Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Clin Endocrinol (Oxf). 2011 Jun;74(6):673-8. doi: 10.1111/j.1365-2265.2011.04023.x.
Interpretation of thyroid function tests (TFTs) is generally straightforward. However, in a minority of contexts the results of thyroid hormone and thyrotropin measurements either conflict with the clinical picture or form an unusual pattern. In many such cases, reassessment of the clinical context provides an explanation for the discrepant TFTs; in other instances, interference in one or other laboratory assays can be shown to account for divergent results; uncommonly, genetic defects in the hypothalamic-pituitary-thyroid axis are associated with anomalous TFTs. Failure to recognize these potential 'pitfalls' can lead to misdiagnosis and inappropriate management. Here, focusing particularly on the combination of hyperthyroxinaemia with nonsuppressed thyrotropin, we show how a structured approach to investigation can help make sense of atypical TFTs.
甲状腺功能测试（TFTs）的解读通常很直接。然而，在少数情况下，甲状腺激素和促甲状腺激素测量的结果与临床表现不符或呈现出不寻常的模式。在许多这种情况下，重新评估临床情况可以为不一致的 TFT 提供解释；在其他情况下，可以证明实验室检测的干扰可以解释结果的差异；罕见情况下，下丘脑-垂体-甲状腺轴的遗传缺陷与异常 TFT 有关。未能认识到这些潜在的“陷阱”可能导致误诊和不当治疗。在这里，我们特别关注甲状腺素血症伴未抑制的促甲状腺激素的组合，展示了如何通过结构化的方法来帮助理解非典型 TFT。
