7 types of thyroid diseases, different test items!

There are so many thyroid-related tests, do you have to do each one?

Laboratory tests commonly used clinically for thyroid disease include: total thyroxine (TT4), total triiodothyronine (TT3), trans T3 (rT3), free T4 (FT4), free T3 (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroglobulin (Tg), thyroglobulin antibody (TgAb), TSH receptor antibody (TRAb), calcitonin (CT), thyroid fine needle aspiration (FNA) and cytology
.

So many tests, do you have to do it? Today, I will introduce what items need to be selected for common thyroid diseases:

Diffuse toxic goiter (Graves disease)

Graves disease is an autoimmune disease that presents with a multisystem syndrome involving the thyroid gland, including hypermetabolic signs, diffuse goiter, exophthalmic signs, characteristic skin lesions, and acrothyroid disease
.

Laboratory test items: TSH, FT4, FT3, TT4, TT3, TRAb, TgAb, TPOAb
.

If the patient has unilateral exophthalmos, elderly patients suspected of hyperthyroidism, suspected T3 hyperthyroidism, T3 inhibition test can be performed to confirm
.
However, T3 suppression tests should be used
with caution in older people and patients with cardiovascular disease.

Hypothyroidism (hypothyroidism)

Hypothyroidism refers to a pathological condition in which the thyroid hormone of the tissues is insufficient or absent, and is a group of diseases
caused by insufficient synthesis, secretion or biological effects of thyroid hormones.
Major causes of hypothyroidism in adults include autoimmune thyroiditis, thyroid radioactive iodine therapy, or thyroid surgery
.

Laboratory testing items: TSH, FT4, FT3, TT4, TT3, rT3
.

Combined with TRH stimulation testing, it is known that the site of the lesion is in the hypothalamus, pituitary gland, or thyroid
gland.

When hypothyroidism is suspected to be caused by autoimmune thyroiditis, TgAb and TPOAb
should be measured.

Subacute thyroiditis

Subacute thyroiditis is usually preceded by a history of upper respiratory tract infection, rapid onset, fever with chills and fatigue, etc.
, characterized by goiter with pain and tenderness
.
Pathological manifestations are the destruction of thyroid follicular tissue structure replaced by granulomatous tissue, accompanied by a large number of inflammatory cells, histiocyte infiltration and megakaryocyte formation
.

Laboratory test items: TSH, FT4, FT3, TgAb, TPOAb
.

In addition, early disease combined with ultrasonography can help distinguish
other diseases.

Bridgemoto thyroiditis

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, is an autoimmune disease
.
The onset of the disease is insidious and the course of the disease is slow, manifested by gradual enlargement of the thyroid gland, and mild hyperthyroidism may occur in the early stage, and then develop into hypothyroidism and gradually worsen.

The pathology is characterized by
massive lymphocyte infiltration and the formation of lymphatic follicles.

Laboratory test items: TSH, FT4, FT3, TgAb, TPOAb
.

FNA can be used to diagnose suspicious nodular lesions and typically manifest as lymphocytic infiltration, glial scarcity, and Hürthle-like changes
in epithelial cells.

goiter

Goiter includes compensatory goiter
due to inadequate thyroid hormone synthesis due to iodine deficiency or congenital defects in enzymes associated with thyroid hormone synthesis.

Laboratory test items: TSH, TT4, TT3, urinary iodine
can be selected.

If the patient also has neurological symptoms, TRH stimulation test can be performed to distinguish it from hyperthyroidism; If the patient has goiter with nodules, FNA and thyroid autoantibody tests can be done to distinguish
thyroid tumors from thyroid tumors and thyroiditis.

Thyroid adenoma

There are three main pathological types
of thyroid adenomas: papillary adenoma, follicular adenoma and Hürthle cell adenoma.

Laboratory tests: thyroid hormone testing can be selected, the results are generally normal (except for autonomic hyperfunctional thyroid adenoma), FNA is helpful to understand the pathological type and distinguish
it from thyroid cancer.

Laboratory tests for thyroid cancer

There are four main pathological types
of thyroid cancer: papillary carcinoma, follicular cell carcinoma, anaplastic carcinoma and medullary carcinoma.

Laboratory test items: thyroid hormone test can be selected, and the results are generally normal
.
Tg detection can understand the secretory ability of thyroid cancer and can be used as a tumor marker for the follow-up of well-differentiated thyroid cancer after surgery.
CT detection can assist in the early diagnosis of MTC and postoperative recurrence monitoring
.

FNA helps to diagnose and understand the type of
pathology.