Thyroid 18-11 rev audio

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Pr. D. Gruson Pharm. Biol. – EurSpeLM, PhD Department of Laboratory Medicine UCL St-Luc, Brussels, Belgium Thyroid and Laboratory tests

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Thyroid diseases Approximately 750 million people worldwide are affected by thyroid disorders

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4 NHANES III: Prevalence of hypothyroidism was 4.6% (0.3 overt and 4.3% subclinical) Prevalence of hyperthyroidism 1.3% (0.5 overt and 0.7% subclinical) In people without known thyroid disease or a family history of thyroid disease Thyroid diseases Caldwell et al.; 2011

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Madariaga et al.; 2014 Hyperthyroidism

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6 https://aidersonprochain.com/hypothyroidie-hyperthyroidie-symptomes/ Symptoms

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Parle et al.; Lancet 2001

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8 Vissenberg et al.; 2015

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9 -Thyroxine (T4) and triiodothyronine (T3) are synthesized from tyrosine residues of Thyroglobulin ( Tg ) in the thyroid epithelial cell. T4 and T3 are released after Tg is endocytosed and proteolytically degraded in the thyrocyte (prohormone). Tg by itself is not biologically active. Tg composes about 75% of the total protein of Thyroid follicular colloid and is secreted in the serum only by the thyroid gland.

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From Spencer et al. 1st Line = Testing for TSH Testing for T4L / T3L

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11 Auto-immune diseases Auto - Antibodies

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12 TPO is a glycosylated membrane-bound protein that belongs to the family of mammalian haem peroxidases that have as common denominator a haem prosthetic group acting as an electron acceptor Thyroid peroxidase (TPO ) Auto-antibodies

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13 Vissenberg et al.; 2015 Thyroid peroxidase (TPO ) Auto-antibodies

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The prevalence of hyperthyroidism in pregnancy ranges from 0.1 to 0.4% Graves’ disease accounting for 85% of cases Activity level of Graves’ disease may fluctuate during gestation, with exacerbation during the first trimester and improvement by late gestation Inadequately treated maternal thyrotoxicosis is associated with an increased risk of: preterm delivery, intrauterine growth restriction and low birth weight, pre- eclampsia, congestive heart failure, and fetal death Skuza KA, J Pediatr, 1996, 128:264-268 Graves disease and pregnancy TSH receptor (TRAb) Auto-antibodies

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placenta Mother foetus T3 TSH T4 iode Ac anti-R-TSH ATS Fetal hyperthyroidism due to the transplacental passage of maternal TSH receptor stimulating antibody (TRAb) levels is rare (0.01% of pregnancies) but it should be considered in any woman with a past or current history of Graves’ disease and may require treatment with maternal antithyroid medications. Graves disease and pregnancy

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16 Centrifugation Sérum / Plasma Testing with blood

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17 Clinical Laboratory systems

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18 damien.gruson@uclouvain.be Thanks for your attention ;-)

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