In a patient with hyperthyroidism due to Graves disease we usually find a very low TSH, high FT3 and FT4 and ... patients sickness, sweating and tachycardia.
RBSLM Annual Meeting 14 November 2015
Transient interference in thyroid function tests on the Roche Cobas E602 module in a case of acute CMV infection. K. Maelegheer1, S. Degandt 1, A.Van den Bruel 2, J. Robbrecht3, J. Billen 4, M.Reynders1, M. Langlois1. 1 Department
of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges 2 Division of Endocrinology, AZ Sint-Jan Hospital, Bruges 3 Laboratory of Clinical Biology, AZ Sint Lucas, Bruges 4 Department of Laboratory Medicine, UZ Leuven, Leuven
INTRODUCTION AND PURPOSE In a patient with hyperthyroidism due to Graves disease we usually find a very low TSH, high FT3 and FT4 and mostly elevated TSI concentrations. Here we report a case with discrepant laboratory test results.
Case Report A 35 year old man was referred to our hospital for nervousness, heart palpitations and sweating. Considering a positive familial history, these symptoms suggested a case of hyperthyroidism.
The patient had discretely, elevated liver function tests and serologic screening was performed. An acute primary CMV infection with PCR-proven, active viral replication was confirmed. A serum sample drawn 4 weeks later showed a significant increase of CMV IgG antibodies and a limited decrease of CMV IgM antibodies (Biomérieux VIDAS).
Laboratory serum tests on a Roche Cobas E602 revealed high FT4, FT3 and TSI but showed a normal TSH concentration. TSH(mU/L) 1,32 (0,3-3,69 )
FT3 (pmol/l)
FT4 (pmol/l)
11,61(3,08-6,78)
40(12-22)
TSI (IU/ml)
TSH
FT3
FT4
TSI
CMV IgM
24/08
1,32
11,61
40
11,25
2,08 (
