scholarly journals A Procedure for the Redefinition of Equivocal Results in Thyroid Function Tests

1980 ◽  
Vol 17 (5) ◽  
pp. 247-251
Author(s):  
David J Barnard ◽  
John P Bingle ◽  
C John Garratt
Keyword(s):  
Thyroid Hormone ◽  
Retrospective Analysis ◽  
Thyroid Function ◽  
Medical Records ◽  
Final Diagnosis ◽  
Thyroid Function Tests ◽  
Control Groups ◽  
Serum Thyroxine ◽  
New Information ◽  
Uptake Test

A retrospective analysis has been made of patients who had been classified (on the basis of measurements of serum thyroxine and thyroid hormone uptake test) as equivocal thyrotoxic (273 patients) or as equivocal hypothyroid (352 patients). The final diagnosis of these patients has been traced from their medical records. The results illustrate that control groups of euthyroid, thyrotoxic, and primary hypothyroid subjects differ from these equivocal groups. The populations initially classified as equivocal have been used to redefine the combinations of values obtained in the serum thyroxine and thyroid hormone uptake test which must be classed as equivocal. Using this redefinition, it is shown that a number of additional tests had been carried out when it could now be predicted with confidence that no useful new information would be obtained. The procedure described is not limited to tests of thyroid function and could easily be applied in most laboratories to redefine the ranges of results classified as equivocal.

Free thyroid hormone index, thyroid hormone/thyroxin-binding globulin ratio, triiodothyronine uptake, and thyroxin-binding globulin compared for diagnostic value regarding thyroid function.

1983 ◽  
Vol 29 (1) ◽  
pp. 74-79 ◽  
Author(s):  
T J Wilke
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Thyroid Function Tests ◽  
Free Thyroid Hormone ◽  
Age Related ◽  
Age Dependent ◽  
Uptake Test ◽  
The Relationship

Abstract The thyroid hormone/thyroxin-binding globulin (TBG) ratio and the free thyroid hormone index (FTI) were compared in 372 subjects classified according to age, sex, and biochemical and clinical findings. Age-related variations in thyroid function tests were investigated, as was the relationship between triiodothyronine uptake and TBG. Men, but not women, showed significant age-dependent changes in concentrations of thyroid hormones. FTI was as good as the thyroid hormone/TBG ratio in hyperthyroidism and was a better index of thyroid status in pregnancy, TBG deficiency, and hypothyroidism. In addition, the triiodothyronine uptake correlated extremely well with TBG (r = -0.95, p less than 0.001) and was very efficient in detecting decreased and significantly increased concentrations of TBG. I conclude that FTI is a better discriminator of functional status of the thyroid over a wider range of TBG values than is the thyroid hormone/TBG ratio. Further, the triiodothyronine uptake test produced diagnostic information equivalent to that of TBG estimation and thus should not be replaced in routine use.

Thyroid Function Tests in Thyroxine-Binding Globulin Deficiency

1979 ◽  
Vol 16 (1-6) ◽  
pp. 313-314 ◽  
Author(s):  
C. F. Cusick
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Reference Range ◽  
Free Thyroxine ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
Thyroxine Binding Globulin ◽  
Serum Thyroxine ◽  
Function Tests ◽  
Lowered Serum

Results are presented on two patients with complete and two with partial thyroxinebinding globulin (TBG) deficiency. All four subjects had lowered serum thyroxine but were clinically euthyroid. While thyroid hormone uptake tests or TBG assay were effective in the recognition of such individuals, indices based on these tests were misleading in assessing their thyroid status. Results within the reference range were obtained with the Immophase Free Thyroxine assay.

scholarly journals DIAGNOSTIC DILEMMA IN DISCORDANT THYROID FUNCTION TESTS DUE TO THYROID HORMONE AUTOANTIBODIES

2017 ◽  
Vol 3 (1) ◽  
pp. e22-e25 ◽  
Author(s):  
Panudda Srichomkwun ◽  
Neal H. Scherberg ◽  
Jasminka Jakšić ◽  
Samuel Refetoff
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Thyroid Function Tests ◽  
Diagnostic Dilemma ◽  
Thyroid Hormone Autoantibodies ◽  
Function Tests

Reference intervals for neonatal thyroid function tests in the first 7 days of life

2018 ◽  
Vol 31 (10) ◽  
pp. 1113-1116 ◽  
Author(s):  
Michelle S. Jayasuriya ◽  
Kay W. Choy ◽  
Lit K. Chin ◽  
James Doery ◽  
Alice Stewart ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Medical Records ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Primary Hypothyroidism ◽  
Specific Reference ◽  
Rapid Decline ◽  
Thyroid Function Tests ◽  
Accurate Identification ◽  
Neonatal Hypothyroidism

Abstract Background: Prompt intervention can prevent permanent adverse neurological effects caused by neonatal hypothyroidism. Thyroid function changes rapidly in the first few days of life but well-defined age-specific reference intervals (RIs) for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free tri-iodothyronine (FT3) are not available to aid interpretation. We developed hour-based RIs using data mining. Methods: All TSH, FT4 and FT3 results with date and time of collection from neonates aged <7 days during 2005–2015 were extracted from the Monash Pathology database. Neonates with more than one episode of testing or with known primary hypothyroidism, identified by treating physicians or from medical records, were excluded from the analysis. The date and time of birth were obtained from the medical records. Results: Of the 728 neonates qualifying for the study, 569 had time of birth available. All 569 had TSH, 415 had FT4 and 146 had FT3 results. For age ≤24 h, 25–48 h, 49–72 h, 73–96 h, 97–120 h, 121–144 h and 145–168 h of life, the TSH RIs (2.5th–97.5th) (mIU/L) were 4.1–40.2, 3.2–29.6, 2.6–17.3, 2.2–14.7, 1.8–14.2, 1.4–12.7 and 1.0–8.3, respectively; the FT4 RIs (mean ± 2 standard deviation [SD]) (pmol/L) were 15.3–43.6, 14.7–53.2, 16.5–45.5, 17.8–39.4, 15.3–32.1, 14.5–32.6 and 13.9–30.9, respectively; the FT3 RIs (mean±2 SD) (pmol/L) were 5.0–9.4, 4.1–9.1, 2.8–7.8, 2.9–7.8, 3.5–7.2, 3.4–8.0 and 3.8–7.9, respectively. Conclusions: TSH and FT4 were substantially high in the first 24 h after birth followed by a rapid decline over the subsequent 168 h. Use of hour-based RIs in newborns allows for more accurate identification of neonates who are at risk of hypothyroidism.

scholarly journals Low Yield of Thyroid-Function Tests in Adult Hospitalized Patients — A Retrospective Analysis

2020 ◽  
Vol Volume 13 ◽  
pp. 343-349 ◽  
Author(s):  
Prerna Dogra ◽  
Robin Paudel ◽  
Sujata Panthi ◽  
Evan Cassity ◽  
Lisa R Tannock
Keyword(s):  
Retrospective Analysis ◽  
Thyroid Function ◽  
Hospitalized Patients ◽  
Thyroid Function Tests ◽  
Function Tests

ABNORMAL REGULATION OF THYROID FUNCTION IN PATIENTS WITH CHRONIC CHAGA'S DISEASE

1966 ◽  
Vol 53 (1) ◽  
pp. 162-176 ◽  
Author(s):  
D. A. Lomonaco ◽  
H. L. Oliveira ◽  
J. Kieffer ◽  
R. R. Pieroni
Keyword(s):  
Thyroid Hormone ◽  
Chagas Disease ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Functional Study ◽  
Control Groups ◽  
Chronic Form ◽  
Significant Difference ◽  
The Difference ◽  
Chronic Chagas Disease

ABSTRACT The problem of thyroid dysfunction in Chagas' disease is discussed on the basis of the functional study of three series of patients with the chronic form of the disease. There was no significant association between Chagas' disease and goiter. No significant difference was found between the average plasma PBI in the groups of patients and that of the control groups. However, the values in the Chagas groups showed a much wider dispersion than those of the non Chagas controls; the difference between the corresponding variances was statistically significant. A loss of efficiency of the mechanisms concerned with the homeostasis of circulating thyroid hormone seems to occur in chronic Chagas' disease. This is interpreted as a possible result of the nervous lesion characteristic of the disease, which might involve neuronal links of homeostatic circuits responsible for the release of TSH.

scholarly journals Relationship between thyroid function and ICU mortality (sick euthyroid syndrome)

2017 ◽  
Vol 4 (5) ◽  
pp. 1266
Author(s):  
Priyadarsini Bose ◽  
Ramesh Dasarathan ◽  
Arun Shivaraman Mulaur Murugesan ◽  
K. S. Chenthil
Keyword(s):  
Critical Illness ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Thyroid Function Tests ◽  
Icu Patients ◽  
Thyroid Profile ◽  
A Prospective Study ◽  
Sick Euthyroid

Background: Sick euthyroid syndrome refers to alterations that occur in thyroid hormone levels in response to any critical illness like sepsis, ARDS, patients on mechanical ventilation and also any ICU patients. This study aimed at the relationship between thyroid hormone level changes and critical illness in ICU patients and predict the mortality based on thyroid hormone levels.Methods: A prospective study was designed to carry out in intensive care unit (ICU), Institute of internal medicine, Rajiv Gandhi government general hospital, Chennai for six months from May to August 2015. A total of 40 patients were selected who fulfilled the selection criteria.Results: APACHE II scores were calculated for all the 40 patients to assess whether thyroid function tests could independently predict the outcome of the patients. Again, the thyroid profile was compared with APACHE II scores in predicting the outcome. Values showed statistically significance.Conclusions: Thyroid profile can be used as an independent factor in predicting the outcome of the patients. Thyroid profile can also increase the sensitivity of APACHE II score in predicting the outcome.

scholarly journals Resistance to thyroid hormone-beta co-existing with partially empty sella in a Jordanian male

2018 ◽  
Vol 2018 ◽  
Author(s):  
Ohoud Al Mohareb ◽  
Mussa H Al Malki ◽  
O Thomas Mueller ◽  
Imad Brema
Keyword(s):  
Genetic Testing ◽  
Thyroid Hormone ◽  
Thyroid Function ◽  
Active Form ◽  
Empty Sella ◽  
Common Finding ◽  
List Type ◽  
Close Monitoring ◽  
Thyroid Function Tests ◽  
Resistance To Thyroid Hormone

Summary Resistance to thyroid hormone-beta (RTHbeta) is a rare inherited syndrome characterized by variable reduced tissue responsiveness to the intracellular action of triiodothyronine (T3), the active form of the thyroid hormone. The presentation of RTHbeta is quite variable and mutations in the thyroid hormone receptor beta (THR-B) gene have been detected in up to 90% of patients. The proband was a 34-year-old Jordanian male who presented with intermittent palpitations. His thyroid function tests (TFTs) showed a discordant profile with high free T4 (FT4) at 45.7 pmol/L (normal: 12–22), high free T3 (FT3) at 11.8 pmol/L (normal: 3.1–6.8) and inappropriately normal TSH at 3.19 mIU/L (normal: 0.27–4.2). Work up has confirmed normal alpha subunit of TSH of 0.1 ng/mL (normal <0.5) and pituitary MRI showed no evidence of a pituitary adenoma; however, there was an interesting coincidental finding of partially empty sella. RTHbeta was suspected and genetic testing confirmed a known mutation in the THR-B gene, where a heterozygous A to G base change substitutes valine for methionine at codon 310. Screening the immediate family revealed that the eldest son (5 years old) also has discordant thyroid function profile consistent with RTHbeta and genetic testing confirmed the same M310V mutation that his father harbored. Moreover, the 5-year-old son had hyperactivity, impulsivity and aggressive behavior consistent with attention deficit hyperactivity disorder (ADHD). This case demonstrates an unusual co-existence of RTHbeta and partially empty sella in the same patient which, to our knowledge, has not been reported before. Learning points: We report the coincidental occurrence of RTHbeta and a partially empty sella in the same patient that has not been previously reported. TFTs should be done in all children who present with symptoms suggestive of ADHD as RTHbeta is a common finding in these children. The management of children with ADHD and RTHbeta could be challenging for both pediatricians and parents and the administration of T3 with close monitoring may be helpful in some cases. Incidental pituitary abnormalities do exist in patients with RTHbeta, although extremely rare, and should be evaluated thoroughly and separately.

scholarly journals Challenges in interpretation of thyroid hormone test results

2016 ◽  
Vol 144 (3-4) ◽  
pp. 200-203
Author(s):  
Tijana Lalic ◽  
Biljana Beleslin ◽  
Slavica Savic ◽  
Mirjana Stojkovic ◽  
Jasmina Ciric ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Genetic Disorder ◽  
Clinical Status ◽  
Nodular Goiter ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
First Case ◽  
Secondary Hypothyroidism

Introduction. In interpreting thyroid hormones results it is preferable to think of interference and changes in concentration of their carrier proteins. Outline of Cases. We present two patients with discrepancy between the results of thyroid function tests and clinical status. The first case presents a 62-year-old patient with a nodular goiter and Hashimoto thyroiditis. Thyroid function test showed low thyroid-stimulating hormone (TSH) and normal to low fT4. By determining thyroid status (?SH, T4, fT4, T3, fT3) in two laboratories, basal and after dilution, as well as thyroxine-binding globulin (TBG), it was concluded that the thyroid hormone levels were normal. The results were influenced by heterophile antibodies leading to a false lower TSH level and suspected secondary hypothyroidism. The second case, a 40-year-old patient, was examined and followed because of the variable size thyroid nodule and initially borderline elevated TSH, after which thyroid status showed low level of total thyroid hormones and normal TSH. Based on additional analysis it was concluded that low T4 and T3 were a result of low TBG. It is a hereditary genetic disorder with no clinical significance. Conclusion. Erroneous diagnosis of thyroid disorders and potentially harmful treatment could be avoided by proving the interference or TBG deficiency whenever there is a discrepancy between the thyroid function results and the clinical picture.

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