Reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in infants’ day 14–30 of life and a comparison with other studies

2020 ◽  
Vol 33 (9) ◽  
pp. 1125-1132
Author(s):  
Jeanne Sze Lyn Wong ◽  
Nalini M. Selveindran ◽  
Rashdan Zaki Mohamed ◽  
Fuziah M. Zain ◽  
Siti S. Anas ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Small Sample Size ◽  
Age Groups ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Small Sample ◽  
Free Thyroxine ◽  
Significant Difference ◽  
Stimulating Hormone

AbstractObjectivesEstablished reference intervals of thyroid function in neonates are important; however, studies often consist of a small sample size or lack of clinical information. We aim to define reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) for infants aged 14–30 days. We also reviewed follow-up TSH for infants with initial values 10–20 mIU/L.MethodsVenous TSH and FT4 of term babies aged 14–30 days with breast milk jaundice that had thyroid function test performed as part of a prolonged jaundice workout from September 2016 to March 2017 were analyzed. Electronic medical records were reviewed to ensure only well babies with no pathological causes of jaundice or conditions that may affect thyroid function were included. TSH and FT4 were analyzed using immunoassay analyzer Dxl 800, Beckman Coulter.ResultsThere were no correlations between FT4 and TSH with gender, birth weight and ethnicity. Correlation coefficient between FT4 and total bilirubin was weak at 0.138 (p=0.001). No association was found between TSH and bilirubin levels. Mean FT4 was higher in the younger age group day 14–21 (p<0.01). There was no significant difference in TSH values between the age groups. Infants with mildly elevated TSH 10–20 mIU/L had normalized values on follow-up (mean, 11.41 vs. 4.42 mIU/L; p<0.01; 95%CI, 5.88–8.09). The following reference intervals (2.5–97.5th percentile) were derived: FT4 day 14–21 (n=513): 11.59–21.00 pmoL/L; FT4 day 22–30 (n=66): 10.14–19.60 pmoL/L; TSH day 14–30 (n=579): 1.90–10.34 mIU/L. Comparison between studies showed variations of reference intervals with different manufacturer assays, age and methodology.ConclusionsOur reference intervals would be useful in the clinical setting. Infants with mildly elevated TSH could be monitored first instead of immediate treatment.

Pediatric reference intervals of free thyroxine and thyroid stimulating hormone in three different hospitals

2018 ◽  
Vol 43 (5) ◽  
pp. 530-539
Author(s):  
Hale Aral ◽  
Ömer Faruk Özer ◽  
Hatice Onur ◽  
Ahmet Mete Çilingirtürk ◽  
İlker Tolga Özgen ◽  
...  
Keyword(s):  
Interaction Effect ◽  
Extreme Values ◽  
Age Groups ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Reference Limits ◽  
Using Data ◽  
Box Cox Transformation ◽  
Stimulating Hormone

Abstract Objective: Using data retrieved from three different hospitals, we established indirect reference intervals of free thyroxine (FT4) and thyroid stimulating hormone (TSH) for the Centaur XP or the Immulite 2000 instruments, in separate reference limits at each subset. Methods: We categorized children into seven age groups: 4–7 days, 8–15 days, 16–23 days, 24–61 days, 3–6 months, 7–36 months and 4–6 years. After a Box-Cox transformation was employed, we followed the Horn algorithm to eliminate the extreme values. Results: The remaining FT4 (11,230) and TSH (11,274) tests were statistically analyzed. We determined separate reference limits at each subset with their own 2.5th and 97.5th percentiles. The interaction effect of both hospital and age grouping on FT4 was meaningful, but there was no interaction effect on TSH. Conclusions: Pediatric FT4 and TSH test results should be interpreted via narrowed age groups, especially in the first 3 weeks of neonatal period. Our reference limits may be recommended in pediatric follow-ups, considering the conditions of prematurity, birth-weight or multiple births. Preanalytical and analytical variations related with complex molecular structure of FT4 should be taken into consideration to ensure the validity of the result.

Establishment of Early Pregnancy Related Thyroid Hormone Models and Reference Intervals for Pregnant Women in China Based on Real World Data

2021 ◽  
Vol 53 (04) ◽  
pp. 272-279
Author(s):  
Chaochao Ma ◽  
Xiaoqi Li ◽  
Lixin Liu ◽  
Xinqi Cheng ◽  
Fang Xue ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Gestational Age ◽  
Dynamic Change ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Stimulating Hormone

AbstractThyroid hormone reference intervals are crucial for diagnosing and monitoring thyroid dysfunction during early pregnancy, and the dynamic change trend of thyroid hormones during pregnancy can assist clinicians to assess the thyroid function of pregnant women. This study aims to establish early pregnancy related thyroid hormones models and reference intervals for pregnant women. We established two derived databases: derived database* and derived database#. Reference individuals in database* were used to establish gestational age-specific reference intervals for thyroid hormones and early pregnancy related thyroid hormones models for pregnant women. Individuals in database# were apparently healthy non-pregnant women. The thyroid hormones levels of individuals in database# were compared with that of individuals in database* using nonparametric methods and the comparative confidence interval method. The differences in thyroid stimulating hormone and free thyroxine between early pregnant and non-pregnant women were statistically significant (p<0.0001). The reference intervals of thyroid stimulating hormone, free thyroxine and free triiodothyronine for early pregnant women were 0.052–3.393 μIU/ml, 1.01–1.54 ng/dl, and 2.51–3.66 pg/ml, respectively. Results concerning thyroid stimulating hormone and free thyroxine reference intervals of early pregnancy are comparable with those from other studies using the same detection platform. Early pregnancy related thyroid hormones models showed various change patterns with gestational age for thyroid hormones. Early pregnancy related thyroid hormones models and reference intervals for pregnant women were established, so as to provide accurate and reliable reference basis for the diagnosing and monitoring of maternal thyroid disfunction in early pregnancy.

Percentile transformation and recalibration functions allow harmonization of thyroid-stimulating hormone (TSH) immunoassay results

2020 ◽  
Vol 58 (10) ◽  
pp. 1663-1672 ◽  
Author(s):  
Andrea Padoan ◽  
Aldo Clerico ◽  
Martina Zaninotto ◽  
Tommaso Trenti ◽  
Renato Tozzoli ◽  
...  
Keyword(s):  
Robust Regression ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Validation Dataset ◽  
New Approach ◽  
Coefficients Of Variation ◽  
Significant Difference ◽  
Before And After ◽  
Roche Diagnostics ◽  
Stimulating Hormone

AbstractBackgroundThe comparability of thyroid-stimulating hormone (TSH) results cannot be easily obtained using SI-traceable reference measurement procedures (RPMs) or reference materials, whilst harmonization is more feasible. The aim of this study was to identify and validate a new approach for the harmonization of TSH results.MethodsPercentile normalization was applied to 125,419 TSH results, obtained from seven laboratories using three immunoassays (Access 3rd IS Thyrotropin, Beckman Coulter Diagnostics; Architect System, Abbott Diagnostics and Elecsys, Roche Diagnostics). Recalibration equations (RCAL) were derived by robust regressions using bootstrapped distribution. Two datasets, the first of 119 EQAs, the second of 610, 638 and 639 results from Access, Architect and Elecsys TSH results, respectively, were used to validate RCAL. A dataset of 142,821 TSH values was used to derive reference intervals (RIs) after applying RCAL.ResultsAccess, Abbott and Elecsys TSH distributions were significantly different (p < 0.001). RCAL intercepts and slopes were −0.003 and 0.984 for Access, 0.032 and 1.041 for Architect, −0.031 and 1.003 for Elecsys, respectively. Validation using EQAs showed that before and after RCAL, the coefficients of variation (CVs) or among-assay results decreased from 10.72% to 8.16%. The second validation dataset was used to test RCALs. The median of between-assay differences ranged from −0.0053 to 0.1955 mIU/L of TSH. Elecsys recalibrated to Access (and vice-versa) showed non-significant difference. TSH RI after RCAL resulted in 0.37–5.11 mIU/L overall, 0.49–4.96 mIU/L for females and 0.40–4.92 mIU/L for males. A significant difference across age classes was identified.ConclusionsPercentile normalization and robust regression are valuable tools for deriving RCALs and harmonizing TSH values.

Method specific second-trimester reference intervals for thyroid-stimulating hormone and free thyroxine

2009 ◽  
Vol 42 (7-8) ◽  
pp. 750-753 ◽  
Author(s):  
Rechelle Silvio ◽  
Karly J. Swapp ◽  
Sonia L. La'ulu ◽  
Kara Hansen-Suchy ◽  
William L. Roberts
Keyword(s):  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Free Thyroxine ◽  
Second Trimester ◽  
Stimulating Hormone

Preterm to term infant postmenstrual age reference intervals for thyroid-stimulating hormone and free thyroxine

2021 ◽  
Author(s):  
George M. Ziegler ◽  
Jonathan L. Slaughter ◽  
Monika Chaudhari ◽  
Herveen Singh ◽  
Pablo J. Sánchez ◽  
...  
Keyword(s):  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Term Infant ◽  
Free Thyroxine ◽  
Postmenstrual Age ◽  
Stimulating Hormone

Differential Clinical Impact Of Gene Mutations and Their Combinations In Primary Cytogenetically Normal Acute Myeloid Leukemia (CN-AML)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2540-2540
Author(s):  
Dimitrios Papaioannou ◽  
Kati Maharry ◽  
Krzysztof Mrózek ◽  
Heiko Becker ◽  
Klaus H. Metzeler ◽  
...  
Keyword(s):  
Annual Meeting ◽  
Small Sample Size ◽  
Prognostic Significance ◽  
Age Groups ◽  
Gene Mutations ◽  
Small Sample ◽  
Clinical Impact ◽  
Cebpa Mutations ◽  
American Society

Abstract In CN-AML, mutations of specific genes have prognostic significance and are used for treatment guidance. However, these mutations are in general not mutually exclusive and CN-AML patients (pts) frequently harbor mutational combinations with unclear prognostic significance because of the concurrent presence of mutations with favorable (CEBPA, NPM1) and unfavorable (ASXL1, DNMT3A, IDH1, IDH2, FLT3-ITD, MLL-PTD, RUNX1, TET2, WT1) impact on outcome. Here, we report the frequency and clinical significance of isolated mutations and their combinations in 364 CN-AML pts. Younger [<60 years (y); n=163] and older (≥60 y; n=201) pts were intensively treated on frontline CALGB/Alliance protocols and, per protocol, did not undergo allogeneic stem cell transplantation in first complete remission (CR). Median follow-up for pts alive was 8.7 y. Pts were analyzed centrally for mutations in the ASXL1, CEBPA, DNMT3A, IDH1, IDH2, NPM1, RUNX1, TET2, and WT1 genes and the presence of FLT3-ITD, FLT3-TKD and MLL-PTD. We found that 99% of pts had ≥1 and 88% ≥2 of the 12 mutations. Specifically, 11% of pts had 1 gene mutated (n1), 40% had 2 (n2), 31% 3 (n3), and 18% harbored ≥4 mutated genes (n4). The distribution of the different n groups in younger and older pts was similar (Fig 1). The expected frequency of each mutated gene in every numerical (n) group was calculated as follows: [no. of pts with the mutated gene] x [total no. of mutations in the n group] / [total no. of mutations in all pts], and compared with the observed frequency. CEBPA, IDH2, NPM1, and RUNX1 mutations were overrepresented in the n1 and n2 groups (P<.001, P<.001, P=.002, P=.02, respectively) and thus likely represent “early” events in leukemogenesis. In contrast, DNMT3A, FLT3-ITD, and TET2 mutations were more frequent in the n3 and n4 groups (P=.008, P<.001, P=.02, respectively) suggesting that they are likely “late” events. The distribution among age groups and clinical impact of the “early” mutations (i.e., CEBPA, NPM1, IDH2) presenting as isolated mutations or in combination with other mutations were then investigated. Isolated RUNX1 mutations could not be evaluated due to small sample size. Younger pts were more likely to harbor an isolated “early” mutated gene than older pts (21% v 12%, P=.03). Specifically, isolated CEBPA and NPM1 mutations were more frequent in younger pts compared with the older (7% v 2%, P=.007; 7% v 3%, P=.07, respectively). In pts with isolated CEBPA mutations, these were always bi-allelic. Single “early” mutated genes varied in their impact on CR achievement (CEBPA: 100%, NPM1: 94%, IDH2: 67%), and overall survival (OS; 3-y OS: CEBPA: 87%, NPM1: 69%, IDH2: 22%). Acquisition of additional mutations adversely modified the prognostic significance of favorable “early” mutations in the CEBPA (Fig 2A) and NPM1 (Fig 2B) genes, but left unchanged the unfavorable effect of IDH2 mutations (Fig 2C). Two mutational combinations were exceptions to this: younger pts with both NPM1 and DNMT3A mutations (8 pts) had an excellent prognosis with 3-y OS of 100%; and older pts with concurrent NPM1 and IDH2 mutations (9 pts; all IDH2 mutations were in codon R140) had a high 3-y OS rate of 67%. We conclude that CEBPA and NPM1 mutations mainly define pts with favorable prognosis when they present as single markers, whereas mutated IDH2 predominantly associates with adverse outcome. The NPM1+DNMT3A and NPM1+IDH2 mutational patterns may define novel favorable molecular subtypes in younger and older CN-AML pts, respectively, but these results require corroboration in larger pt cohorts. Disclosures: Mrózek: AMERICAN SOCIETY OF HEMATOLOGY: I will review abstracls submitted for presentation at the 55th ASH Annual Meeting in the 611 category Other. Eisfeld:AMERICAN SOCIETY OF HEMATOLOGY: I will review abstracls submitted for presentation at the 55th ASH Annual Meeting in the 608 category Other.

scholarly journals Visual attention and inhibitory control in children, teenagers and adults with autism without intellectual disability: results of oculomotor tasks from a 2-year longitudinal follow-up study (InFoR)

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Anouck Amestoy ◽  
Etienne Guillaud ◽  
Giulia Bucchioni ◽  
Tiziana Zalla ◽  
Daniel Umbricht ◽  
...  
Keyword(s):  
Inhibitory Control ◽  
Time Course ◽  
Small Sample Size ◽  
Age Groups ◽  
Autism Spectrum ◽  
Small Sample ◽  
Control Group ◽  
Attention Switching ◽  
Follow Up Study

Abstract Background Inhibitory control and attention processing atypicalities are implicated in various diseases, including autism spectrum disorders (ASD). These cognitive functions can be tested by using visually guided saccade-based paradigms in children, adolescents and adults to determine the time course of such disorders. Methods In this study, using Gap, Step, Overlap and Antisaccade tasks, we analyzed the oculomotor behavior of 82 children, teenagers and adults with high functioning ASD and their peer typically developing (TD) controls in a two-year follow-up study under the auspices of the InFoR-Autism project. Analysis of correlations between oculomotors task measurements and diagnostic assessment of attentional (ADHD-RS and ADHD comorbidity indices) and executive functioning (BRIEF scales) were conducted in order to evaluate their relationship with the oculomotor performance of participants with ASD. Results As indicated by the presence of a Gap and Overlap effects in all age groups, the oculomotor performances of ASD participants showed a preserved capability in overt attention switching. In contrast, the difference in performances of ASD participants in the Antisaccade task, compared to their TD peers, indicated an atypical development of inhibition and executive functions. From correlation analysis between our oculomotor data and ADHD comorbidity index, and scores of attention and executive function difficulties, our findings support the hypothesis that a specific dysfunction of inhibition skills occurs in ASD participants that is independent of the presence of ADHD comorbidity. Limitations These include the relatively small sample size of the ASD group over the study’s two-year period, the absence of an ADHD-only control group and the evaluation of a TD control group solely at the study’s inception. Conclusions Children and teenagers with ASD have greater difficulty in attention switching and inhibiting prepotent stimuli. Adults with ASD can overcome these difficulties, but, similar to teenagers and children with ASD, they make more erroneous and anticipatory saccades and display a greater trial-to-trial variability in all oculomotor tasks compared to their peers. Our results are indicative of a developmental delay in the maturation of executive and attentional functioning in ASD and of a specific impairment in inhibitory control.

scholarly journals Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

2020 ◽  
Vol 8 (9) ◽  
pp. 3165
Author(s):  
Iskender Ekinci ◽  
Hande Peynirci
Keyword(s):  
Thyroid Function ◽  
Smoking Status ◽  
Antithyroid Drug ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Newly Diagnosed ◽  
Function Tests ◽  
Significant Difference ◽  
Stimulating Hormone

Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/l than TRab ≥10 IU/l (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice.

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