Clinical Chemistry Case 113 May 3, 2023 pathadmin 615 Comments 1. Lorena Marcano-Bonilla, MD, Ph.D. and Lori Sokoll, Ph.D. An adult with a history of relapsing multiple sclerosis and hypertension presents to her follow up appointment complaining of increasing fatigue and difficulty concentrating. Upon further questioning, the patient denies tremors, palpitations, changes in bowel movements, weight loss, changes in vision, or heat intolerance. Among the tests ordered were thyroid function tests. Serum TSH and free T4 (FT4) were 0.03 microIU/mL (reference range: 0.50-4.50 microIU/mL) and 5.2 ng/mL (0.8-1.8 ng/dL), respectively. TSH and free T4 results were within the reference range at visits one and three years prior. What is the explanation for these results?A. The patient has Graves' disease and should be started on Methimazole 20 mg PO dailyB. The patient has heterophile antibodies in her serum interfering in the two assaysC. The previous results were from a different laboratory with different methods and reference rangesD. The pattern of abnormally low TSH and high FT4 suggests high-dose biotin intake Loading...
