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dosage that ensures maternal serum free thyroxine (FT4) levels at or moderately above the upper limit of the reference range is reported to be appropriate for fetal euthyroid status [ 2 ]. This recommendation was incorporated into the 2017 American
Department of Paediatrics, Southport and Ormskirk NHS Trust, Ormskirk, United Kingdom
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21 Mikołajczak A, Borszewska-Kornacka MK, Bokiniec R: Sonographic reference ranges for the thyroid gland in euthyroid term newborns. Am J Perinatol 2015; 32: 1257–1262. 10.1055/s-0035-1552937 26023906 22 Mahajan SD, Aalinkeel R, Singh S
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remission and relapse groups on admission. Reference ranges Remission group ( n = 39) Relapse group ( n = 40) P ALT (U/L) 5–40 25.00 (19.00–37.00) 28.50 (21.75–37.50) 0.50 AST (U/L) 5–40 25.00 (20
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/kg body weight, aiming for free thyroxine serum levels (fT4) prior to intake in the upper part of normal reference ranges ( 1 ). However, variability in TH absorption and metabolism, concomitant treatments and inaccurate interpretation of TSH levels still
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Heart Center Bad Neustadt, Clinic for Interventional Electrophysiology, Bad Neustadt an der Saale, Germany
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FT 4 outside their respective reference ranges; (7) an insufficient amount of preoperative serum aliquots, and (8) any antiarrhythmic medication pre- or perioperatively with the exception of β-blocking agents and verapamil. All patients had received
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been on L-T4 for a minimum of 4 months and had normal serum TSH values (local reference ranges were 0.1–5.5 or 0.2–6.0 mU/l) were compared with 535 age- and sex-matched controls [ 11 ]. Two questionnaires were used: the General Health Questionnaire (GHQ
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Graves' ophthalmopathy (GO) is characterized by swelling of orbital fat and extraocular muscles, but little attention has been given to differential involvement of fat and muscles. Advancements in imaging allow rather accurate measurements of orbital bony cavity volume (OV), fat volume (FV) and muscle volume (MV), and are the topics of this review. Ratios of FV/OV and MV/OV neutralize gender differences. In adult Caucasian controls, mean values ± SD of FV/OV are 0.56 ± 0.11 and of MV/OV are 0.15 ± 0.02. FV increases substantially and MV decreases slightly with advancing age, requiring age-specific reference ranges. In 95 consecutive untreated Caucasian GO patients, both FV and MV were within normal limits in 25%, increased FV but normal MV was present in 5%, normal FV but increased MV was detected in 61%, and both increased FV and MV was evident in 9%. Increased FV was associated with more proptosis and longer GO duration. Increased MV was associated with older age, more severe GO (more proptosis and diplopia, worse eye muscle ductions), higher TBII and current smoking. At the cellular and molecular level differential involvement of fat and muscles might be related to differences between fibroblast phenotypes and cytokine profiles in each compartment, to different orbital T cell subsets during the course of the disease and to peroxisome proliferator activator receptor-γ polymorphisms and modulation of 11β-hydroxysteroid dehydrogenase-1. Enlarged muscles are apparently a rather early phenomenon in GO, whereas increases in fat mass occur relatively late. Why a minor subset of GO patients presents with an increase of only fat remains poorly understood.
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outside but FT 4 and FT 3 within their respective reference ranges). Evered et al. [ 8 ] proposed 40 years ago to grade hypothyroidism along biochemical criteria. They distinguished between grade I (subclinical), grade II (mild), and grade III (overt
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Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki, Japan
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compression and marked lateral displacement of the trachea to the left as shown in Figure 1 a. Thyroid-associated data were almost normal: thyroid stimulating hormone, 0.429 μIU/mL (reference range, 0.400–6.000 μIU/mL); free tri-iodothyronine, 2.49 pg
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significant cervical lymph node enlargement and swollen tonsils. Thyroid palpation revealed a diffuse firm and painless goiter. In an additional blood analysis, an erythrocyte sedimentation rate of 8 mm/h (reference range, <15 mm/h) and C-reactive protein