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  • Reference range x
  • Hyperthyroidism and thyrotoxicosis x
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Thea Riis Department of Endocrinology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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

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Thomas Heiberg Brix Department of Endocrinology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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Lars Folkestad Department of Endocrinology, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

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.8 2.9 2.1  >3 3.2 1.9 2.8 2.1 2.4 1.5 CCI, Charlson Comorbidity Index; HT, hyperthyroid; HTP, hyperthyroid population; IQR, interquartile range; n , total number of events; RP, reference population. Risk of

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Yiyun Cui Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Jinlong Chen Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Rui Guo Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Ruize Yang Department of Public Health, Children's Hospital of Nanjing Medical University, Nanjing, China

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Dandan Chen Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Wei Gu Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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Francis Manyori Bigambo School of Public Health, Nanjing Medical University, Nanjing, China

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Xu Wang Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, China

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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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Claire L Wood Department of Paediatric Endocrinology, Great North Children’s Hospital, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, UK

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Niamh Morrison Department of Paediatric Endocrinology, Great North Children’s Hospital, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Michael Cole Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, UK

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Malcolm Donaldson Department of Child Health, University of Glasgow School of Medicine, Glasgow, UK

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David B Dunger Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
Wellcome Trust-MRC Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK

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Ruth Wood Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK

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Simon H S Pearce Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, UK
Department of Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

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Timothy D Cheetham Department of Paediatric Endocrinology, Great North Children’s Hospital, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, UK

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on behalf of the British Society for Paediatric Endocrinology and Diabetes (BSPED)

thyroxine (FT4) response in the two groups; specifically the time taken for TSH levels to rise or for FT4 concentrations to fall within the local reference ranges. Free tri-iodothyroinine (FT3) concentrations were not measured routinely in this trial

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Alessandro Brancatella Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Laura Pierotti Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Nicola Viola Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Isabella Lupi Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Lucia Montanelli Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Chiara Cremolini Oncology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

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Paolo Piaggi Department of Information Engineering, University of Pisa, Pisa, Italy

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Antonio Chella Pneumology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy

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Andrea Antonuzzo Oncology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy

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Daniele Sgrò Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Lucia Antonangeli Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Chiara Sardella Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Sandra Brogioni Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Claudio Marcocci Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Ferruccio Santini Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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Francesco Latrofa Endocrinology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy

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). Reference ranges were 8–18 ng/dL for FT4, 2.5–5.0 ng/L for FT3 and 0.4–4 mIU/L for TSH. Tg was measured by an immunometric assay (Access Thyroglobulin assay; Beckman Coulter, Inc., Fullerton, CA, USA) (functional sensitivity 0.1 ng/mL). TgAbs were measured

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J Karmisholt Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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S L Andersen Department of Clinical Institute, Aalborg University, Aalborg, Denmark
Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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I Bulow-Pedersen Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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A Krejbjerg Department of Oncology, Aalborg University Hospital, Aalborg, Denmark

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B Nygaard Department of Endocrinology and Internal Medicine, Herlev University Hospital, Copenhagen, Denmark

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A Carlé Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Institute, Aalborg University, Aalborg, Denmark

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, agranulocytosis, and liver failure. Thyroid hormone and antibody assays Serum total T3 (reference range: Aalborg 1.1–2.5 nmol/L, Copenhagen 1.0–2.6 nmol/L), and TSH (reference range: Aalborg 0.30–4.5mU/L, Copenhagen 0.40–4.0 mU/L) were measured by automatic

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

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

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Peter F Berglund Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Birgitta Johansson Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

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Helena Filipsson Nyström Wallenberg’s Centre of Molecular and Translational Medicine, Region Västra Götaland, Sweden
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
Gothenburg Centre for Person Centred-Care (GPCC), Göteborg, Sweden

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Hospital, Göteborg ( n  = 64) and from the Department of Medicine at Kungälv’s Hospital, Kungälv ( n  = 1) in Sweden. They were eligible for the study if they were premenopausal, with fT4 levels ≥50 pmol/L (reference range: 12–22) and/or total T3 ≥6.0 nmol

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Caiyan Mo Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Han Chen Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Qi Zhang Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Ying Guo Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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Liyong Zhong Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

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gradually worsened and developed proptosis, so she came to our department in July 2022, and her thyroid function after admission is shown in Table 1 . Unless otherwise specified, the normal ranges of thyroid function are free thyroxine (FT4) 7.64–16.03 pmol

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Georgios Kostopoulos Department of Endocrinology and Metabolism, Ippokratio General Hospital of Thessaloniki, Greece

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Grigoris Effraimidis Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

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subclinical hyperthyroidism and FT4 within the normal reference range. Study Year Country Design Subjects, n Age, years FU, years Thyroid function AF, % Risk (95% CI) Overt hyperthyroidism  Selmer

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Stan R Ursem Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands

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Anita Boelen Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Eveline Bruinstroop Department of Endocrinology and Metabolism, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands

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Petra J M Elders Department of General Practice, Amsterdam UMC Location Vrije Universiteit, Amsterdam, The Netherlands
Amsterdam Public Health Research Institute, Amsterdam UMC, The Netherlands

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Jacobijn Gussekloo LUMC Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands

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Rosalinde K E Poortvliet LUMC Center for Medicine for Older People, Leiden University Medical Center, Leiden, The Netherlands
Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands

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Annemieke C Heijboer Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands

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Wendy P J den Elzen Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Laboratory Specialized Diagnostics & Research, Department of Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
Amsterdam Public Health Research Institute, Meibergdreef, Amsterdam, The Netherlands

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overactivity, defined by a TSH (thyroid-stimulating hormone) concentration below the reference interval with fT4 (free thyroxine; thyroid hormone) within the reference interval ( 1 ). The prevalence of subclinical hyperthyroidism ranges from 0.7% to 1.8% in

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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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