[Don't be guided purely by numbers: false increased TSH values due to analytical interference]. / Vaar niet alleen op een getal.
Ned Tijdschr Geneeskd
; 1642020 07 02.
Article
in Nl
| MEDLINE
| ID: mdl-32757509
ABSTRACT
BACKGROUND:
Physicians are often guided by laboratory values. When a clinical presentation does not match laboratory values, one must consider the possibility that these values may be falsely increased or decreased. A common cause is analytical interference. CASE DESCRIPTION A 57-year-old male, presenting with fatigue and palpitations, had high TSH and normal FT4 values. Although there were no fitting clinical symptoms for these values, the patient was treated with levothyroxine assuming he had subclinical hypothyroidism. TSH levels remained high, however, whereas FT4 levels increased and the patient developed thyrotoxicosis. Eventually, it was discovered that the TSH was falsely elevated.CONCLUSION:
The patient turned out to have macro TSH, where TSH forms conjunctions with IgG into larger molecules. These conjugates cause a rarely occurring interference during laboratory analysis, resulting in a falsely increased TSH value.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thyroid Function Tests
/
Thyroxine
/
Immunoglobulin G
/
Thyrotropin
/
Hypothyroidism
Type of study:
Diagnostic_studies
Limits:
Humans
/
Male
/
Middle aged
Language:
Nl
Journal:
Ned Tijdschr Geneeskd
Year:
2020
Document type:
Article