Comparison of methods for assessing thyroid function in nonthyroidal illness
Various tests of thyroid function were studied in sick patients with nonthyroidal illness (NTI) in order to determine the utility of each test for differentiating these patients from a group with hypothyroidism. We evaluated each test in 22 healthy volunteers who served as controls, 20 patients with hypothyroidism, 14 patients admitted to medical intensive care unit whose serum T/sub 4/ was less than 5 ..mu..g/dl, 13 patients with chronic liver disease, 32 patients on chronic hemodialysis for renal failure, 13 ambulatory oncology patients receiving chemotherapy 16 pregnant women, 7 women on estrogens, and 20 hyperthyroid patients. On all samples, we measured serum T/sub 4/, the free T/sub 4/ index by several methods, free T/sub 4/ by equilibrium dialysis, free T/sub 4/ calculated from thyronine-binding globulin (TBG) RIA, free T/sub 4/ by three commercial kits (Gammacoat, Immophase, and Liquisol), T/sub 3/, rT/sub 3/, and TSH (by 3 different RIA). Although all of the methods used for measuring free T/sub 4/ (including free T/sub 4/ index, free T/sub 4/ by dialysis, free T/sub 4/ assessed by TBG, and free T/sub 4/ assessed by the 3 commercial kits) were excellent for the diagnosis of hypothyroidism, hyperthyroidism, and euthyroidism in the presence of high TBG, none of these methods showed that free T/sub 4/ was consistently normal in patients with NTI; with each method, a number of NTI patients had subnormal values. In the NTI groups, free T/sub 4/ measured by dialysis and the free T/sub 4/ index generally correlated significantly with the commercial free T/sub 4/ methods. Serum rT/sub 3/ was elevated or normal in NTI patients and low in hypothyroid subjects. Serum TSH provided the most reliable differentiation between patients with primary hypothyroidism and those with NTI and low serum T/sub 4/ levels.
- Research Organization:
- Univ. of California at Los Angeles
- OSTI ID:
- 5545454
- Journal Information:
- J. Clin. Endocrinol. Metab.; (United States), Journal Name: J. Clin. Endocrinol. Metab.; (United States) Vol. 54:2; ISSN JCEMA
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
AMINO ACIDS
BIOLOGICAL FUNCTIONS
BODY
CARBOXYLIC ACIDS
COMPARATIVE EVALUATIONS
DIAGNOSIS
DISEASES
ENDOCRINE DISEASES
ENDOCRINE GLANDS
FUNCTIONS
GLANDS
HORMONES
HYPOTHYROIDISM
ISOTOPE APPLICATIONS
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANS
PATIENTS
PEPTIDE HORMONES
PITUITARY HORMONES
RADIOASSAY
RADIOIMMUNOASSAY
THYROID
THYROID HORMONES
THYROXINE
TRACER TECHNIQUES
TRIIODOTHYRONINE
TSH