Biochemical pattern of thyroid function test and clinical impression of thyroid disorder in a rural tertiary health institution in Nigeria

Abstract

Background: Thyroid disorders are one of the most common endocrine disorders seen globally. Diagnostic challenge may arise both clinically and biochemically because of the multiple function of thyroid hormones (THs). Request for thyroid function test (TFT s) may be based on clinical impression that may suggest thyroid dysfunction or obvious symptoms and signs that are diagnostic of hyperthyroidism or hypothyroidism. Materials and Methods: This retrospective study looks at the biochemical patterns of TFTs and the clinical impression of thyroid disorders in a rural tertiary institution. Information extracted from the laboratory register includes indication for the test, the hospital number, the gender, the age, and the THs assayed. The corresponding biochemical pattern of the TFT result was established. Results: A total of 297 requests were submitted for TH assay; 34 were excluded from the present study because there were no clinical information. There were 239 females and 24 males giving a female-to-male ratio of 9.9:1. Majority of the requests (36.5%) were for goiters, followed by gynecological disorders (20.9%) and clinical thyroid disorders (17.9%). About 46% (45.8%) of the goiter cases were biochemically euthyroid, whereas 13.5% were biochemically primary hyperthyroid. Among the 47 cases of thyroid disorders by the physician’s clinical impression, 27.7% were euthyroid, 17% were biochemically hyperthyroid, and 10.6% were hypothyroid. Of the 55 gynecological disorders assessed, only 7.3% show biochemical evidence of TH alteration with 56.4% being euthyroid. About 47% (46.6%) of those that did routine medical examination had altered TH level that includes hyperthyroidism and hypothyroidism. Conclusion: Goiter is the most prevalent thyroid disorder in this environment. Biochemical pattern of thyroid function test in our environment was mostly euthyroid despites clinical features suggestive of thyroid disorders.

Advances in Thyroid Function Tests: Precision Diagnostics and Clinical Implications

“…Although significant advancements have been made in thyroid function testing, it is essential to acknowledge the presence of certain obstacles and limitations. A notable constraint was the dependence on a solitary biomarker, such as TSH, to identify thyroid diseases [ 7 ]. Although this technique has demonstrated efficacy in numerous instances, it needs to be improved in comprehensively capturing the intricate nature of thyroid function, occasionally resulting in erroneous diagnoses.…”

“…Although this technique has demonstrated efficacy in numerous instances, it needs to be improved in comprehensively capturing the intricate nature of thyroid function, occasionally resulting in erroneous diagnoses. Another historical obstacle that was encountered pertained to the need for uniformity in TFTs, resulting in discrepancies in outcomes across diverse laboratory settings [ 7 ]. The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) has undertaken standardization initiatives to tackle this matter, aiming to enhance uniformity and dependability in thyroid function testing on a global scale.…”

“…Incorporating molecular testing into thyroid diagnosis signifies a significant change in the area. Molecular assays investigating genetic alterations linked to thyroid malignancies offer substantial contributions to risk assessment and the development of tailored treatment strategies [6][7][8]. Including distinct genetic alterations, such as BRAF and RAS mutations, has become essential in evaluating the malignancy risk associated with thyroid nodules.…”