Affordable Access

The diagnostic challenge of euthyroid hyperthyroxinemia.

Authors
  • Stockigt, J R
  • Barlow, J W
Type
Published Article
Journal
Australian and New Zealand journal of medicine
Publication Date
Apr 01, 1985
Volume
15
Issue
2
Pages
277–284
Identifiers
PMID: 3927889
Source
Medline
License
Unknown

Abstract

In euthyroid hyperthyroxinemia high levels of thyroxine (T4) may be either transient or persistent, associated with high, normal, or low levels of tri-iodothyronine (T3). Euthyroid hyperthyroxinemia may occur: as a response to abnormal plasma binding (thyroxine binding globulin, albumin, prealbumin, or autoantibodies), because of hormone resistance, after exposure to drugs such as amiodarone, cholecystographic contrast agents, or propranolol, during acute psychiatric illness or stress, and in hyperemesis gravidarum. In some instances the cause of persistent hyperthyroxinemia still remains obscure. No single investigation (including free hormone measurement and the response of thyrotropin to its releasing hormone) can distinguish all of these entities from true hyperthyroidism. Hence, re-evaluation in cases of diagnostic uncertainty should begin with clinical reassessment. Techniques are now available to identify easily some causes of euthyroid hyperthyroxinemia, allowing us to recognise patients and relatives who are at risk of inappropriate treatment. Because measurement of serum T4 remains the key investigation for diagnosis of thyroid dysfunction, it is important to appreciate the full range of conditions that compromise its specificity.

Report this publication

Statistics

Seen <100 times