 2006 to 2007.  There were two groups under which the study was conducted. Group A: Seventy-five patients of DUB from Department of Gynecology in reproductive age group (15-45 years) presenting with menstrual irregularities like menorrhagia, oligomenorrhoea, amenorrhoea, hypomenorrhoea and ploymenorrhoea were studied for thyroid profile. Group B comprised of 25 patients including already diagnosed 17 hypothyroid and 8 hyperthyroid patients. The study protocol included thorough history taking, general physical examination, meticulous per speculum and pelvic examination and routine investigations like Hb, BT, CT, TLC, DLC, Platelet count and ABO-Rh in all patients, Serum T3, T4, TSH estimation.Results: Most of the patients were in 35-45 years age group. Prevalence of infertility was more in hypothyroid group. 22.66% patients with DUB were detected as hypothyroid where as 13.33% patients were detected as hyperthyroid.Conclusions: Thyroid function tests, many of which are sensitive radioimmunoassay, radiometric assays and even new chemiluminescence method, which can detect minute changes in hormone levels must be done in women presenting with menstrual disorders.

Intermittent course of chronic goitrous autoimmune thyroiditis

1981 ◽  
Vol 98 (2) ◽  
pp. 210-214 ◽  
Author(s):  
Harald Frey
Keyword(s):  
Thyroid Function ◽  
Autoimmune Thyroiditis ◽  
Thyroid Disease ◽  
Thyroid Function Tests ◽  
Chronic Autoimmune Thyroiditis ◽  
Function Tests ◽  
Small Doses ◽  
Biochemical Remission

Abstract. A case is reported of a woman of 30 where chronic autoimmune thyroiditis was diagnosed in 1970. The diagnosis was based on palpation, thyroid function tests and elevated titres of antibodies against thyroid constituents. She was initially treated with small doses of prednisone with complete clinical and biochemical remission which persisted also after therapy was withdrawn. In the following 10 years she had three new episodes of goitre and biochemical hypothyroidism, all responding fast and completely to small doses of prednisone. Between these episodes she had periodes of several months up to 3 years with no detectable thyroid disease even when not on treatment.

Ageing and thyroid disease

2011 ◽  
pp. 1519-1526
Author(s):  
Stefano Mariotti
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Increased Risk ◽  
Intensive Investigation ◽  
The Relationship ◽  
Mild Hypothyroidism

The relationship between ageing and the thyroid has been the object of intensive investigation (1) for several pathophysiological, epidemiological, and clinical reasons. Symptoms of ageing can easily be confused with hypothyroidism, and decreased thyroid function was once believed to be a hallmark of senescence. Thyroid diseases are common in the elderly, but their clinical manifestations are different from those seen in younger patients, being more vague, subtle, and often hidden by concurrent diseases. The interpretation of thyroid function tests is often difficult in elderly individuals, due to age-associated changes of thyroid physiology, alterations of thyroid function tests secondary to nonthyroidal illness, and/or drug intake. Treatment of thyroid disease deserves special attention in elderly patients due to the increased risk of complications and/or drug interactions. If untreated, thyroid dysfunctions may lead to significant morbidity in elderly people, mostly through an aggravation of coexistent cardiovascular disease. A remarkable exception to this concept is represented by mild hypothyroidism, which in the oldest elderly population appears to be associated with no harm, and possibly increased survival.

scholarly journals Corrigendum to “Challenges in Interpretation of Thyroid Function Tests in Pregnant Women with Autoimmune Thyroid Disease”

2017 ◽  
Vol 2017 ◽  
pp. 1-1
Author(s):  
Ulla Feldt-Rasmussen ◽  
Sofie Bliddal ◽  
Åse Krogh Rasmussen ◽  
Malene Boas ◽  
Linda Hilsted ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
Thyroid Disease ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Function Tests ◽  
Autoimmune Thyroid ◽  
Function Tests

scholarly journals Thyroid function tests: often justified in the acutely ill

2000 ◽  
Vol 37 (2) ◽  
pp. 158-164 ◽  
Author(s):  
E J Lamb ◽  
J Martin
Keyword(s):  
Thyroid Function ◽  
Thyroid Disease ◽  
Clinical History ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Function Tests ◽  
Lost To Follow Up ◽  
Symptoms And Signs ◽  
Tsh Levels

It is claimed that inappropriate requesting of thyroid function tests (TFTs) is common in acutely ill patients. Consecutive inpatient TFTs ( n=129) were assessed in relation to clinical history and common symptoms and signs of thyroid disease. Requests were justified in 69% of cases, most commonly on the basis of atrial fibrillation and/or tachycardia. There were no clear reasons for requesting TFTs in the remaining cases, although the yield of abnormal results in these patients was similar to that in those with justified requests. Thyroid stimulating hormone (TSH) concentration was increased (median 7·5 mU/L, range 4·8-38·6 mU/L) in 22 patients, six of whom had biochemical and/or clinical evidence of hypothyroidism (previously undiagnosed) and five of whom had pre-existing hypothyroidism. Of the remaining 11 patients with increased TSH levels, three were confirmed to have compensated hypothyroidism; non-thyroidal illness (NTI) (including the effect of drugs) accounted for four cases. In four patients (one of whom died during the admission) follow-up was not possible. Of six patients with reduced TSH concentration (range < 0·05-0·35 mU/L), one was thyrotoxic on carbimazole, one was receiving thyroxine for hypothyroidism, one had NTI and three were lost to follow-up (two of whom died during their admission). Manifestations of thyroid disease are protean and often subtle, and TFTs are thus clinically justified in many unwell inpatients. Although NTI contributes to some cases of abnormal TSH levels, a significant number of TFT abnormalities are consistent with underlying thyroid abnormality requiring investigation/treatment.

scholarly journals Screening for overt thyroid disease in early pregnancy may be preferable to searching for small aberrations in thyroid function tests

2013 ◽  
Vol 79 (3) ◽  
pp. 297-304 ◽  
Author(s):  
Peter Laurberg ◽  
Stine L. Andersen ◽  
Inge B. Pedersen ◽  
Stig Andersen ◽  
Allan Carlé
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Thyroid Disease ◽  
Thyroid Function Tests ◽  
Function Tests
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