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Maik Pietzner Institute of Clinical Chemistry and Laboratory Medicine, Berlin, Germany

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Georg Homuth Interfaculty Institute for Genetics and Functional Genomics, Berlin, Germany

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Kathrin Budde Institute of Clinical Chemistry and Laboratory Medicine, Berlin, Germany

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Ina Lehmphul Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

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Uwe Völker Interfaculty Institute for Genetics and Functional Genomics, Berlin, Germany

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Henry Völzke Institute for Community Medicine, University Medicine Greifswald, Ernst Moritz Arndt University, Greifswald, Germany

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Matthias Nauck Institute of Clinical Chemistry and Laboratory Medicine, Berlin, Germany

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Josef Köhrle Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

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Nele Friedrich Institute of Clinical Chemistry and Laboratory Medicine, Berlin, Germany

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), use of thyroid medications (ATC code H03A or H03B, n = 98) or serum thyrotropin (TSH) levels outside the reference range (0.30-3.59 mU/l, n = 51). Ultimately, 715 subjects, aged between 21 and 81 years, were included in the present analysis

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Victor J M Pop Department of Medical Psychology, Tilburg University, The Netherlands

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Johannes G Krabbe Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands

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Maarten Broeren Department of Clinical Chemistry, Maxima Medical Centre, Veldhoven, The Netherlands

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Wilmar Wiersinga Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands

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Margaret P Rayman Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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reference ranges of TSH and FT4 during pregnancy in TPO-Ab negative women excluding women on thyroid hormone medication, using the 2.5th and 97.5th percentile to define the lower and upper limit of normal thyroid function. IH was defined as an FT4

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Birgitta Johansson Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Mats Holmberg ANOVA, Karolinska University Hospital, Norra Stationsgatan 69, Stockholm, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden

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Simon Skau Department of Clinical Neuroscience, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
Department of Pedagogical, Curricular and Professional Studies, Faculty of Education, University of Gothenburg, Gothenburg, Sweden

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Helge Malmgren Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

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Helena Filipsson Nyström Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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was 4.0 months. Inclusion criteria were as follows: (i) premenopausal, (ii) free thyroxine ≥ 50 pmol/L (reference range 12–22) and/or total triiodothyronine ≥ 6.0 pmol/L (reference range 1.3–3.1), and (iii) positive thyroid-stimulating hormone

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Ilaria Muller Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Clinical Sciences and Community Health, University of Milan, Italy

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Anita Daturi Department of Clinical Sciences and Community Health, University of Milan, Italy

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Matteo Varallo Department of Clinical Sciences and Community Health, University of Milan, Italy

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Tiziana E Re Internal Medicine - High Intensity of Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Davide Dazzi Casa di Cura Val Parma SRL, Langhirano (Parmigiano: Langhiràn), Italy

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Sara Maioli Department of Clinical Sciences and Community Health, University of Milan, Italy

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Erica Crivicich Department of Clinical Sciences and Community Health, University of Milan, Italy

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Francesco Di Marco Department of Clinical Sciences and Community Health, University of Milan, Italy

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Virgilio Longari Nuclear Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Beatrice Dazzi Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Massimo Castellani Nuclear Medicine Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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Giovanna Mantovani Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Clinical Sciences and Community Health, University of Milan, Italy

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Maura Arosio Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Clinical Sciences and Community Health, University of Milan, Italy

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Mario Salvi Endocrinology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

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thyroglobulin (TgAb) were measured by enzyme-linked immunosorbent assay (ThermoFisher) and autoantibodies to TSH receptor (TRAb) by Immulite 2000/2000 XPi TSI (Siemens). Normal reference ranges were < 35 KIU/L (TPOAb), < 60 KIU/L (TgAb) and < 0.55 KIU/L (TRAb

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Hideyuki Imai Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Natsuko Watanabe Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Rei Hirose Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Masakazu Koshibu Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Masahiro Ichikawa Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Akiko Sankoda Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Shigenori Hiruma Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Nami Suzuki Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Masako Matsumoto Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Miho Fukushita Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Ai Yoshihara Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Jaeduk Yoshimura Noh Department of Internal Medicine, Ito Hospital, Tokyo, Japan

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Kiminori Sugino Department of Surgery, Ito Hospital, Tokyo, Japan

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Koichi Ito Department of Surgery, Ito Hospital, Tokyo, Japan

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-CT kits (Cosmic, Tokyo, Japan). Levels are expressed in terms of the inhibition index of TRP binding and are presented as percentages. The reference range was defined by the manufacturer as ≤10%. Anti-thyroglobulin antibodies (TgAb) and anti

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María de los Ángeles Garayalde Gamboa Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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Melina Saban Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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Marina Ines Curriá Service of Endocrinology, Metabolism, Nutrition, and Diabetes, Buenos Aires British Hospital, Buenos Aires, Argentina

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(he had lost 12 kg within 3 months) presenting the following laboratory values: TSH >100 mIU/L (reference range [RR]: 0.35–4.94), free thyroxine (FT4) <5 pmol/L (RR: 9–19), total thyroxine (TT4) 1.8 μg/dL (RR: 4.9–11.7), and total triiodothyronine (TT3

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Sara Donato Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal

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Helder Simões Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal

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Valeriano Leite Endocrinology Department, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal
NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
Unidade de Investigação em Patobiologia Molecular, Instituto Português de Oncologia de Lisboa, Lisbon, Portugal

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12 × 7 mm in the oophorectomy bed (shown in Fig.  1 ). She got pregnant at the age of 37, and during pregnancy, Tg increased further to 21.5 ng/mL at the 20th week. TSH was kept <0.1 mUI/L (reference range: 0.30–4.20 mUI/L) during pregnancy in

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Camilla Bøgelund Larsen Department of Endocrinology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Eva Rabing Brix Petersen Department of Clinical Biochemistry and Immunology, Hospital of Southern Jutland, Aabenraa, Denmark

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Martin Overgaard Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark

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Steen Joop Bonnema Department of Endocrinology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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. Further analyses included search for a mutation in the TSH-receptor-gene and the TSH-beta-gene, also with negative results [ 7 ]. Plasma TSH in both parents was within the reference range. Fig. 2. a Serial dilution analyses were made with two

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Kaoru Kobayashi Kuma Hospital, Kobe City, Hyogo, Japan

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Mitsuyoshi Hirokawa Kuma Hospital, Kobe City, Hyogo, Japan

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Tomonori Yabuta Kuma Hospital, Kobe City, Hyogo, Japan

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Mitsuhiro Fukushima Kuma Hospital, Kobe City, Hyogo, Japan

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Minoru Kihara Kuma Hospital, Kobe City, Hyogo, Japan

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Yuuki Takamura Kuma Hospital, Kobe City, Hyogo, Japan

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Yasuhiro Ito Kuma Hospital, Kobe City, Hyogo, Japan

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Akihiro Miya Kuma Hospital, Kobe City, Hyogo, Japan

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Nobuyuki Amino Kuma Hospital, Kobe City, Hyogo, Japan

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Akira Miyauchi Kuma Hospital, Kobe City, Hyogo, Japan

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ultrasonography without performing cytological examination at another hospital. The serum concentration of thyroid-stimulating hormone was 2.4 μIU/ml (reference range 0.3-5.0), free thyroxine 0.98 ng/dl (0.70-1.60), and thyroglobulin 80.4 ng/ml (<35

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Mahdi Kamoun Endocrinology and Metabolism Department

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Michèle d'Herbomez Department of Nuclear Medicine, Lille University Hospital, Lille

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Christine Lemaire Department of Endocrinology, Regional Hospital of Béthune, Béthune

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Armelle Fayard Endocrinology and Metabolism Department

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Rachel Desailloud Endocrinology and Metabolism Department, Amiens University Hospital, Amiens, France

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Damien Huglo Department of Nuclear Medicine, Lille University Hospital, Lille

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Jean-Louis Wemeau Endocrinology and Metabolism Department

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TSH values, being persistently within the reference range despite use of different TSH assays, made this diagnosis less likely. Antibody interference in thyroid hormone immunoassays may result either from autoantibodies or heterophile antibodies [ 10

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