CASE ANALYSIS 3
•
A 59 YEAR OLD MAN WHO
HAS BEEN DIAGNOSED WITH ACUTE RESPIRATORY DISTRESS SYNDROME SHOWED SYMPTOMS OF
HYPOTHERMIA, COOLNESS IN THE EXTREMITIES, DECREASED BLOOD PRESSURE AND PULSE,
FATIGUE, AND DELAY IN REFLEX TIME. A
THYROID PROFILE WAS ORDERED WITH THE FOLLOWING RESULTS:
LABORATORY FINDINGS
•
FT4 = 4.0
•
s.-TSH = 1.0 uU/mL
QUESTIONS
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1. FROM THE CASE HISTORY AND THE LABORATORY
DATA, WHAT IS A LIKELY DIAGNOSIS?
•
Possibly
euthyroidism or hypothyroidism, but since s-TSH is normal, it might be
borderline case or a physiological factor is present.
•
2. WHAT ADDITIONAL LABORATORY TEST/S WOULD BE
APPROPRIATE?
•
FT3, TT3,
Stimulation tests, TBG, or perform a delta check (repeat tests)
•
3. WHAT ADDITIONAL INFORMATION CONCERNING THE
PATIENT WOULD BE HELPFUL IN INTERPRETING RESULTS?
•
Patient’s
history, surgical procedures done, drugs taken
•
4. IS TREATMENT FOR THYROID DISORDER INDICATED?
•
Observe
first for a few weeks and wait for additional tests and delta checks.
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