Abstract
Immunoassays used to assess thyroid function are vulnerable to different types of interference that may affect clinical decision-making. We report the case of a 37-year-old woman who developed iatrogenic hypothyroidism after having received radioiode therapy who visited our hospital for her annual checkup. The patient was asymptomatic, without signs suggestive of thyroid disease. However, laboratory analysis proved otherwise: thyrotropin (TSH) 7.75mU/L, thyroxine (FT4) >7.7ng/dL. The inconsistency between her clinical symptoms and the biochemistry data raised the possibility of a methodological interference. A thorough evaluation of the main causes of interference was conducted in the laboratory to exclude the presence of interference in TSH and FT4. Finally, different interfering agents were identified, which affected free thyroid hormone and TSH determination.
Highlights
The parameters used to assess thyroid function include thyrotropin (TSH), free thyroxine (FT4) and free triiodothyronine (FT3)
Immunoassays used to assess thyroid function are vulnerable to different types of interference that may affect clinical decision-making
Case presentation: We report the case of a 37-year-old woman who developed iatrogenic hypothyroidism after having received radioiode therapy who visited our hospital for her annual checkup
Summary
The parameters used to assess thyroid function include thyrotropin (TSH), free thyroxine (FT4) and free triiodothyronine (FT3). The relationship between TSH and thyroid hormones does not fit with the expected feedback mechanisms This may be due both to a pathophysiological process and to methodological interference. The presence of interferences was assessed using the following protocol [8]: 1) Results were confirmed by repeating the test in the same sample using the same method to discard a problem. 2) Measurements were repeated in a new sample from the same patient, which yielded the same results. 3) Measurements were repeated using a different method For this purpose, (in this regard) the sample was sent to other laboratories where a different analyzer was used.
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