Elevation of free thyroxine measurements in patients without thyrotoxicosis.
Elevation of free thyroxine measurements in patients without thyrotoxicosis.
复制标题
无甲状腺毒症患者游离甲状腺素测量值升高。
DOI：
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
M. Sheppard
中科院分区：
文献类型：
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作者：
D. Wood;A. Zalin;W. Ratcliffe;M. Sheppard
最近发展的一步类似物测定技术来测量血清中游离甲状腺素，这意味着这种估计已被广泛用作甲状腺功能的第一线测试。然而，这些检测试剂盒会受到两种方式的体外干扰：家族性白蛋白异常性高甲状腺素血症中存在血清白蛋白变体，或存在循环甲状腺激素结合抗体。在这两种情况下，游离甲状腺素的结果都是假的高。这可能对患者的治疗产生严重影响，我们描述了10例患者，其中发现游离甲状腺素浓度过高导致诊断混乱，10例中有8例患者接受了不适当的抗甲状腺治疗。临床医生应该意识到这些技术问题，如果游离甲状腺素浓度的结果似乎不适合患者的临床状态，那么应该通过灵敏的免疫测定方法测量促甲状腺激素（TSH）。如果结果仍然令人困惑，则应寻找血清白蛋白或甲状腺激素结合抗体的变体。
The recent development of single step analogue assay techniques to measure free thyroxine in serum has meant that this estimation has become widely used as a first line test of thyroid function. However these assays are subject to in-vitro interference in two ways: where there is a variant serum albumin in familial dysalbuminaemic hyperthyroxinaemia, or where there are circulating thyroid hormone binding antibodies. In both these situations a spuriously high result for free thyroxine is obtained. This may have serious implications for patient management and we describe 10 patients in whom the finding of a misleadingly high free thyroxine concentration led to confusion in diagnosis and, in eight of the 10, to inappropriate antithyroid treatment. Clinicians should be aware of these technical problems and where a result for the free thyroxine concentration seems inappropriate to the patient's clinical state then measurement of thyrotrophin (TSH) by a sensitive immunometric method should be performed. If the results remain confusing the presence of a variant serum albumin or thyroid hormone binding antibodies should be sought.