Falsely Elevated Thyroid Stimulating Hormone in Two Cases Requiring Special Follow-up

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dc.authoridYanik colak, Serpil/0000-0003-3602-7697
dc.authoridCelik, Mehmet/0000-0001-7364-370X
dc.authoridANDAC, BURAK/0000-0001-8680-0313
dc.authorwosidCelik, Mehmet/HKO-3681-2023
dc.contributor.authorColak, Serpil Yanik
dc.contributor.authorOzgun, Eray
dc.contributor.authorAndac, Burak
dc.contributor.authorOkur, Mine
dc.contributor.authorBulbul, Buket Yilmaz
dc.contributor.authorCelik, Mehmet
dc.date.accessioned2024-06-12T11:07:58Z
dc.date.available2024-06-12T11:07:58Z
dc.date.issued2023
dc.departmentTrakya Üniversitesien_US
dc.description.abstractInappropriate thyroid stimulating hormone (TSH) refers to an elevation in TSH levels that does not match the clinical findings and free T3 and free T4 levels. Several conditions can cause this, such as pituitary tumors that produce TSH, resistance to thyroid hormones, macro-TSH, and antibody interference. Macro-TSH is a condition that causes TSH to be measured high in the blood for a long time by forming a complex with immunoglobulins, mostly IgG. However, patients are clinically euthyroid because macro-TSH is not a bioactive complex. It is essential to exclude the diagnosis of falsely elevated TSH to protect patients from unnecessary or high -dose levothyroxine therapy. In our first case, we presented a patient in whom subclinical hypothyroidism was detected during in vitro fertilization treatment, and levothyroxine was started. The other case was an operated papillary thyroid cancer patient. In both cases, although the dose of levothyroxine was increased, insufficient TSH response to increased fT4/fT3 levels suggested inappropriate TSH elevation. The polyethylene glycol (PEG) precipitation method was used to detect the assay variability. TSH recovery after PEG was 0.96016 and 21016, respectively, supporting the diagnosis of macro-TSH. In both cases, detecting Macro-TSH was crucial in preventing thyrotoxicosis caused by excessive levothyroxine dosage. In addition, delay in treatment for infertility was prevented in the first case.en_US
dc.identifier.doi10.4274/nkmj.galenos.2023.19870
dc.identifier.endpage399en_US
dc.identifier.issn2587-0262
dc.identifier.issue4en_US
dc.identifier.startpage395en_US
dc.identifier.urihttps://doi.org/10.4274/nkmj.galenos.2023.19870
dc.identifier.urihttps://hdl.handle.net/20.500.14551/22258
dc.identifier.volume11en_US
dc.identifier.wosWOS:001186688600010en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.language.isoenen_US
dc.publisherGalenos Publ Houseen_US
dc.relation.ispartofNamik Kemal Medical Journalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectMacro-TSHen_US
dc.subjectSubclinical Hypothyroidismen_US
dc.subjectPolyethylene Glycol Precipitation Methoden_US
dc.subjectInterferenceen_US
dc.subjectHeterophilic Antibodyen_US
dc.subjectAntibody Interferenceen_US
dc.subjectMacro-Thyrotropinen_US
dc.subjectTshen_US
dc.titleFalsely Elevated Thyroid Stimulating Hormone in Two Cases Requiring Special Follow-upen_US
dc.typeArticleen_US

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