ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)
The TRH test is a valuable diagnostic test in central hypothyroidism with low T4
Liv Norma Smith* 1 , Sara Ellegaard Christensen* 1 , Christian Rosendal 1 , Helga Angela Gulisano 2 , Kåre Ettrup 2 , Eigil H Nielsen 1 , Jesper Karmisholt 1 & Jakob Dal 1,3
1Aalborg University Hospital, Endocrinology, Aalborg, Denmark; 2Aalborg University Hospital, Neurosurgery, Aalborg, Denmark; 3Steno Diabetes Center North Jutland, Aalborg, Denmark
Objective: To evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.
Methods: Systematic evaluation of 368 TRH tests including measurements of TBG corrected thyroxine (T4corr), baseline TSH (TSH0) and fold and absolute TSH increase (TSHfold, TSHabsolute) in patients with pituitary disease.
Results: Patients diagnosed with CH (n=40) show comparable TSH0 (P-value 0.57) but lower T4corr (P-value 0.001) and TSHfold response (P-value 0.001) compared to patients without CH. In 54% (44 of 81 cases) of the patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and normalisation in T4corr (62 to 74nmol/l, P-value 0.001) was observed during the follow-up period (7.7 years, SD ±4.9). Two of the 44 patients (4.5%) were started on replacement therapy due to spontaneous deterioration. In patients with normal T4corr (n=258), no patients were diagnosed with CH based on the TRH test. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (P-value 0.006), although, symptoms were reported in most patients with pituitary disease. There were only mild adverse effects related to the TRH test except for one case (0.3%) with a pituitary apoplexy.
Conclusions: The TRH test is a useful and safe diagnostic test but could be reserved for patients with pituitary disease and a low T4. Approximately 50 % of patients with a low T4corr were considered to have normal pituitary thyroid function based on the TRH test results.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more