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- W2087526627 abstract "A few cases of patients with signs or symptoms suggestive of hyperthyroidism, yet normal serum free thyroxine (FT4) and triiodothyronine (T3), prompted us to explore high sensitivity measurements of TSH as an additional criterion in the diagnosis of hyperthyroidism. We used an immunoradiometric-type assay employing two different monoclonal anti-TSH antibodies (Hybritech, San Diego). Serum TSH concentrations measured in 20 healthy women were (X±SD) 1.8±0.7 with a range of 0.4–3.2 uU/ml. In this control group FT4 was 1.4±0.2 (normal: 0.8–2.3 ng/dl) and T3 115±15 (normal 70–200 ng/dl). Patients with miscellaneous disorders, but no thyroid disease had TSH levels similar to those in this control group. Untreated clinically hyperthyroid patients (n=21, Graves'/toxic multinodular goiter) with high serum FT4 (4.4±0.6) and T3 (378±123) had, with one exception, a suppressed serum TSH of < 0.3 uU/ml. In hypothyroid patients taking thyroxine, serum TSH was subnormal in 8 of 9 patients with elevated serum FT4 (3.1–4.5), in 4 patients clinically suspected to be hyperthyroid despite normal FT4 (1.0–1.7) and T3 (105–170) and in 6 of 13 patients who also had normal FT4 but appeared euthyroid. Similarly, 14 of 20 (70%) patients who had undergone thyroidectomy for thyroid cancer and were taking thyroxine had serum TSH of < 0.3 (7 of these had also abnormal FT4 = 2.5–3.4), while 30% were taking insufficient thyroxine to suppress the serum TSH (FT4 = 1.2–2.5). Baseline TSH correlated with peak TSH post TRH-stimulation (n=15, 12 children and 3 adults, r=0.84): Subnormal TSH of < 0.3 or 0.4 was coupled with no rise, or a blunted response, resp., and normal baseline TSH with a normal TRH-test. We conclude that measurement of serum TSH by highly sensitive assays could establish the diagnosis of hyperthyroidism in equivocal cases, replace TRH-stimulation studies in most such cases, and be useful in optimization of thyroxine replacement therapy." @default.
- W2087526627 created "2016-06-24" @default.
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- W2087526627 date "1984-09-01" @default.
- W2087526627 modified "2023-10-16" @default.
- W2087526627 title "CLINICAL EXPERIENCE WITH A SENSITIVE TSH ASSAY" @default.
- W2087526627 doi "https://doi.org/10.1097/00003072-198409001-00019" @default.
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