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Royal Victoria Infirmary, Newcastle upon Tyne, UK
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Queen Elizabeth Hospital, Gateshead, UK
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age (60-70 years as moderately old, >70 years as older and >80-85 years as oldest old) is essential for the establishment of a diagnosis that should also consider ‘age-specific reference ranges for serum TSH' (recommendation 14) in older people. It has
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R3. For TPOAb-positive subjects' rates, reference values R1, R2 and R3 were 15% (3/20), 5% (1/20) and 20% (4/20), respectively. Table 1 Prevalence of thyroid hormone deficiency using three reference ranges Rates of positive TPOAb
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Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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hospital visit. Palpation revealed a painless, firm, 2.5 × 2.0-cm nodule on the right side of her neck. Thyroid function tests revealed a euthyroid status. Anti-thyroglobulin and anti-thyroperoxidase antibodies levels were high (1,490 IU/mL [reference range
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mU/l) and by age (<70 years categorised as ‘younger' and over 80 or 85 years as ‘oldest old'). It is stated that ‘age-specific local reference ranges for serum TSH should be considered in order to establish a diagnosis of SCH in older people' [ 1
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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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smoke. Abnormal laboratory tests included high free thyroxine and free triiodothyronine levels, a markedly low thyrotropin titer, thyroperoxidase antibody (TPOAb) level of >6,500 IU/mL (reference range, 0–100 IU/mL), and TRAb level of >40 IU/L (reference
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of 2017 were retrospectively included. Twenty-two patients were included (Table 1 ). There were 10 men (44%) and 12 women (56%) with a median age of 47 years (range 16–85 years). Graves’ disease (GD) was diagnosed in 13 patients (59%), 7 patients (32
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between 3.5 and 18% (depending on the reference range for serum TSH and the iodine intake of the population), and the main cause is the presence of TAI, most often diagnosed by increased levels of TPO-Abs [ 1 , 3 ]. In a pilot study by Andersen et al
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within the trimester-specific pregnancy reference range or, when not available, to the following reference range upper limits: first trimester, 2.5 mU/L; second trimester, 3.0 mU/L; third trimester, 3.5 mU/L ( 2 ). The more recent American Thyroid
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Department of Pathology, Albert Einstein School of Medicine, New York, N.Y., USA
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full Committee (C-STFT) and we authors are respectively chair, member and past president at IFCC. We have worked over the years towards the goal of standardization of free T 4 and TSH testing. Because, unlike free T 4 , there is no reference