Scribd
Upload
10 views14 pages

3 Patho Hyperthyroidism

The document outlines the biochemical analysis and diagnostic tests for hyperthyroidism, specifically focusing on Graves' disease, toxic multinodular goiter, and toxic adenoma. It details the diagnostic workflow, key biochemical tests, and the significance of antibody testing in diagnosing autoimmune thyroid disorders. The summary emphasizes the role of TSH, TRAb, and imaging techniques like RAIU scans in determining the underlying causes of hyperthyroidism.

Uploaded by

harshatc654
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
10 views14 pages

3 Patho Hyperthyroidism

The document outlines the biochemical analysis and diagnostic tests for hyperthyroidism, specifically focusing on Graves' disease, toxic multinodular goiter, and toxic adenoma. It details the diagnostic workflow, key biochemical tests, and the significance of antibody testing in diagnosing autoimmune thyroid disorders. The summary emphasizes the role of TSH, TRAb, and imaging techniques like RAIU scans in determining the underlying causes of hyperthyroidism.

Uploaded by

harshatc654
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 14

HYPERTHYROIDISM:

BIOCHEMICAL
ANALYSIS &
DIAGNOSTIC TESTS
Graves’ Disease, Toxic Multinodular Goiter (MNG),
and Toxic Adenoma

~ Roll no. 3
Diagnostic
Workflow
■ Clinical suspicion (symptoms + signs).
■ Initial Lab tests: TSH, FT4, FT3 → ↓TSH +
↑FT4/FT3 = Hyperthyroidism.
■ Further Antibody tests: TRAb (and consider TSI if
TRAb negative and high suspicion for Graves').
■ Imaging: Ultrasound + Radioactive Iodine Uptake
(RAIU) scan.
FT4 (Free Thyroxine)
TSH (Thyroid-Stimulating
Hormone) ■ Thyroxine (T4) is the main hormone produced by the
thyroid gland.
 TSH is produced by the pituitary gland in
■ In the blood, most T4 is bound to proteins, but a
the brain. small amount is "free" (FT4) and biologically active,
 Its primary role is to stimulate the thyroid meaning it's available to affect the body's tissues.

gland to produce and release thyroid ■ FT4 measurement reflects the amount of thyroid
hormone that is readily available for use by the body.
hormones (T4 and T3).
■ Normal ranges vary but are typically around 0.8 to
 TSH levels are a sensitive indicator of the 1.8 ng/dL.
thyroid gland's overall function.

 TSH is typically the first test ordered to FT3 (Free Triiodothyronine)


assess thyroid function.

 Normal ranges can vary slightly between ■ FT3 levels can be helpful in diagnosing
laboratories but are generally around 0.5 to hyperthyroidism, especially when FT4 levels are
normal (sometimes seen in early or mild
5.0 mIU/L for adults. hyperthyroidism or T3 toxicosis).
■ It can also be useful in evaluating the severity of
hyperthyroidism.
■ Normal ranges vary but are typically around 2.3 to
4.2 pg/mL.
Antibody Testing (TRAb, TSI, TPO)
 These blood tests look for specific antibodies that
the body's immune system may produce that
target the thyroid gland. These are often TSI (Thyroid Stimulating
associated with autoimmune thyroid disorders. Immunoglobulin)
 TRAb (TSH Receptor Antibodies):

 These antibodies bind to the TSH receptor on


■ As mentioned above, TSI is a type of TRAb
thyroid cells.
that specifically stimulates the TSH
There are two main types of TRAb: receptor, leading to increased thyroid
1. Stimulating TRAb (TSI - Thyroid Stimulating
hormone production and hyperthyroidism.
Immunoglobulin): These mimic the action of TSH, ■ The TSI test directly measures the presence
leading to overstimulation of the thyroid gland and
hyperthyroidism, as seen in Graves' disease.
and level of these stimulating antibodies.

2. Blocking TRAb: These block TSH from binding to


■ It is also highly specific for Graves' disease
its receptor, potentially leading to hypothyroidism. and can be particularly useful when TRAb
results are equivocal or when differentiation
 TRAb testing is primarily used in the diagnosis and
between different causes of
management of Graves' disease, a common cause
of hyperthyroidism.
hyperthyroidism is needed.
 It can also be measured in pregnant women with a
history of Graves' disease to assess the risk of
neonatal hyperthyroidism in the baby.
Key Biochemical
Tests
Graves’ Disease
(Autoimmune)
Biochemical Hallmarks:
■ TSH: <0.01 mIU/L (typically fully suppressed).
■ FT4/FT3: Markedly elevated.
■ TRAb/TSI: Positive (highly suggestive; consider TSI
if TRAb negative but clinical suspicion high).
Imaging:
■ RAIU scan: Diffuse increased uptake.
■ Ultrasound: Hypoechoic, hypervascular ("thyroid
inferno").
Toxic Multinodular
Goiter (MNG)
Biochemical Findings:
■ TSH: Low.
■ FT4/FT3: Mild to moderate elevation (T3-toxicosis is
common).
■ TRAb: Negative. Imaging:
■ RAIU scan: Patchy uptake ("hot" nodules with suppressed
background).
■ Ultrasound: Multiple nodules of varying sizes.
Toxic Thyroid
Adenoma
Biochemical Findings:
■ TSH: Suppressed.
■ FT4/FT3: Elevated (often T3-predominant).
■ TRAb: Negative. Imaging:
■ RAIU scan: Single area of increased uptake ("hot" nodule)
with suppressed surrounding thyroid tissue.
■ Ultrasound: Solitary nodule (often hypoechoic).
Differential Diagnosis
Summary
Summary & Key
Takeaways
■ TSH is typically the initial screening test and is suppressed
in hyperthyroidism.
■ Positive TRAb strongly suggests Graves’ disease, while
imaging (RAIU scan) is crucial for differentiating Toxic MNG
and Toxic Adenoma.
■ RAIU scan helps determine the underlying etiology (cause)
of hyperthyroidism based on the pattern of iodine uptake.
References
■ Guidelines: American Thyroid Association (ATA) guidelines
(e.g., 2016), Endocrine Society clinical practice guidelines.
■ Textbooks: Werner & Ingbar's The Thyroid; Greenspan's
Basic & Clinical Endocrinology.
Thank
you

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy