A grave interference: TSH interference due to macro-TSH post-thyroidectomy for graves[rdquo] disease

McCarthy, Aisling; Moran, Carla

doi:10.1530/endoabs.82.wc4

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“…Also in adults, a lack of identification of macro-TSH may result in therapeutic problems. One case study reported inadequate treatment of a patient with Graves' disease with L-T4 based on falsely increased TSH concentrations caused by the presence of macro-TSH [103].…”

Section: Characteristics Of Macro-tsh and Hypotheses Concerning Its R...mentioning

confidence: 99%

Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation

Frőhlich

Wahl

2023

IJMS

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Thyroid-stimulating hormone (TSH) and thyroid hormone levels are standard parameters in blood analysis. However, the immunoassays employed may lead to false-positive or false-negative results when the sample contains certain materials that interfere with the assay. Macro-TSH, a complex of TSH with immunoglobulin or albumin, may cause apparently increased TSH concentrations. TSH is produced in the pars tuberalis (PT) of the pituitary gland and by thyrotrophs of the pars distalis (PD). It was found that variable glycosylation can render the molecule more strongly bound to antibodies or albumin in the blood, leading to the hypothesis that macro-TSH consists mainly of PT-TSH. Although less known than PD-TSH, PT-TSH plays an important role in the central regulation of thyroid metabolism. The present review summarizes the physiological function of human PT-TSH and its role in macro-TSH formation. The prevalence of macro-hyperthyrotropinemia, the structure of PT-TSH and macro-TSH, problems in the measurement of TSH, and the action of PT-TSH in animals with seasonal breeding are discussed. Despite the absence of a specific function of macro-TSH in the organism, the identification of macro-TSH is important for avoiding unnecessary treatment based on a falsified readout of increased TSH concentrations as numerous individual case reports describe.

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Section: Characteristics Of Macro-tsh and Hypotheses Concerning Its R...mentioning

confidence: 99%

Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation

Frőhlich

Wahl

2023

IJMS

View full text Add to dashboard Cite

show abstract

A grave interference: TSH interference due to macro-TSH post-thyroidectomy for graves[rdquo] disease

Cited by 1 publication

References 0 publications

Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation

Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation

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