Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Diagnosis of Thyroid Dysfunction

Diagnosis of Thyroid Dysfunction Abstract To the Editor. —When mild thyroid dysfunction is to be detected, much depends on the criterion used for final diagnosis. In the article by dos Remedios et al published in the Archives (1980;140:1045-1049), "the final diagnosis was made clinically by physicians experienced in thyroid disease." If it were possible to come anywhere near 100% accuracy in such a way, laboratory tests would be of little use. (The parameter to be evaluated should, of course, not be included.) My doubts are strengthened by their finding that the free thyroxine index (FT4I) had 100% sensitivity, an opinion adopted in an editorial by Martin Nusynowitz, MD, in the same issue (p 1017). It is, however, well known that not only "subclinical" but also mild clinical hypothyroidism (responding to levothyroxine sodium therapy) can occur in the presence of a normal FT4I; serum thyroid-stimulating hormone (TSH) levels used to be elevated References 1. Evered DC, Ormston BJ, Smith PA, et al: Grades of hypothyroidism. Br Med J 1973;1:657-662.Crossref 2. Hollander CS: On the nature of the circulating thyroid hormone: Clinical studies of triiodothyronine and thyroxine in serum using gas chromatographic methods. Trans Assoc Am Physicians 1968;81:76-91. 3. Wiener JD: Value of the free triiodothyronine index in the diagnosis of hyperthyroidism. Eur J Nucl Med 1980;5:119-124.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Diagnosis of Thyroid Dysfunction

Archives of Internal Medicine , Volume 142 (3) – Mar 1, 1982

Diagnosis of Thyroid Dysfunction

Abstract

Abstract To the Editor. —When mild thyroid dysfunction is to be detected, much depends on the criterion used for final diagnosis. In the article by dos Remedios et al published in the Archives (1980;140:1045-1049), "the final diagnosis was made clinically by physicians experienced in thyroid disease." If it were possible to come anywhere near 100% accuracy in such a way, laboratory tests would be of little use. (The parameter to be evaluated should, of course, not be...
Loading next page...
 
/lp/american-medical-association/diagnosis-of-thyroid-dysfunction-lLYBf7WRuN
Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340160226047
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —When mild thyroid dysfunction is to be detected, much depends on the criterion used for final diagnosis. In the article by dos Remedios et al published in the Archives (1980;140:1045-1049), "the final diagnosis was made clinically by physicians experienced in thyroid disease." If it were possible to come anywhere near 100% accuracy in such a way, laboratory tests would be of little use. (The parameter to be evaluated should, of course, not be included.) My doubts are strengthened by their finding that the free thyroxine index (FT4I) had 100% sensitivity, an opinion adopted in an editorial by Martin Nusynowitz, MD, in the same issue (p 1017). It is, however, well known that not only "subclinical" but also mild clinical hypothyroidism (responding to levothyroxine sodium therapy) can occur in the presence of a normal FT4I; serum thyroid-stimulating hormone (TSH) levels used to be elevated References 1. Evered DC, Ormston BJ, Smith PA, et al: Grades of hypothyroidism. Br Med J 1973;1:657-662.Crossref 2. Hollander CS: On the nature of the circulating thyroid hormone: Clinical studies of triiodothyronine and thyroxine in serum using gas chromatographic methods. Trans Assoc Am Physicians 1968;81:76-91. 3. Wiener JD: Value of the free triiodothyronine index in the diagnosis of hyperthyroidism. Eur J Nucl Med 1980;5:119-124.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1982

References