Abnormal value for serum TSH with normal values for peripheral thyroid hormones.

[Argirios Argiriou]

14/07/2015
Läkartidningen.


Summary

During investigation of thyroid function it is not unusual to find an abnormal value for serum TSH with normal values for peripheral thyroid hormones. However this does not always reflect a functional thyroid disturbance. Analytical interference of TSH measurement is an example when antibodies in the patient’s serum interfere with the measurement of TSH giving a false high serum TSH value. Another unusual case is macro-TSH that represents a macromolecular complex between TSH and immunoglobulin that decreases its renal clearance giving a spuriously elevated serum TSH value. By discussing a patient with macro-TSH we would like to remind the clinicians about the importance to have a direct communication with the clinical chemistry department especially when a patient without any clinical signs for thyroid disease has an elevated isolated TSH.

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