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[Determination of thyroid hormone].

Y Ochi¹, Y Kajita

¹Research Institute for Production Development, Nantan General Hospital.

Nihon Rinsho. Japanese Journal of Clinical Medicine

|September 14, 1999

Summary

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Thyroid hormone autoantibodies can interfere with thyroid function tests, leading to inaccurate free T4 and free T3 measurements in autoimmune thyroid disease. Simultaneous testing of free T4, free T3, and TSH is recommended for accurate thyroid function evaluation.

Area of Science:

Endocrinology
Clinical Chemistry
Immunology

Context:

Thyroid function tests, including total and free thyroxine (T4) and triiodothyronine (T3), are crucial for diagnosing thyroid disorders.
Autoimmune thyroid disease (AID) is often associated with thyroid hormone autoantibodies (THAb).
THAb can interfere with immunoassays, potentially leading to erroneous results.

Purpose:

To review the clinical utility of measuring T4, T3, reverse T3 (rT3), free T4 (FT4), and free T3 (FT3) in patients with AID.
To highlight the impact of THAb on FT4 and FT3 measurements in specific assays.
To discuss the discrepancy between laboratory findings and clinical presentation in patients with THAb.

Summary:

Autoantibodies against thyroid hormone (THAb) are common in patients with AID, particularly those with thyroglobulin autoantibodies (TgAb).

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Certain free thyroid hormone assays (e.g., Amerlite MAb FT4(FT3), Amerlex FT4(FT3)) may yield spuriously elevated FT4 or FT3 values in the presence of THAb (anti-T4 or anti-T3).

This interference can cause a discrepancy between laboratory results and a patient's clinical condition.

Impact:

Accurate thyroid function assessment in AID patients requires careful consideration of potential antibody interference.
Simultaneous measurement of FT4, FT3, and thyroid-stimulating hormone (TSH) is proposed as a reliable method to ascertain true thyroid status.
This approach helps to resolve discrepancies and ensure appropriate clinical management of autoimmune thyroid disease.