Analysis of current thyroid function test ordering practices

Kluesner, Joseph; Beckman, Darrick; Tate, Joshua; Beauvais, Alexis; Kravchenko, Maria; Wardian, Jana L.; Graybill, Sky; Colburn, Jeffrey A.; Folaron, Irene; True, Mark W.

doi:10.1111/jep.12846

Cited by 19 publications

(6 citation statements)

References 28 publications

(75 reference statements)

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“…The spectrum of such disorders is so wide and might include congenital hypothyroidism, acquired hypothyroidism that caused by different etiologies, either autoimmune or non autoimmune and hyperthyroidism that Include Grave's disease. (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) The reported incidence of congenital hypothyroidism (CH) in DS is much higher compared with that of normal population, estimated to be thirty times higher. (10 -14) Most of patients were due to thyroid aplasia or hypoplasia.…”

Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction in patients with Down Syndrome: Beyond hypothyroidism

Sharifah D. A Al-Issa,

Khalid F.M Al-Kahtani,

Hamza J Khader

et al. 2023

World J. Bio. Pharm. Health Sci.

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Down Syndrome (DS) is the most common chromosomal disorder among live-born infants. Its’ prevalence varies world-wide, from one in 700 to 1500 live-births. This is even higher in Saudi Arabia which was reported as 18 per 10,000 live-births. The majority of patients is due to non-dysjunction of chromosome 21, while the remaining are either due to translocation or mosaicion. DS is associated with an increased risk of various endocrine disorders, of which thyroid dysfunction is the commonest. The spectrum of thyroidal dysfunctions in patients with DS, include congenital hypothyroidism (CH), subclinical hypothyroidism (SH), acquired hypothyroidism, autoimmune and non autoimmune. and hyperthyroidism, including graves disease. In this report, we present our experience with the various thyroid dysfunction in different patients with DS. The need for an annual evaluation of the thyroid function to detect early abnormalities, hence, an early intervention.

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Section: Discussionmentioning

confidence: 99%

Thyroid dysfunction in patients with Down Syndrome: Beyond hypothyroidism

Sharifah D. A Al-Issa,

Khalid F.M Al-Kahtani,

Hamza J Khader

et al. 2023

World J. Bio. Pharm. Health Sci.

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“…Therefore, knowing exactly what the normal range is, and especially what the upper limit of the normal range is, is extremely important since a patient with elevated TSH levels but a normal fT4 concentration is considered to have a disease that has been termed subclinical hypothyroidism. Unnecessary testing of fT3 and fT4 can lead to added economic burden in an era of rising healthcare costs, while rarely contributing to the evaluation or management of thyroid disorders [45].…”

Section: Discussionmentioning

confidence: 99%

Estimated change in prevalence of abnormal thyroid-stimulating hormone levels in China according to the application of the kit-recommended or NACB standard reference interval

Shan

Wang

et al. 2021

EClinicalMedicine

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Background Both the kit-recommended and United States National Academy of Clinical Biochemistry (NACB) standard thyroid-stimulating hormone (TSH) reference intervals (RIs) are used to determine thyroid dysfunction in clinical practice and epidemiological surveys in China. However, a number of kit-recommended RIs were derived from the European or United States reference population. Methods A nationally representative cross-sectional study with 78,470 enrolled participants aged 18 years or older from China was performed. Serum concentrations of thyroid hormones, TSH, thyroid antibodies (by Roche Diagnostics), and urine iodine concentration (UIC) were measured. Findings The abnormal TSH weighted prevalence was 15.33% (95% CI, 14.24% to 16.49%) according to the kit-recommended RI and 6.89% (6.46% to 7.34%) according to the NACB standard RI. The NACB standard prevalence of abnormal TSH was associated with an absolute change in abnormal TSH prevalence of −11.20% (−12.23% to −10.18%) among women. When estimating the proportion of supranormal TSH levels according to background characteristics, the NACB standard definition decreased the prevalence by more than 10% in some categories, with the highest absolute difference of −13.92% (−15.52% to −12.33%) observed among the elderly, −12.85% (−13.68% to −12.02%) among those with UIC ≥300 μg/L, and −12.15% (−13.02% to −11.28%) among non-smokers. For subnormal TSH, with the highest absolute difference of 3.17% (2.74% to 3.61%) observed among regular smokers, 3.11% (2.49% to 3.74%) among the elderly, and 2.53% (2.29% to 2.77%) among those with BMI <25. Interpretation For adults in China, the NACB standard RI of TSH reveals a lower estimated prevalence of supranormal TSH levels than the kit-recommended RI. Because of the public health significance of overt and subclinical hypothyroidism and the very large population base in China, the TSH RI should be further assessed. Funding National Health Commission of the People's Republic of China and National Natural Science Foundation of China.

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“…The thyroid disorders that occur in children with DS include congenital hypothyroidism (CH), subclinical hypothyroidism (SH), acquired hypothyroidism, and hyperthyroidism [ 7 ]. Thyroid function tests (TFTs) like thyroid-stimulating hormone (TSH), free T4 (FT4), and free T3 (FT3) are routinely used for assessment of thyroid dysfunction [ 8 ]. TSH is a very sensitive marker of changes in thyroid status; incremental alterations in FT4 level lead to logarithmic changes in the secretion of pituitary TSH [ 9 ].…”

Section: Thyroid Dysfunctionmentioning

confidence: 99%

“…TSH is a very sensitive marker of changes in thyroid status; incremental alterations in FT4 level lead to logarithmic changes in the secretion of pituitary TSH [ 9 ]. Measurement of both TSH and FT4 is advised to determine thyroid function accurately and to monitor treatment in children with thyroid disorders [ 8 ]. Screening using TFT for thyroid disease at birth, at 6 months of age, at 12 months, and annually thereafter is the standard of care [ 10 - 13 ].…”

Section: Thyroid Dysfunctionmentioning

confidence: 99%

Endocrinal dysfunction in children with Down syndrome

Metwalley

Farghaly

2022

Ann Pediatr Endocrinol Metab

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Down syndrome (DS) is the most common genetic disorder in live-born infants. Children with DS are at increased risk of numerous endocrinal comorbidities. The information contained in this article will provide pediatricians with a narrative overview of different presentations, diagnoses, and management recommendations of various endocrinal disorders in children with DS. We systematically searched PubMed, Embase, Google Scholar, MEDLINE, EBSCO, and Science Direct, and potentially relevant articles were identified and retrieved from electronic and print journals.

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Analysis of current thyroid function test ordering practices

Cited by 19 publications

References 28 publications

Thyroid dysfunction in patients with Down Syndrome: Beyond hypothyroidism

Thyroid dysfunction in patients with Down Syndrome: Beyond hypothyroidism

Estimated change in prevalence of abnormal thyroid-stimulating hormone levels in China according to the application of the kit-recommended or NACB standard reference interval

Endocrinal dysfunction in children with Down syndrome

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