Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 33: 2178-2184, 1987;
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bayer, M. F.
Right arrow Articles by McDougall, I. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bayer, M. F.
Right arrow Articles by McDougall, I. R.

Clinical Chemistry, Vol 33, 2178-2184, Copyright © 1987 by American Association for Clinical Chemistry

Diagnostic performance of sensitive measurements of serum thyrotropin during severe nonthyroidal illness: their role in the diagnosis of hyperthyroidism

MF Bayer, JA Macoviak and IR McDougall
Department of Diagnostic Radiology, Stanford University School of Medicine, CA 94305.

Serum thyrotropin (TSH) concentrations were measured serially in 14 heart-transplant recipients (group 1) and 21 patients undergoing coronary artery bypass surgery (group 2), all without thyroid disease, and randomly in 158 patients hospitalized for various other nonthyroidal illnesses, including 144 judged euthyroid (group 3), six with increased FT4 and (or) T3 (group 4), and eight classified hypothyroid by conventional tests. The serial measurements indicated profound fluctuations. In group 1, TSH was subnormal in 21% of studies and increased in 10%. In group 2, corresponding abnormalities were found in 7% and 13%, respectively. Transiently low or high TSH tended to be associated with normal free thyroxin (FT4), prolonged subnormal TSH (greater than 1 week) with subnormal FT4. By contrast, subnormal TSH plus elevated FT4, or high TSH plus low FT4, were not encountered, making it unlikely that they occur by chance in severely ill patients who are not also hyper- or hypothyroid. In group 3, a suppressed TSH (plus borderline high FT4, T3/FT3) identified four cases of subclinical hyperthyroidism; however, another 11% of patients had subnormal and 10% had above-normal TSH, paired with normal FT4 and no evidence of thyroid disease. In group 4, suppressed TSH confirmed hyperthyroidism in five of six patients, and all in group 5 had increased TSH. We conclude that, in the hospital setting, sensitive TSH measurement can help to detect or confirm mild hyperthyroidism, but the positive predictive value of TSH alone may be as low as 35%.


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


Home page
 Clin. Chem.Home page
J. E.M. Midgley
Direct and Indirect Free Thyroxine Assay Methods: Theory and Practice
Clin. Chem., August 1, 2001; 47(8): 1353 - 1363.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
G. Sundbeck, R. Jagenburg, P.-M. Johansson, S. Eden, and G. Lindstedt
Clinical Significance of Low Serum Thyrotropin Concentration by Chemiluminometric Assay in 85-Year-Old Women and Men
Arch Intern Med, March 1, 1991; 151(3): 549 - 556.
[Abstract] [PDF]

Home page
 Arch Intern MedHome page
E. T. de los Santos, G. H. Starich, and E. L. Mazzaferri
Sensitivity, Specificity, and Cost-effectiveness of the Sensitive Thyrotropin Assay in the Diagnosis of Thyroid Disease in Ambulatory Patients
Arch Intern Med, March 1, 1989; 149(3): 526 - 532.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1987 by the American Association for Clinical Chemistry.