Clinical Chemistry
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Clinical Chemistry 32: 433-436, 1986;
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Clinical Chemistry, Vol 32, 433-436, Copyright © 1986 by American Association for Clinical Chemistry

Immunoradiometric assay of thyrotropin in plasma: its value in predicting response to thyroliberin stimulation and assessing thyroid function in amiodarone-treated patients

WM Wiersinga, E Endert, MD Trip and N Verhaest-de Jong

We measured thyrotropin in plasma by an ultrasensitive immunoradiometric assay (TSH-IRMA, "Sucrosep," Boots-Celltech), before and after thyroliberin (TRH) stimulation, in 71 patients with suspected thyroid-function disorders. Thirty-three were taking amiodarone; none was receiving (anti)thyroid drugs. The patients were divided into four groups, according to their TSH response to TRH (as measured previously by conventional TSH-RIA) and the concentrations of thyroxin (T4) and triiodothyronine (T3) in their plasma. Observed ranges of plasma TSH- IRMA (milli-int. units/L) before and after TRH were: euthyroid (n = 20), 0.2-3.0 and 1.7-15.5; subclinically hypothyroid (n = 14), 4.3-18.5 and 20-75; hyperthyroid (n = 17), less than 0.09 and less than 0.09- 0.4; and subclinically hyperthyroid (n = 20), less than 0.09-1.1 and less than 0.09-2.6. Evidently TSH-IRMA results for a single sample completely distinguish hyperthyroidism from euthyroidism. However, TSH- IRMA values may also be undetectable in subclinical hyperthyroidism. The TSH response to TRH can be predicted from basal TSH-IRMA results less than 0.09 or greater than or equal to 0.8 milli-int. unit/L, intermediate values can be associated with either a normal TSH response (euthyroidism) or a decreased TSH response (subclinical hyperthyroidism only). We advocate TSH-IRMA as the first diagnostic test of thyroid function for amiodarone-treated patients.


The following articles in journals at HighWire Press have cited this article:


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 Arch Intern MedHome page
C. T. Sawin, A. Geller, M. M. Kaplan, P. Bacharach, P. W. F. Wilson, and J. M. Hershman
Low Serum Thyrotropin (Thyroid-Stimulating Hormone) in Older Persons Without Hyperthyroidism
Arch Intern Med, January 1, 1991; 151(1): 165 - 168.
[Abstract] [PDF]


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Copyright © 1986 by the American Association for Clinical Chemistry.