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We recently had an elderly patient admitted to hospital in a moribund state. The patient was admitted to ITU and the SpR made a clinical diagnosis of Myxoedema Coma. The patient was on Carbimazole for 'thyrotoxicosis'. I was asked for urgent TFTs. As a provisional clinical diagnosis has already been made and treament initiated, I could not see the merit of urgent TFT. They were done the day after and confirmed hypothyroidism. Sometimes it is difficult to know the right approach to these situations. Such requests are likely to be infrequent and if, in my own view, a valid result could be provided with no major extra effort then they should be done. After all it is usually possible to accomodate such request if this was 'during normal working hours' without too much trouble. The important thing is, of course, that treatment should not be withheld pending the laborataory results being available. After all TFTs where not as easily available in the days when Richard Asher described the condition. =========================================== Ahmed Waise FRCP FRCPath Cosultant Chemcial Pathologist Friarage hospital, Northallerton, North Yorks DL6 1JG Tel 01609 763030 Fax 01609 764632 EMail: [log in to unmask] ========================================== > ---------- > From: > [log in to unmask][SMTP:[log in to unmask] > s.uk] > Reply To: [log in to unmask] > Sent: 21 June 1999 11:01 > To: [log in to unmask] > Subject: Hypothermia, are TFT's urgent? > > An unconscious hypothermic (core temp 31'C) 28y old women was > recently > admitted through casualty at 6.0 PM on a Saturday evening. > > Urgent investigations were requested (U&E, Glucose, Amylase, CK, > LFT > Salicylate & paracetamol & thyroid function tests). > > The casualty consultant insisted that the TFT's were done > urgently > that evening, as myxoedema could not be excluded as a > contributing > cause to her hypothermia. Was the urgency of this request > reasonable, > or could the TFT's have been left until Sunday morning or even > Monday? > > I would be interested to know how other laboratories would > approach > this scenario. We did the TFT's that evening. > > John Tovey > Nevill Hall Hospital > Abergavenny > email: [log in to unmask] > >