> ----------
> From: Chubb, Paul
> Sent: Thursday, 19 November 1998 9:08AM
> To: 'Craig Webster'
> Subject: RE: ? Thyrotoxicosis
>
> Have you considered anti-T4/T3 antibodies in the patients serum? You don't
> say what reference ranges you use but the FT4 and TT4 look discordant.You
> could try measuring the TT4 in the serum after treatment with PEG to
> precipitate Ig's (along with some control patient's serum similarly
> treated) to get an estimate of what the real T4 is.
>
> Paul Chubb
> Biochemistry,
> Fremantle Hospital.
> ----------
> From: Craig Webster[SMTP:[log in to unmask]]
> Reply To: Craig Webster
> Sent: Wednesday, 18 November 1998 6:43PM
> To: Acb-Clin-Chem-Gen
> Subject: ? Thyrotoxicosis
>
> We have a patient with some signs of thyrotoxicosis
>
> Lid retraction
> Weight loss
>
> However his thyroid function results are as follows (typical example)
>
> Total T4 70
> Free T4 19.5
> TSH < 0.03
>
> The TSH has been consistently suppressed during the last two to three
> months. Thinking this may be a T3 toxicosis we had a total T3 measured
> which
> came back 1t 1.50 (1.20 - 2.20).
>
> He also has strongly positive thyroid autoantibody titres.
>
> What's the next step ?
> Is this patient toxic ?
> Should we consider measuring LATS ABs ?
> What about a TRH test ?
>
>
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