Toxic Adenoma laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
Measurement of serum TSH is considered as the best initial test in the evaluation of thyroid disorders. Findings of routine laboratory tests include elevated serum calcium, elevated alkaline phosphatase, elevated ferritin levels, low (LDL) cholesterol levels. | Measurement of serum TSH is considered as the best initial test in the evaluation of thyroid disorders. The serum free T 4 and free or total T 3 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== | ==Laboratory Findings== | ||
Revision as of 14:19, 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. The serum free T 4 and free or total T 3 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 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.