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Real or Not Real? An Elevated TSH - PubMed

5 hours ago
  • #Macro-TSH
  • #Thyroid Function Tests
  • #Immunoassay Interference
  • A 19-year-old male presented with mild fatigue and chronic constipation.
  • Lab results showed elevated TSH (85 mIU/L) but normal free thyroxine and total triiodothyronine.
  • Diagnosis of Macro-TSH was confirmed via TSH antibody testing and gel filtration chromatography.
  • Macro-TSH is rare and can mimic hypothyroidism, requiring further evaluation when TSH results don't match clinical presentation.
  • Testing options include commercially available TSH antibody tests or gold-standard gel filtration chromatography (not commercially available).
  • Case highlights the importance of investigating incompatible thyroid function test results to avoid misdiagnosis.