Euthyroid Sick Syndrome in Pulmonary Tuberculosis before and after Treatment

Alterations of circulating thyroid hormones are frequently present in chronic nonthyroidal illnesses and may predict prognosis. Pulmonary tuberculosis, a common treatable debilitating disease, may provide a useful model for detailed evaluation of changes of thyroid hormones in relation to subsequent recovery or mortality. Over a period of 12 months, we performed a prospective study of 40 consecutive Chinese patients aged over 50 years and admitted with newly diagnosed pulmonary tuberculosis. Blood samples were drawn for serial thyroid function tests [free thyroxine (T4), free triiodothyronine (T3) and thyroid-stimulating hormone] before treatment and at 1, 2 and 4 months afterwards. Mortality was determined up to 12 months of follow-up. The euthyroid sick syndrome occurred in 63% of patients at presentation. Twelve of 25 euthyroid sick patients died as compared to one of 15 patients with normal baseline thyroid function tests ( P < 0·02). Among euthyroid sick patients, those who died had significantly lower free T3 concentration at presentation than those who survived ( P < 0·05). An undetectable free T3 concentration at presentation was associated with a subsequent mortality of 75% (9 of 12). Of the survivors, all patients demonstrated a significant rise in serum free T4 concentrations following treatment, which was apparent by 1 month. These data suggest that an undetectable free T3 concentration at presentation reflects severity of illness and predicts a subsequent high mortality.

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Subclinical hypothyroidism

Oxford Textbook of Endocrinology and Diabetes ◽

10.1093/med/9780199235292.003.3252 ◽

2011 ◽

pp. 543-547

Author(s):

Jayne A. Franklyn

Keyword(s):

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Expert Panel ◽

Elevated Serum ◽

Thyroid Stimulating Hormone ◽

Free Thyroxine ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Function Tests ◽

Serum Tsh

Subclinical hypothyroidism is defined biochemically as the association of a raised serum thyroid-stimulating hormone (TSH) concentration with normal circulating concentrations of free thyroxine (T4) and free triiodothyronine (T3). The term subclinical hypothyroidism implies that patients should be asymptomatic, although symptoms are difficult to assess, especially in patients in whom thyroid function tests have been checked because of nonspecific complaints such as tiredness. An expert panel has recently classified individuals with subclinical hypothyroidism into two groups (1): (1) those with mildly elevated serum TSH (typically TSH in the range 4.5–10.0 mU/l) and (2) those with more marked TSH elevation (serum TSH >10.0 mU/l).

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Altered Thyroid Function Tests Observed in Hypophosphatasia Patients Treated with Asfotase Alfa

International Journal of Endocrinology ◽

10.1155/2021/5492267 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Hajime Kato ◽

Naoko Hidaka ◽

Minae Koga ◽

Yuka Kinoshita ◽

Masaomi Nangaku ◽

...

Keyword(s):

Thyroid Hormone ◽

Thyroid Function ◽

Magnetic Beads ◽

Underlying Mechanism ◽

Thyroid Stimulating Hormone ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Asfotase Alfa ◽

Function Tests ◽

One Step

Background. Asfotase alfa is the only approved treatment that can normalize mineralization in patients with hypophosphatasia (HPP). Its interference in alkaline phosphatase (ALP) dependent immunoassays has been reported. Objective. To describe thyroid function tests interfered with by asfotase alfa and elucidate the underlying mechanism. Patients and Methods. Three patients with HPP treated with asfotase alfa were included. Thyroid hormone levels measured using five different immunoassays with or without ALP as a labeling enzyme during asfotase alfa treatment were evaluated. Results. After the initiation of asfotase alfa, three HPP patients showed low free triiodothyronine (FT3) and free thyroxine (FT4) measured with AIA-2000 (Tosoh, Tokyo, Japan), an enzyme immunoassay system that uses ALP as a labeling enzyme, but their thyroid-stimulating hormone (TSH) levels were within the normal range. The other CLEIA system using ALP as a label, AIA-CL2400 (Tosoh, Tokyo, Japan), and ALP-independent immunoassay systems demonstrated normal FT3 and FT4 levels. These data suggested that although the thyroid function of these three patients was normal, asfotase alfa interfered with the thyroid hormone measurements made with AIA-2000. AIA-2000 and AIA-CL2400 adopted one-step and delayed one-step measurements, respectively, and the same antibody was used for both immunoassays. However, asfotase alfa may be absorbed on the magnetic beads used in the AIA reagent with the AIA-2000 system but not absorbed on the microparticles used in AIA-CL2400. Conclusion. Clinicians should be aware of the possible interference in thyroid function measurements by adopting specific types of immunoassays in asfotase alfa-treated HPP patients.

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THYROID FUNCTION TESTS: A REVIEW

10.36106/ijsr/2502260 ◽

2021 ◽

pp. 73-76

Author(s):

Vasudev Sankhla ◽

Aman Deep

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Radioactive Iodine ◽

Thyroid Stimulating Hormone ◽

Thyroid Function Tests ◽

Function Tests ◽

Tsh Secretion ◽

Line Test ◽

Radioactive Iodine Uptake

Thyroid function tests are one of the most common endocrine panels in general practice because a good understanding of when to order them, indications for treatment are important for the optimal treatment of thyroid dysfunction. Thyroid-stimulating hormone (TSH) should be the rst test to be performed on any patient with suspected thyroid dysfunction and in follow-up of individuals on treatment. It is useful as a rst-line test because even small changes in thyroid function are sufcient to cause a signicant increase in TSH secretion. Thyroxine levels may be assessed in a patient with hyperthyroidism, to determine the severity of hyperthyroxinemia. Antithyroid peroxidase measurements should be considered while evaluating patients with subclinical hypothyroidism and can facilitate the identication of autoimmune thyroiditis during the evaluation of nodular thyroid disease. The measurement of TSH receptor antibody must be considered when conrmation of Graves’ disease is needed and radioactive iodine uptake cannot be done.

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Reference Intervals of Thyroid Hormones and Correlation of BMI with Thyroid Function in Healthy Zhuang Ethnic Pregnant Women

BioMed Research International ◽

10.1155/2018/2032413 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yonghong Sheng ◽

Dongping Huang ◽

Shun Liu ◽

Xuefeng Guo ◽

Jiehua Chen ◽

...

Keyword(s):

Thyroid Hormones ◽

Pregnant Women ◽

Thyroid Function ◽

Reference Intervals ◽

Thyroid Stimulating Hormone ◽

Specific Reference ◽

American Thyroid Association ◽

Reference Ranges ◽

Free Triiodothyronine ◽

Cross Sectional

Ethnic differences in the level of thyroid hormones exist among individuals. The American Thyroid Association (ATA) recommends that an institution or region should establish a specific thyroid hormone reference value for each stage of pregnancy. To date, a limited number of studies have reported the level of thyroid hormones in Chinese minorities, and the exact relationship between BMI and thyroid function in pregnant women is ill. This study was performed to establish trimester-specific reference ranges of thyroid hormones in Zhuang ethnic pregnant women and explore the role of body mass index (BMI) on thyroid function. A total of 3324 Zhuang ethnic health pregnant women were recruited in this Zhuang population-based retrospective cross-sectional study. The values of thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by automatic chemiluminescence immunoassay analyzer. Multivariate linear regression and binary logistic regression were constructed to evaluate the influence of BMI on the thyroid function. The established reference intervals for the serum thyroid hormones in three trimesters were as follows: TSH, 0.02–3.28, 0.03–3.22, and 0.08-3.71 mIU/L; FT4, 10.57–19.76, 10.05–19.23, and 8.96–17.75 pmol/L; FT3, 3.51–5.64, 3.42–5.42, and 2.93–5.03 pmol/L. These values were markedly lower than those provided by the manufacturers for nonpregnant adults which can potentially result in 6.10% to 19.73% misclassification in Zhuang pregnant women. Moreover, BMI was positively correlated with isolated hypothyroxinemia (OR=1.081, 95% CI=1.007–1.161), while the correlation between the BMI and subclinical hypothyroidism was not statistically significant (OR=0.991, 95% CI=0.917–1.072). This is the first study focusing on the reference ranges of thyroid hormones in Guangxi Zhuang ethnic pregnant women, which will improve the care of them in the diagnosis and treatment. We also found that high BMI was positively associated with the risk of isolated hypothyroxinemia.

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

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2020.57704 ◽

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.

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THYROID FUNCTION TESTS IN ADULTS WITH DOWN'S SYNDROME

Acta Endocrinologica ◽

10.1530/acta.0.0880048 ◽

1978 ◽

Vol 88 (1) ◽

pp. 48-54 ◽

Cited By ~ 25

Author(s):

S. Korsager ◽

E. M. Chatham ◽

H. P. Østergaard Kristensen

Keyword(s):

Thyroid Function ◽

Down's Syndrome ◽

Clinical Signs ◽

Down’S Syndrome ◽

Thyroid Stimulating Hormone ◽

Thyroid Function Tests ◽

Thyroid Status ◽

Biochemical Tests ◽

Old Patients ◽

Function Tests

ABSTRACT Thyroid status was studied in 24 patients above the age of 40 years with Down's syndrome. Three patients had thyroid function tests indicating hypothyroidism. Eight patients had thyroid autoantibodies in serum and 8 patients had a higher than normal level of thyroid stimulating hormone in serum. None of the patients had figures indicating thyrotoxicosis. None of the patients showed any of the clinical signs usually seen in patients with hypothyroidism. It is concluded that biochemical tests indicating hypothyroidism are much more often seen in patients with Down's syndrome than in normal subjects and that thyroid status should be assessed in old patients with this disease.

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Thyroid function in neonates with severe respiratory failure on extracorporeal membrane oxygenation

Perfusion ◽

10.1177/026765910101600606 ◽

2001 ◽

Vol 16 (6) ◽

pp. 469-475 ◽

Cited By ~ 8

Author(s):

Dan L Stewart ◽

Noah Ssemakula ◽

Duncan R MacMillan ◽

L Jane Goldsmith ◽

Larry N Cook

Keyword(s):

Respiratory Failure ◽

Extracorporeal Membrane Oxygenation ◽

Thyroid Function ◽

Newborn Infants ◽

Thyroid Stimulating Hormone ◽

Thyroid Function Tests ◽

Severe Respiratory Failure ◽

Serum Concentrations ◽

Free Triiodothyronine ◽

Membrane Oxygenation

The object was to study thyroid function in neonates with severe respiratory failure on extracorporeal membrane oxygenation (ECMO) and determine whether abnormal thyroid function correlates with prognosis. Total and free thyroxine (T4, FT4), total and free triiodothyronine (T3, FT3), reverse triiodothyronine (rT3), thyroid-stimulating hormone, and thyroxine binding globulin were measured in 14 newborn infants with severe respiratory failure (age 1-30 days) from samples collected before anesthesia for cannula placement, at 30, 60, and 360 min after initiation of ECMO, and on days 2, 4, 6, and 8. The patients were divided into survivors and non-survivors for statistical analyses. No differences were noted between survivors and non-survivors in the pre-ECMO mean serum concentrations of the thyroid function tests analyzed. In nine survivors, mean serum T4, FT4, T3, FT3, and rT3 all declined significantly within 30-60 min after initiation of ECMO, compared to baseline values. The values for all mean serum concentrations recovered completely and exceeded baseline between days 2 and 8. In five non-survivors, the decline of all mean serum values was not statistically significant and recovery to baseline was not achieved. The ratios of mean serum concentration of rT3/FT3were significantly different between survivors and non-survivors across all times during the ECMO course ( p λ 0.0005). These findings indicate that abnormalities in thyroid function occur in neonates with severe respiratory failure on ECMO and that the rT3/FT3 ratio correlates with prognosis over the ECMO course. Survival was associated with a significant reduction of serum thyroid hormone concentrations followed by recovery. We speculate that, in neonates with respiratory failure on ECMO, adaptive mechanisms which enhance survival include the capacity to down-regulate the pituitary-thyroid axis.

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Thyroid dysfunction in chronic schizophrenia in albania

European Psychiatry ◽

10.1016/s0924-9338(11)73219-9 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1515-1515 ◽

Cited By ~ 1

Author(s):

Y. Themeli ◽

I. Aliko ◽

A. Hashorva

Keyword(s):

Thyroid Hormones ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Chronic Schizophrenia ◽

Hashimoto Thyroiditis ◽

Diabetes Mellitus Type 1 ◽

Thyroid Function Tests ◽

Thyroid Antibodies ◽

Normal Thyroid ◽

Function Tests

BackgroundThyroid dysfunction is relatively common in patients with schizophrenia.This study seeks to determine the prevalence and pattern of thyroid dysfunction and thyroid antibodies presence in a group of adult psychiatric inpatients with chronic schizophrenia.MethodsThyroid function tests and thyroid antibodies measurement were performed on 88 patients hospitalized in Psichiatric Clinic of UHC “Mother Teresa” from december 2006 to december 2007.55 of them (62,5%) were females and 33 of them (37,5%) males. A median age of 43 years (range16 to 70 years) and a median duration of hospitalization of 10 years (range 1 to 30 years) was assessed.ResultsTAb were found in 22 patients (25%), of which 18 females and 4 males. 16% of them resulted with positive anticorps for Hashimoto Thyroiditis; 9% for Graves‘disease.According to thyroid function tests70% had normal test, 8% had elevated TSH: 3% of them with low thyroid hormones and 5% with normal thyroid hormones. 20% of cases had low TSH: 5% of them with high level of thyroid hormones, 15% with normal thyroid hormones. Hypothyroidism was more frequent in elderly patients ( > 60 years old), and in those treated with Risperidone. Most of cases (73%) with thyroid disorders resulted from endemic geographic areas. 37% of them mentioned familial history for thyroid pathology, and 23% for diabetes mellitus type 1.ConclusionThyroid abnormalities are common in patients with chronic schizophrenia.This fact call for caution in the use and interpretation of thyroid function tests in these patients.

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Report of the IFCC Working Group for Standardization of Thyroid Function Tests; Part 2: Free Thyroxine and Free Triiodothyronine

Clinical Chemistry ◽

10.1373/clinchem.2009.140194 ◽

2010 ◽

Vol 56 (6) ◽

pp. 912-920 ◽

Cited By ~ 78

Author(s):

L. M. Thienpont ◽

K. Van Uytfanghe ◽

G. Beastall ◽

J. D. Faix ◽

T. Ieiri ◽

...

Keyword(s):

Thyroid Function ◽

Working Group ◽

Free Thyroxine ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Function Tests

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Relationship between Different Psoriasis Types and Thyroid Dysfunction: A Retrospective Analysis

Scanning ◽

10.1155/2021/1834556 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Juan Du ◽

Chunyue Ma ◽

Runnan Wang ◽

Lanmei Lin ◽

Luhui Gao ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Thyroid Function Tests ◽

Free Triiodothyronine ◽

Hormone Levels ◽

Significant Difference ◽

Total Thyroxine

Objective. The aim of this study was to investigate the relationship between different psoriasis types and thyroid dysfunction. Methods. The data of patients diagnosed with psoriasis between January 2013 and October 2018 who underwent thyroid function tests were collected. Free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) were measured. The thyroid function of patients with psoriasis vulgaris, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis was evaluated, and the differences in hormone levels and antibodies in the pituitary-thyroid axis with psoriasis type were analyzed. Results. The data of a total of 468 patients were analyzed in this study. The proportion of normal hormone levels was higher among vulgaris patients ( P < 0.001 ), while the erythrodermic patients were more likely to have decreased FT3 or FT4 but normal TSH ( P < 0.001 ). FT3 levels were lower in pustular patients ( P < 0.05 ), FT4 levels were lower in erythrodermic patients ( P < 0.05 ), and TSH levels were higher in patients with psoriatic arthritis ( P < 0.05 ). TPOAb levels were higher than normal in all patients, but there was no significant difference in the levels of TPOAb and TGAb among 4 types of the patients. Conclusion. Psoriasis is related to thyroid dysfunction, especially in patients with atypical psoriasis types. The possibility of complications should be considered in erythrodermic patients.

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