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Polyethylene glycol thyroid-stimulating hormone (PEG-TSH) testing in the management of pediatric thyroid dysfunction.
- Source :
-
Endocrine [Endocrine] 2024 May; Vol. 84 (2), pp. 524-532. Date of Electronic Publication: 2023 Oct 26. - Publication Year :
- 2024
-
Abstract
- Purpose: The polyethylene glycol (PEG) methodology is used for investigating incongruities in laboratory assays, such as thyroid-stimulating hormone (TSH) measurements. The aim of the study is to investigate the practical application of PEG-TSH testing in cases of discrepancies between elevated TSH and normal free thyroxine (FT4) levels.<br />Methods: A real-life observational study conducted in a tertiary medical center. The hospital's electronic database was queried for TSH tests performed in pediatric patients between 2015 and 2023. Of those, PEG-TSH were identified. Patients' clinical and biochemical characteristics and PEG-TSH-guided management were assessed.<br />Results: In total, 2949 TSH tests were performed in 891 children and adolescents for various indications. Among them were 61 (2.1%) PEG-TSH results, mean age 7.1 ± 5.3 years, of 38 patients (4.3%), comprised of 16 with congenital hypothyroidism, 16 with subclinical hypothyroidism, and 6 with Hashimoto thyroiditis. Both the TSH and the PEG-TSH levels of patients with congenital hypothyroidism were higher than those of the other two groups (P = 0.021 and P = 0.009, respectively), with no group differences in FT4 levels. Spearman's correlation analysis revealed a strong association between TSH and PEG-TSH levels: r = 0.871, P < 0.001. In nearly one-half of the cases, clinical decisions made by clinicians (decreasing the dose or not initiating L-thyroxine treatment) were affected by the PEG-TSH results.<br />Conclusion: Our findings support PEG-TSH testing for determining appropriate TSH levels and avoid unnecessary thyroid hormone treatment among children and adolescents. We propose the suitability of managing their clinical condition based upon age-appropriate clinical parameters and FT4 levels when their PEG-TSH levels are within the normal range.<br /> (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Humans
Child
Male
Female
Adolescent
Child, Preschool
Thyroid Diseases blood
Thyroid Diseases drug therapy
Thyroid Diseases diagnosis
Infant
Congenital Hypothyroidism diagnosis
Congenital Hypothyroidism drug therapy
Congenital Hypothyroidism blood
Hashimoto Disease blood
Hashimoto Disease drug therapy
Hashimoto Disease diagnosis
Thyrotropin blood
Polyethylene Glycols therapeutic use
Polyethylene Glycols administration & dosage
Thyroxine blood
Thyroid Function Tests
Subjects
Details
- Language :
- English
- ISSN :
- 1559-0100
- Volume :
- 84
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Endocrine
- Publication Type :
- Academic Journal
- Accession number :
- 37882906
- Full Text :
- https://doi.org/10.1007/s12020-023-03575-5