甲状腺激素自身抗体导致甲状腺功能检查结果不一致时的诊断困境
Diagnostic Dilemma in Discordant Thyroid Function Tests Due to Thyroid Hormone Autoantibodies.
作者信息
Srichomkwun Panudda, Scherberg Neal H, Jakšić Jasminka, Refetoff Samuel
机构信息
Department of Medicine, The University of Chicago, Chicago, Illinois.
Department of Pediatrics, General Hospital, Sibenik, Croatia.
出版信息
AACE Clin Case Rep. 2017 Winter;3(1):e22-e25. doi: 10.4158/EP151142.CR.
OBJECTIVE
Assay interference could be the cause of abnormal thyroid function tests. Early recognition prevents inappropriate patient management. The objective of this report is to present a case with discordant thyroid function tests in different thyroid assay platforms due to thyroid autoantibodies.
METHODS
We present a case her family, laboratory data and methods that investigate immunoassay interference.
RESULTS
A 21-year-old woman with autoimmune thyroid disease was treated for hypothyroidism with levothyroxine and noted to have elevated total and free thyroxine, free triiodothyronine but normal thyroid-stimulating hormone. Repeat thyroid function tests using different platforms revealed discrepant results. Further investigation showed that the patient had positive thyroid hormone autoantibodies (THAAbs).
CONCLUSION
We demonstrates abnormal thyroid function tests caused by THAAbs. The latter were the cause of interference with assays resulting in discrepant test results inconsistent with the clinical presentation. Early recognition would prevent inappropriate patient management.
目的
分析干扰可能是甲状腺功能检查异常的原因。早期识别可避免对患者进行不恰当的治疗。本报告的目的是呈现一例因甲状腺自身抗体导致不同甲状腺检测平台上甲状腺功能检查结果不一致的病例。
方法
我们呈现了该病例及其家族情况、实验室数据以及调查免疫分析干扰的方法。
结果
一名患有自身免疫性甲状腺疾病的21岁女性因甲状腺功能减退接受左甲状腺素治疗，发现总甲状腺素和游离甲状腺素、游离三碘甲状腺原氨酸升高，但促甲状腺激素正常。使用不同平台重复进行甲状腺功能检查显示结果存在差异。进一步调查表明该患者甲状腺激素自身抗体（THAAbs）呈阳性。
结论
我们证明了THAAbs可导致甲状腺功能检查异常。THAAbs是干扰检测的原因，导致检测结果与临床表现不一致。早期识别可避免对患者进行不恰当的治疗。
Zotero 插件