Document Detail


Low thyrotropin (TSH) levels in goiter. Relationship with scintigraphic findings and other biological parameters.
MedLine Citation:
PMID:  2484906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Low TSH levels are frequently encountered in patients presenting with goiter. We assayed TSH in 599 goitrous patients who were referred to us for scintigraphy and ultrasonography. When TSH levels were low or when a hot nodule was discovered at scintigraphy, free T3, free T4 and sex hormone-binding globulin (SHBG) were also assayed. TSH levels were always low in overt hyperthyroidism with elevated free T3. TSH levels were also low in patients with normal free T3 and free T4 in circumstances leading to mild hyperthyroidism such as hot nodules that suppressed extranodular thyroid tissue uptake, toxic multinodular goiter, De Quervain thyroiditis and some patients on amiodarone treatment. Low TSH levels were also encountered in 29% of the clinically euthyroid patients presenting with a multinodular goiter with normal iodine uptake, no hot area and normal free T3 levels. In diffuse goiter, low TSH and normal free T3 levels were more frequently associated when iodine uptake was low, mainly due to subacute thyroiditis which can be clinically silent. Low TSH levels were rarely observed in patients with "simple" goiter or uninodular goiter without hot areas. SHBG, which was elevated in 94% of the Graves' disease patients tested, was normal in all but two patients with low TSH and normal free T3 levels. This assay appeared to be of little relevance in goiter. In addition to imaging techniques which are usually performed first, TSH should be systematically assayed in goiter, except in cases of solitary cold nodules. When low, the patient is at risk of developing overt hyperthyroidism. Conversely, when an isolated low TSH level is observed, scintigraphy should be performed.
Authors:
J N Talbot; F Duron; M L Piketty; M O Habert; M D Laforest; G Milhaud
Related Documents :
888746 - Thyroid function tests in the elderly in the community.
9559026 - Thyroid dysfunction: how to manage overt and subclinical disease in older patients.
14750556 - Pcbs, hexachlorobenzene and dde are not associated with recurrent miscarriage.
3143866 - Clinical utility and cost-effectiveness of sensitive thyrotropin assays in ambulatory a...
7459626 - Does osmotic control of gastric emptying persist after truncal vagotomy?
15642296 - The value of ultrasonic examination of the lumbar spine in infants with specific refere...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thyroidology / A.P.R.I.M     Volume:  1     ISSN:  -     ISO Abbreviation:  Thyroidology     Publication Date:  1989 Apr 
Date Detail:
Created Date:  1991-04-05     Completed Date:  1991-04-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9100266     Medline TA:  Thyroidology     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  39-44     Citation Subset:  IM    
Affiliation:
Service de Médecine Nucléaire, Hôpital Saint-Antoine, Paris, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Goiter / blood*,  radionuclide imaging,  ultrasonography
Humans
Hyperthyroidism / blood
Retrospective Studies
Thyroid Gland / radionuclide imaging*,  ultrasonography
Thyrotropin / blood*
Chemical
Reg. No./Substance:
9002-71-5/Thyrotropin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Anti-bovine TSH antibodies in patients with Graves' disease and primary myxedema.
Next Document:  Clinical use of a new pharmaceutical preparation containing L-thyroxine in solution. Preliminary rep...