Toxic Adenoma laboratory findings: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
Measurement of serum [[TSH]] is considered as the best initial test in the evaluation of [[thyroid]] disorders. The serum free [[T4]] and free or total [[T3]] levels are elevated or in the upper part of the normal range. Findings of routine laboratory tests include elevated serum [[calcium]], elevated [[alkaline phosphatase]], elevated [[Ferritin|ferritin levels]], low ([[LDL Cholesterol|LDL]]) [[cholesterol]] levels. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
*Measurement of serum [[TSH]] is considered as the initial test in the evaluation of [[thyroid]] disorders.<ref name="pmid12625976">{{cite journal |vauthors=Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, LiVosli VA, Niccoli-Sire P, John R, Ruf J, Smyth PP, Spencer CA, Stockigt JR |title=Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease |journal=Thyroid |volume=13 |issue=1 |pages=3–126 |year=2003 |pmid=12625976 |doi=10.1089/105072503321086962 |url=}}</ref><ref name="pmid15496625">{{cite journal |vauthors=Hegedüs L |title=Clinical practice. The thyroid nodule |journal=N. Engl. J. Med. |volume=351 |issue=17 |pages=1764–71 |year=2004 |pmid=15496625 |doi=10.1056/NEJMcp031436 |url=}}</ref><ref name="pmid10434771">{{cite journal |vauthors=Cattaneo F, Bürgi U, Mueller B |title=[Goiter and nodular thyroid disease: clinical guidelines for diagnosis and treatment. (Waiting? Hormone therapy? Surgery? radioiodine?)] |language=German |journal=Ther Umsch |volume=56 |issue=7 |pages=356–63 |year=1999 |pmid=10434771 |doi=10.1024/0040-5930.56.7.356 |url=}}</ref><ref name="pmid8844728">{{cite journal |vauthors=Hurley DL, Gharib H |title=Evaluation and management of multinodular goiter |journal=Otolaryngol. Clin. North Am. |volume=29 |issue=4 |pages=527–40 |year=1996 |pmid=8844728 |doi= |url=}}</ref> | |||
*It should be measured in all patients with a [[thyroid nodule]] or [[goiter]]. | |||
*The serum free [[T4]] and free or total [[T3]] levels are elevated or in the upper part of the normal range. | |||
*Toxic adenomas can be associated with overt or subclinical [[hyperthyroidism]]. | |||
**In overt [[hyperthyroidism]], usually both serum (free) [[T4]] and [[T3]] are elevated. | |||
**Isolated [[T3]] toxicosis, in which the serum [[T3]] concentration is elevated but free [[T4]] is normal, occurs in approximately 1% of patients with [[hyperthyroidism]]. | |||
*When the [[TSH]] is low, but both free [[T4]] and [[T3]] levels are normal, the patient has subclinical or mild [[hyperthyroidism]], which is common in [[toxic multinodular goiter]], especially in older patients. | |||
*Findings of routine laboratory tests include: | |||
** Elevated serum [[calcium]] | |||
** Elevated [[Alkaline phosphatase|alkaline phosphatase]] | |||
** Elevated [[ferritin]] levels | |||
** Low ([[LDL Cholesterol|LDL]]) [[cholesterol]] levels. | |||
{| class="wikitable" | |||
!Tests | |||
!Findings | |||
|- | |||
|[[TSH]] | |||
|Low | |||
|- | |||
|Free [[T4]] | |||
|Elevated | |||
|- | |||
|[[Total T3]] | |||
|Elevated | |||
|- | |||
|CMP | |||
| | |||
* [[Hypercalcemia]] | |||
* Elevated [[aminotransferases]] | |||
* [[Alkaline phosphatase|Elevated alkaline phosphatase]] | |||
|- | |||
|TSH receptor | |||
antibodies | |||
|Negative | |||
|- | |||
|Thyroid peroxidase | |||
antibodies | |||
|Negative | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 18:13, 19 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Measurement of serum TSH is considered as the best initial test in the evaluation of thyroid disorders. The serum free T4 and free or total T3 levels are elevated or in the upper part of the normal range. Findings of routine laboratory tests include elevated serum calcium, elevated alkaline phosphatase, elevated ferritin levels, low (LDL) cholesterol levels.
Laboratory Findings
- Measurement of serum TSH is considered as the initial test in the evaluation of thyroid disorders.[1][2][3][4]
- It should be measured in all patients with a thyroid nodule or goiter.
- The serum free T4 and free or total T3 levels are elevated or in the upper part of the normal range.
- Toxic adenomas can be associated with overt or subclinical hyperthyroidism.
- In overt hyperthyroidism, usually both serum (free) T4 and T3 are elevated.
- Isolated T3 toxicosis, in which the serum T3 concentration is elevated but free T4 is normal, occurs in approximately 1% of patients with hyperthyroidism.
- When the TSH is low, but both free T4 and T3 levels are normal, the patient has subclinical or mild hyperthyroidism, which is common in toxic multinodular goiter, especially in older patients.
- Findings of routine laboratory tests include:
- Elevated serum calcium
- Elevated alkaline phosphatase
- Elevated ferritin levels
- Low (LDL) cholesterol levels.
| Tests | Findings |
|---|---|
| TSH | Low |
| Free T4 | Elevated |
| Total T3 | Elevated |
| CMP | |
| TSH receptor
antibodies |
Negative |
| Thyroid peroxidase
antibodies |
Negative |
References
- ↑ Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, LiVosli VA, Niccoli-Sire P, John R, Ruf J, Smyth PP, Spencer CA, Stockigt JR (2003). "Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease". Thyroid. 13 (1): 3–126. doi:10.1089/105072503321086962. PMID 12625976.
- ↑ Hegedüs L (2004). "Clinical practice. The thyroid nodule". N. Engl. J. Med. 351 (17): 1764–71. doi:10.1056/NEJMcp031436. PMID 15496625.
- ↑ Cattaneo F, Bürgi U, Mueller B (1999). "[Goiter and nodular thyroid disease: clinical guidelines for diagnosis and treatment. (Waiting? Hormone therapy? Surgery? radioiodine?)]". Ther Umsch (in German). 56 (7): 356–63. doi:10.1024/0040-5930.56.7.356. PMID 10434771.
- ↑ Hurley DL, Gharib H (1996). "Evaluation and management of multinodular goiter". Otolaryngol. Clin. North Am. 29 (4): 527–40. PMID 8844728.