Thyroid function tests during carbimazole therapy

Scott, D L; Tymms, D J; Taylor, M. A. R.; Chapman, C.

doi:10.1136/pgmj.56.662.838

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Patients with hyperthyroidism on carbimazole therapy tend to normalize T4 ahead of T3, the latter being a better indicator of the clinical status. Hence, some patients may have normal T4 despite being clinically hyperthyroid [ 15 ]. However, T3 is usually high in such cases (isolated T3 toxicosis).…”

Section: Discussionmentioning

confidence: 99%

Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

Jevalikar

Gupta

Bhatia

et al. 2011

Int J Pediatr Endocrinol

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Cardiac failure is an uncommon complication of juvenile hyperthyroidism. We describe an adolescent boy with Graves' disease who developed manifestations of heart failure while on antithyroid medications. There was no evidence of any underlying cardiac disease. He had paradoxical euthyroid hormone profile which rose to hyperthyroid range when the manifestations of the cardiac failure subsided. The case highlights several unusual features of Graves' disease.

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Section: Discussionmentioning

confidence: 99%

Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

Jevalikar

Gupta

Bhatia

et al. 2011

Int J Pediatr Endocrinol

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Clinical Value of a Sensitive Immunoradiometric Assay for TSH

et al. 1985

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SUMMARY.We have investigated a sensitive immunoradiometric assay for serum thyroid-stimulating hormone (TSH) in 45 thyrotoxic patients not on treatment, 464 euthyroid patients and 111 hypothyroid patients on replacement therapy. Fortythree thyrotoxic and seven euthyroid patients were found to have an undetectable TSH (less than 0·2 mIUIL). Previous work has shown a very clear separation of thyrotoxic and euthyroid patients using sensitive TSH assays. However, our extended study here has revealed that a significant number of euthyroid patients with undetectable TSH (1,5% in our study) are likely to be found if TSH becomes the initial test for thyroid function.Thirty of the hypothyroid patients on thyroxine were found to have undetectable TSH, but only one showed clinical signs of thyrotoxicosis. Most of the patients, although having raised serum free T4, had serum free T3 levels within the euthyroid range or just slightly elevated.Most radioimmunoassays for plasma TSH achieve adequate sensitivity for them to be used in the diagnosis and monitoring of treatment of hypothyroidism. However, their sensitivity, normally not less than 1 mUlL, is insufficient for use in investigating thyrotoxic patients.We here describe the use, in clinical practice, of a sensitive immunoradiometric assay (IRMA) capable of detecting 0·2 mUlL of TSH. This assay, a preliminary trial of which has been reported,' has been found valuable in aiding both the diagnosis of thyrotoxicosis and hypothyroidism and for monitoring hypothyroid patients on replacement therapy. Patients and Methods PATIENTSAll patients in this study were classified both clinically and on the basis of routine thyroid function tests. There were 45 thyrotoxic patients, 11 men and 34 women, none of whom were receiving anti-thyroid therapy at the time of blood sampling. The euthyroid population Correspondence: K R Allen, Clinical Biochemistry Department, Wexham Park Hospital, Slough, Berks SL24HL. 506studied consisted of 151 men and 313 women with ages ranging from 16 to 95 years. In addition, we tested 111 hypothyroid patients who were receiving thyroxine. This group included both newly treated patients and patients who had been receiving thyroxine for some years. These doses ranged from 100-200 ug thyroxine daily except for one patient who had been taking 400 J.lg thyroxine daily. Serum from hypothyroid patients with TSH concentrations of less than 0·2 mUlL were assayed for free T3 and free T4. METHODSSerum TSH was measured using an IRMA with magnetic separation of the antibody ('Maiaclone', Serono Diagnostics, Woking, Englandj.? Serum free T4 and free T3 were measured using Amerlex kits (Amersham International). Results SENSITIVITYThe limit of detection of the assay was determined by analysing the zero TSH standard 20 times in this one assay run. 2·5 standard deviations at zero dose was found to be 0·2 mUlL.

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Thyroid function tests during carbimazole therapy

Cited by 2 publications

References 12 publications

Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

Paradoxical euthyroid hormone profile in a case of Graves' disease with cardiac failure

Clinical Value of a Sensitive Immunoradiometric Assay for TSH

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