[T.R.H. test in 93 cases of thyroid disease]

Area of Science:

• Endocrinology
• Thyroid physiology

Background:

• The thyrotropin-releasing hormone (TRH) stimulation test is a diagnostic tool for evaluating the hypothalamic-pituitary-thyroid axis.
• Understanding TSH response patterns is crucial for diagnosing various thyroid dysfunctions.

Purpose of the Study:

• To investigate the diagnostic utility of the TRH stimulation test in a cohort of 93 patients.
• To correlate TSH response patterns with specific thyroid conditions.

Main Methods:

• Intravenous administration of TRH to 93 patients.
• Monitoring of thyroid-stimulating hormone (TSH) levels post-injection.
• Analysis of TSH response in patients with thyrotoxicosis, toxic adenomas, primary hypothyroidism, and other thyroid pathologies.

Main Results:

• Negative or weak TSH responses were observed in thyrotoxicosis, toxic adenomas, and Multiple Endocrine Neoplasia, type 2 (MEN2).
• Normal TSH responses were noted in non-ablative hyperthyroid nodules.
• High and positive TSH responses were characteristic of primary hypothyroidism.
• Paradoxical responses, including delayed and elevated TSH, suggested pituitary TSH reserve in hypothalamo-pituitary disorders post-hypophysectomy.
• Positive responses in non-functional goiters and thyroiditis indicated a need for substitutive or suppressive therapy.

Conclusions:

• The TRH stimulation test effectively differentiates various thyroid conditions based on TSH response patterns.
• Results in hypothalamo-pituitary pathology can indicate residual pituitary function.
• The test guides therapeutic strategies, such as substitutive or suppressive therapy, for goiters and thyroiditis.