Screening of Geriatric Patients for Thyroid Dysfunction with Thyrotropin-Releasing-Hormone Test, Sensitive Thyrotropin and Free Thyroxine Estimation
| Autor: | I. Szabolcs, J. Herrmann, Chr. Ploenes, Wolfdieter Bernard |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Male
Aging endocrine system medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Clinical Biochemistry Thyrotropin Thyroid Function Tests Hyperthyroidism Sensitivity and Specificity Biochemistry Thyroid function tests Endocrinology TRH stimulation test Hypothyroidism Predictive Value of Tests Internal medicine medicine Humans Mass Screening Euthyroid Thyrotropin-Releasing Hormone Mass screening Aged Triiodothyronine medicine.diagnostic_test business.industry Biochemistry (medical) Thyroid General Medicine Middle Aged Thyroid Diseases Thyroxine medicine.anatomical_structure Predictive value of tests Female Thyroid function business hormones hormone substitutes and hormone antagonists |
| Zdroj: | Hormone and Metabolic Research. 22:298-302 |
| ISSN: | 1439-4286 0018-5043 |
| DOI: | 10.1055/s-2007-1004906 |
| Popis: | Hospitalized geriatric patients (N = 354) from an iodine-deficient area were screened with sensitive thyrotropin (TSH), free and total thyroxine (FT4, T4) and total triiodothyronine (T3) to determine the occurrence rate of clinical and subclinical thyroid dysfunction. The diagnostic value of the tests was compared to each other and to that of the thyrotropin-releasing-hormone test (TRH-test) in order to find the optimal first line screening test in geriatric patients. Clinical hyperthyroidism was found in 13, subclinical hyperthyroidism in 10, overt hypothyroidism in 6 and subclinical hypothyroidism in 8 cases. 20.6% of the patients were euthyroid but had subnormal TSH response to TRH, as a sign of possible thyroid autonomy. The low occurrence rate of clinical thyroid disorders (4.8%) does not justify the screening of geriatric patients in general, but the high probability of thyroid autonomy makes reasonable the investigation of every geriatric patient before iodine administration. Suppressed basal TSH and high FT4 were found to be both sensitive and specific in diagnosing clinical hyperthyroidism, but the predictive value was insufficient; elevated T4 and T3 are specific, but not sensitive. Basal TSH is sensitive, specific and has a good predictive value in diagnosing euthyroidism, whereas normal T4, FT4 or T3 are not specific enough for euthyroidism. Basal TSH is better as a first line test of thyroid function than FT4. A normal basal TSH confirms euthyroidism by itself. Other tests (TRH test, T4, FT4, T3) are necessary to elucidate the clinical importance of a subnormal or suppressed basal TSH. |
| Databáze: | OpenAIRE |
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