Artifactual elevation of thyroid-stimulating hormone
Article Abstract:
The thyroid-stimulating hormone (TSH) assay is a sensitive test for measuring levels of TSH, also referred to as thyrotropin. This hormone is released by the anterior portion of the pituitary and stimulates the thyroid gland. Because the TSH assay is so sensitive, abnormal results may be detected in patients without other evidence of thyroid disease. A patient with normal thyroid function was found to have normal levels of the thyroid hormone thyroxine, which is released by the thyroid gland, but increased blood levels of TSH. The elevated levels of TSH could not be reduced by administration of thyroid hormone or thyrotropin-releasing hormone (TRH). Pituitary glycoproteins, which are protein and carbohydrate complexes, were not detected in the blood, and imaging of the hypothalamus and pituitary appeared normal. Additional immunological tests using mouse immunoglobulin G revealed that the transient elevations of TSH levels were due to the presence of antimouse antibody, or immune protein produced against the mouse, in the patient's circulation. In other words, the results were spurious because of the TSH assay method itself. Unusual increases in TSH levels are not common. However, factors that interfere with accurate measurement of TSH levels should be considered when TSH levels are inconsistent with state of thyroid function. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Thyroid hormone resistance in a large kindred: physiologic, biochemical, pharmacologic, and neuropsychologic studies
Article Abstract:
Resistance of the body to respond normally to circulating levels of thyroid tissue affects the pituitary gland and a variety of other tissues. A group of 89 persons in four generations of a family was studied. Half of the subjects underwent thyroid function tests, one quarter of which were found to have a resistance to thyroid hormones. The pattern of inheritance was determined by autosomes (any chromosome that is not a sex chromosome). Physiologic measurements of five affected members showed a wide range of severity. Various tissues and system groups including bone, endocrine, heart, and the nervous system were studied. Affected patients had a wide variety in the degree of resistance among tissues and between individuals. The authors conclude that a decision to treat with thyroid hormone requires careful assessment of numerous physiologic, psychologic and biochemical parameters.
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1989
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