PEMERIKSAAAN

LABORATORIUM KELAINAN
THYROID

Dr.Budi Dermawan Lubis, SpPK

Dr.Siti Hajar , M.Ked, SpPK
Diiodotyronine (DIT)
THYROID REVIEW
Thyroid secretion 100% T4 (85ug) and 20% T3
(8.5ug)
T4 peripheral deiodinase : - 40% T3 (26ug)
- 45% rT3 (29ug)
Carrier protein 99.9 T4, 99.7 T3: TBG, transthyretin
albumin, free T3 more active 3x than fT4
HYPERTHYROIDISM
Hypermetabolic condition due excessive thyroid
hormone (tyrotoxicosis)
Symptoms: weight loss, excessive sweating, difficult
concentrating, tachycardia, tremor, arrhythmia,
palpitation, insomnia, metabolic related.
Causes: primary, secondary / central, infected,
iodine induce, autoimmune (graves, Hashimoto),
postpartum tyroiditis, HCG induced, eutyroid
hyperthroxinemia: thyroid hormone resistance.
Subclinical hypertyroidism is important in patients
who over 60 due risk atrial fibrillation, osteoporosis
HYPOTHYROIDISM
Deficiency thyroid hormone secretion action, women
affected than men.
Symptoms: hair loss, weight gain, muscle weakness
somnolence, cretinism, myxedema
Causes: primary (iodine defeciency/endemic goiter),
post surgical removal, radiation, secondary,
hashimoto tyroiditis
Congenital hypothyroidism: 1:4000 live birth, birth
weight, epiphyses lack calcification, umbillical hernia
normal range neonate 1-3 days 12-22ug/dl, TSH
<20 mIU/l.
THYROID FUNGTION TEST
Indication:
1. Screening thyroid dysfunction
TSH normal : no futher testing (no symptom)
TSH high: fT4 TSH low: fT4, T3
2. Monitoring levotyroxine therapy,
Thyroid goiter TSH value <0.5mIU/l
3. Monitoring treatment hyperthyroidism
Based on fT4 T3 assay
 LABORATORY ASSAY
TSH
Immunoassay third generation with sensitivity
0.01mIU/L, normal range 0.5-5.0 mIU/L
Sample: serum or plasma, stable 5 days at 2-8 C
Peak at 2-4 am, lowest at 5-6pm.
Neonate 30 minute of life 25-160mIU/L adult
level at 7-10 days.
Thyroxine (T4)
TT4 immunoassay with blocking agent, normal
range 5-12.5 ug/dl
Sample: serum, stable 7 days at room temperature
fT4 normal range 0.7-2.0 ng/dl.
 LABORATORY ASSAY
Triiodothyronine (T3)
T3 normal range 0.9-2.46 nmol/L
Sample: serum, stable 24 hour at 2-8 C
Antithyroid Antibodies
Indication: chronic autoiimune thyroiditis
Anti-tyroglobulin (colloid Ag), anti-peroxidase
(microsomal Ag) both of this increase in hashimoto
thyroiditis
Thyroid stimulating immunoglobulin (TSI) graves
disease
Metabolic related: lipid profile, blood glucose,
alkaline phospatase