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Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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Changing Immunochemistry Platforms: Thyroid Function Test Comparison and Reference Intervals Based on Clinical Needs.

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|August 29, 2022
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Summary

New Siemens Atellica assays for thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) showed good correlation but a positive bias compared to Abbott Architect. Established reference intervals (RIs) were adjusted for clinical use.

Keywords:
Atellica®immunoassayindirect methodreference intervalthyroid hormone

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Area of Science:

  • Clinical Chemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Thyroid dysfunction diagnosis relies on thyroid stimulating hormone (TSH), free thyroxine (FT4), and free tri-iodothyronine (FT3) testing against established reference intervals (RIs).
  • Transitioning immunoassay platforms, such as from Abbott Architect to Siemens Atellica, necessitates establishing new RIs to ensure accurate patient results.
  • Accurate RIs are crucial for correct diagnosis and management of thyroid disorders.

Approach:

  • Verified Siemens Atellica thyroid hormone immunoassays against Abbott Architect assays using real-life patient data from a laboratory information system (LIS).
  • Employed the indirect method with a single result per patient to establish new RIs for TSH, FT4, and FT3 on the Atellica platform.
  • Validated the reliability of using LIS data to identify results from presumably healthy individuals for RI determination.

Key Points:

  • Siemens Atellica and Abbott Architect assays demonstrated good correlation, but Atellica exhibited a positive bias ranging from 13% to 53%, most pronounced for FT4.
  • The initial 95% RIs for Atellica were determined as 0.4-3.8 mU/L for TSH, 0.9-1.6 ng/dL for FT4, and 227-416 pg/dL for FT3.
  • Assay variations for Atellica were within acceptable limits (≤4%).

Conclusions:

  • Successfully established and verified thyroid hormone RIs for the Siemens Atellica platform using the indirect method, a first-time achievement.
  • The developed model reliably selected healthy patient data from LIS for RI establishment.
  • Close collaboration and critical review of the new RIs with local endocrinologists are essential for optimal clinical application.