High Concentrations of Furosemide Inhibit Serum Binding of Thyroxine

Stockigt, Jan R.; Lim, Chen‐Fee; Barlow, John W.; Stevens, Virginia; Topliss, Duncan J.; Wynne, K.N.

doi:10.1210/jcem-59-1-62

Cited by 56 publications

(23 citation statements)

References 24 publications

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“…A interferência por droga resulta da presença in vitro de um agente diagnóstico ou terapêutico no soro da amostra em concentração suficiente para interferir com o teste, como ocorre freqüentemente com o furosemide e a heparina (114,115). As três principais classes de anticorpos que causam interferência nos imunoensaios dos HTs são os auto-anticorpos, os anticorpos heterófilos e o fator reumatóide.…”

Section: Fatores Interferentes Nos Ensaios De T 4 E T 3 Total E Livreunclassified

Fatores Interferentes na Interpretação de Dosagens Laboratoriais no Diagnóstico de Hiper e Hipotireoidismo

Graf

Carvalho

2002

Arq Bras Endocrinol Metab

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Laboratory Interfering Factors in the Diagnosis of Hyper and Hypothyroidism.Since the first reports in the medical literature describing the clinical presentation of hypo and hyperthyroidism, very little has changed on the semiologic scenario of these entities and even in their therapeutic approach. The changing trends refer much more to the tools used to diagnose thyroid disease. In parallel with these developments, we understand much better about the factors that interfere in the interpretation of thyroid function tests in the diagnosis of hyper and hypothyroidism. In this article, we analyzed the utility of serum TSH and thyroid hormone measurements, as well the pitfalls and interferences in its common daily use. (Arq Bras Endocrinol Metab 2002;46/1:51-64)

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Section: Fatores Interferentes Nos Ensaios De T 4 E T 3 Total E Livreunclassified

Fatores Interferentes na Interpretação de Dosagens Laboratoriais no Diagnóstico de Hiper e Hipotireoidismo

Graf

Carvalho

2002

Arq Bras Endocrinol Metab

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“…Non-thyroidal illness has been shown to affect thyroid function tests (26)(27)(28)(29)(30)(31)(32). Thyroid function tests are therefore optimally performed in ambulatory and otherwise well patients, but there is a clinical need for determining the presence or absence of thyroid disease in patients with non-thyroidal illness.…”

Section: Discussionmentioning

confidence: 99%

Critical Evaluation of Fully Automated Enzyme Immunoassays for Free Thyroxine and Thyrotropin

Mattiazzo¹,

Ramasamy²

1994

CCLM

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! Summary:The technical and diagnostic performance of fully automated immunoassays for free thyroxine and thyrotropin using streptavidin/biotui technology (Enzymun-Test®) were examined. The between-assay precision for ! free thyroxine was 10.4%, 5.4%, 2.5%, 2.3%, 1.1% and 1.8% at 3. 02, 6.27, 17.2, 21.9, 25.6, 42.7 pmol/I; and for | thyrotropin was 14.2%, 4.7%, 2.9%, 2.8%, 3.2%, 4.5% at 0.12, 0.46, 1.03, 2.05, 4.8, 12.7 mU/1. The functional 1 detection limit of the assay was 0.09 mU/1. Results for the free thyroxine method correlated well with the IMx (r =0.91) and the equilibrium dialysis (r = 0.95) assay. Results for the thyrotropin method correlated well with the Tandem®-TSH (r = 0.99) and the IMx (r = 0.99) assays. The euthyroid reference r nge was 11-23 pmol/1 and 0.5-3.9 mU/1 for free thyroxine and thyrotropin respectively. The free thyroxine assay was not influenced by changes in albumin or thyroxine binding globulin concentration but showed increases at oleic acid concentrations | > 4 mmol/1. Spuriously elevated free thyroxine concentration were found in 4 patients, due to assay interference i by antibodies in the serum. In a follow up study of 46 patients with non-thyroidal illness, serial measurements * showed fluctuating free thyroxine and thyrotropin concentrations with abnormal results occurring in 34%. In a hospital setting, a wider r nge pf free thyroxine (10-28 pmol/1) and thyrotropin (0.22-5.9 mU/1) concentration ι may be observed in patients who are clinically euthyroid. Abnormal thyroid function tests were however transient , and follow up resolved most diagnostic problems.

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“…At high serum concentrations, a temporal relationship between furosemide levels and serum-free T4 levels has been established. This is postulated to be secondary to temporary displacement of T4 to tissues allowing later reentry into the circulation (24).…”

Section: Effects Of Dialysis On Thyroid Hormone Levelsmentioning

confidence: 99%