The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels

ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T...
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Autor*in:	Sara Ellegaard Christensen [verfasserIn] Liv Norma Smith [verfasserIn] Christian Alexander H. Rosendal [verfasserIn] Helga Angela Gulisano [verfasserIn] Kåre Schmidt Ettrup [verfasserIn] Peter Vestergaard [verfasserIn] Eigil Husted Nielsen [verfasserIn] Jesper Scott Karmisholt [verfasserIn] Jakob Dal [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism

Übergeordnetes Werk:	In: Frontiers in Endocrinology - Frontiers Media S.A., 2011, 14(2023)
Übergeordnetes Werk:	volume:14 ; year:2023

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fendo.2023.1226887

Katalog-ID:	DOAJ09179126X

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520			\|a ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results.
650		4	\|a thyrotropin-releasing hormone (TRH)
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author_variant	s e c sec l n s lns c a h r cahr h a g hag k s e kse p v pv p v pv e h n ehn j s k jsk j d jd j d jd
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allfields	10.3389/fendo.2023.1226887 doi (DE-627)DOAJ09179126X (DE-599)DOAJc7d5311346ec4c369db8722a9376d88d DE-627 ger DE-627 rakwb eng RC648-665 Sara Ellegaard Christensen verfasserin aut The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results. thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology Liv Norma Smith verfasserin aut Christian Alexander H. Rosendal verfasserin aut Helga Angela Gulisano verfasserin aut Kåre Schmidt Ettrup verfasserin aut Peter Vestergaard verfasserin aut Peter Vestergaard verfasserin aut Eigil Husted Nielsen verfasserin aut Jesper Scott Karmisholt verfasserin aut Jakob Dal verfasserin aut Jakob Dal verfasserin aut In Frontiers in Endocrinology Frontiers Media S.A., 2011 14(2023) (DE-627)645090948 (DE-600)2592084-4 16642392 nnns volume:14 year:2023 https://doi.org/10.3389/fendo.2023.1226887 kostenfrei https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d kostenfrei https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full kostenfrei https://doaj.org/toc/1664-2392 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023
spelling	10.3389/fendo.2023.1226887 doi (DE-627)DOAJ09179126X (DE-599)DOAJc7d5311346ec4c369db8722a9376d88d DE-627 ger DE-627 rakwb eng RC648-665 Sara Ellegaard Christensen verfasserin aut The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results. thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology Liv Norma Smith verfasserin aut Christian Alexander H. Rosendal verfasserin aut Helga Angela Gulisano verfasserin aut Kåre Schmidt Ettrup verfasserin aut Peter Vestergaard verfasserin aut Peter Vestergaard verfasserin aut Eigil Husted Nielsen verfasserin aut Jesper Scott Karmisholt verfasserin aut Jakob Dal verfasserin aut Jakob Dal verfasserin aut In Frontiers in Endocrinology Frontiers Media S.A., 2011 14(2023) (DE-627)645090948 (DE-600)2592084-4 16642392 nnns volume:14 year:2023 https://doi.org/10.3389/fendo.2023.1226887 kostenfrei https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d kostenfrei https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full kostenfrei https://doaj.org/toc/1664-2392 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023
allfields_unstemmed	10.3389/fendo.2023.1226887 doi (DE-627)DOAJ09179126X (DE-599)DOAJc7d5311346ec4c369db8722a9376d88d DE-627 ger DE-627 rakwb eng RC648-665 Sara Ellegaard Christensen verfasserin aut The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results. thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology Liv Norma Smith verfasserin aut Christian Alexander H. Rosendal verfasserin aut Helga Angela Gulisano verfasserin aut Kåre Schmidt Ettrup verfasserin aut Peter Vestergaard verfasserin aut Peter Vestergaard verfasserin aut Eigil Husted Nielsen verfasserin aut Jesper Scott Karmisholt verfasserin aut Jakob Dal verfasserin aut Jakob Dal verfasserin aut In Frontiers in Endocrinology Frontiers Media S.A., 2011 14(2023) (DE-627)645090948 (DE-600)2592084-4 16642392 nnns volume:14 year:2023 https://doi.org/10.3389/fendo.2023.1226887 kostenfrei https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d kostenfrei https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full kostenfrei https://doaj.org/toc/1664-2392 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023
allfieldsGer	10.3389/fendo.2023.1226887 doi (DE-627)DOAJ09179126X (DE-599)DOAJc7d5311346ec4c369db8722a9376d88d DE-627 ger DE-627 rakwb eng RC648-665 Sara Ellegaard Christensen verfasserin aut The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results. thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology Liv Norma Smith verfasserin aut Christian Alexander H. Rosendal verfasserin aut Helga Angela Gulisano verfasserin aut Kåre Schmidt Ettrup verfasserin aut Peter Vestergaard verfasserin aut Peter Vestergaard verfasserin aut Eigil Husted Nielsen verfasserin aut Jesper Scott Karmisholt verfasserin aut Jakob Dal verfasserin aut Jakob Dal verfasserin aut In Frontiers in Endocrinology Frontiers Media S.A., 2011 14(2023) (DE-627)645090948 (DE-600)2592084-4 16642392 nnns volume:14 year:2023 https://doi.org/10.3389/fendo.2023.1226887 kostenfrei https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d kostenfrei https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full kostenfrei https://doaj.org/toc/1664-2392 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023
allfieldsSound	10.3389/fendo.2023.1226887 doi (DE-627)DOAJ09179126X (DE-599)DOAJc7d5311346ec4c369db8722a9376d88d DE-627 ger DE-627 rakwb eng RC648-665 Sara Ellegaard Christensen verfasserin aut The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results. thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology Liv Norma Smith verfasserin aut Christian Alexander H. Rosendal verfasserin aut Helga Angela Gulisano verfasserin aut Kåre Schmidt Ettrup verfasserin aut Peter Vestergaard verfasserin aut Peter Vestergaard verfasserin aut Eigil Husted Nielsen verfasserin aut Jesper Scott Karmisholt verfasserin aut Jakob Dal verfasserin aut Jakob Dal verfasserin aut In Frontiers in Endocrinology Frontiers Media S.A., 2011 14(2023) (DE-627)645090948 (DE-600)2592084-4 16642392 nnns volume:14 year:2023 https://doi.org/10.3389/fendo.2023.1226887 kostenfrei https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d kostenfrei https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full kostenfrei https://doaj.org/toc/1664-2392 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 14 2023
language	English
source	In Frontiers in Endocrinology 14(2023) volume:14 year:2023
sourceStr	In Frontiers in Endocrinology 14(2023) volume:14 year:2023
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism Diseases of the endocrine glands. Clinical endocrinology
isfreeaccess_bool	true
container_title	Frontiers in Endocrinology
authorswithroles_txt_mv	Sara Ellegaard Christensen @@aut@@ Liv Norma Smith @@aut@@ Christian Alexander H. Rosendal @@aut@@ Helga Angela Gulisano @@aut@@ Kåre Schmidt Ettrup @@aut@@ Peter Vestergaard @@aut@@ Eigil Husted Nielsen @@aut@@ Jesper Scott Karmisholt @@aut@@ Jakob Dal @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	645090948
id	DOAJ09179126X
language_de	englisch
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In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value &lt;0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">thyrotropin-releasing hormone (TRH)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">pituitary disease</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">central hypothyroidism</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">TRH test</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">hypopituitarism</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Diseases of the endocrine glands. 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callnumber-first	R - Medicine
author	Sara Ellegaard Christensen
spellingShingle	Sara Ellegaard Christensen misc RC648-665 misc thyrotropin-releasing hormone (TRH) misc pituitary disease misc central hypothyroidism misc TRH test misc hypopituitarism misc Diseases of the endocrine glands. Clinical endocrinology The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
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topic_title	RC648-665 The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels thyrotropin-releasing hormone (TRH) pituitary disease central hypothyroidism TRH test hypopituitarism
topic	misc RC648-665 misc thyrotropin-releasing hormone (TRH) misc pituitary disease misc central hypothyroidism misc TRH test misc hypopituitarism misc Diseases of the endocrine glands. Clinical endocrinology
topic_unstemmed	misc RC648-665 misc thyrotropin-releasing hormone (TRH) misc pituitary disease misc central hypothyroidism misc TRH test misc hypopituitarism misc Diseases of the endocrine glands. Clinical endocrinology
topic_browse	misc RC648-665 misc thyrotropin-releasing hormone (TRH) misc pituitary disease misc central hypothyroidism misc TRH test misc hypopituitarism misc Diseases of the endocrine glands. Clinical endocrinology
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title	The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
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title_full	The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
author_sort	Sara Ellegaard Christensen
journal	Frontiers in Endocrinology
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author_browse	Sara Ellegaard Christensen Liv Norma Smith Christian Alexander H. Rosendal Helga Angela Gulisano Kåre Schmidt Ettrup Peter Vestergaard Eigil Husted Nielsen Jesper Scott Karmisholt Jakob Dal
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author-letter	Sara Ellegaard Christensen
doi_str_mv	10.3389/fendo.2023.1226887
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title_sort	trh test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low t4 levels
callnumber	RC648-665
title_auth	The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
abstract	ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results.
abstractGer	ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results.
abstract_unstemmed	ObjectiveTo evaluate the value of the thyrotropin-releasing hormone (TRH) test in the diagnosis of central hypothyroidism (CH) in patients with pituitary disease.MethodsSystematic evaluation of 359 TRH tests in patients with pituitary disease including measurements of thyroxine (T4), TBG-corrected T4 (T4corr), baseline TSH (TSH0) and relative or absolute TSH increase (TSHfold, TSHabsolute).ResultsPatients diagnosed with CH (n=39) show comparable TSH0 (p-value 0.824) but lower T4corr (p-value <0.001) and lower TSH increase (p-value <0.001) compared to patients without CH. In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value <0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). There were only mild and reversible adverse effects related to the TRH test except for possibly one case (0.3%) experiencing a pituitary apoplexy.ConclusionThe TRH test could be reserved to patients with pituitary disease, low T4 levels without convincing signs of CH. Approximately 50% of patients with a slightly decreased T4 were considered to have normal pituitary thyroid function based on the TRH test results.
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title_short	The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels
url	https://doi.org/10.3389/fendo.2023.1226887 https://doaj.org/article/c7d5311346ec4c369db8722a9376d88d https://www.frontiersin.org/articles/10.3389/fendo.2023.1226887/full https://doaj.org/toc/1664-2392
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author2	Liv Norma Smith Christian Alexander H. Rosendal Helga Angela Gulisano Kåre Schmidt Ettrup Peter Vestergaard Eigil Husted Nielsen Jesper Scott Karmisholt Jakob Dal
author2Str	Liv Norma Smith Christian Alexander H. Rosendal Helga Angela Gulisano Kåre Schmidt Ettrup Peter Vestergaard Eigil Husted Nielsen Jesper Scott Karmisholt Jakob Dal
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up_date	2024-07-03T22:18:00.730Z
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In 54% (42 of 78 cases) of patients with low T4corr, the CH diagnosis was rejected based on a high TSHfold. In these cases, a spontaneous increase and mean normalization in T4corr (from 62 to 73 nmol/L, p-value &lt;0.001) was observed during the follow-up period (7.6 ± 5.0 years). Three of the 42 patients (7%) were started on replacement therapy due to spontaneous deterioration of thyroid function after 2.8 years. Patients diagnosed with CH reported significantly more symptoms of hypothyroidism (p-value 0.005), although, symptoms were reported in most patients with pituitary disease. The TRH test did not provide clinical relevant information in patients with normal T4 or patients awaiting pituitary surgery (78%, 281 of 359). 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