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. | |||
==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> | *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> | ||
Revision as of 14:17, 13 September 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.
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 T 4 and free or total T 3 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 T 3 toxicosis, in which the serum T 3 concentration is elevated but free T 4 is normal, occurs in approximately 1% of patients with hyperthyroidism.
- When the TSH is low, but both free T 4 and T 3 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 phosphataseh
- 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.