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Manual de Exames


Letra T


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TSH - HORMÔNIO TIREOESTIMULANTE - Ultrasensivel

Material:

Soro

Instruções de coleta:

Jejum não necessário.

Informações:

Diagnóstico do hipotireoidismo primário. O TSH é um hormônio glicoprotéico, secretado pelas células tireotróficas do lóbulo anterior da glândula pituitária, que estimula a tiróide a liberar T3 e T4, sendo controlado pelos níveis séricos destes últimos e pelo TRH hipotalâmico. Com o emprego dos ensaios ultra-sensíveis que chegam a níveis de sensibilidade de 0,01mU/L, a dosagem de TSH teve sua utilidade ampliada. Pode ser considerado o melhor exame isolado para a investigação de hipotireoidismo e hipertireoidismo. Na maioria dos pacientes com hipotireoidismo primário, os resultados de TSH são marcadamente elevados (3 a 100 vezes o normal). Os resultados de um ensaio sensível para TSH que estão dentro dos intervalos de referência excluem a disfunção tireoidiana. No hipotireoidismo subclínico o TSH está elevado; o T4 livre, o T4 total e o T3 podem apresentar níveis normais. Nas mulheres com mais de 50 anos de idade a prevalência de hipotireoidismo subclínico é de 15 - 20%. Variáveis fisiológicas que alteram os níveis de TSH: gravidez, idade, ritmo circadiano. Em alguns momentos na gravidez, o HCG compete com o TSH (funcionando como TSH), passando a dirigir a tireóide. Não é incomum encontrar, no primeiro e segundo meses da gravidez, TSH suprimido e T4 livre elevado com HCG >100.000 unidades. Interferentes: dopamina -, corticóides -, carbamazepina -, triiodotironina -, amiodarona +, clomifene +, haloperidol +, fenotiazidas +, morfina +, propiltiuracil +, TRH.

Referência:

  • 1ªsemana de vida : até 25,000 uUI/mL
  • 2ªsemana a 11 meses : 0,800 a 6,300 uUI/mL
  • 1 a 5 anos : 0,700 a 6,000 uUI/mL
  • 6 a 10 anos : 0,600 a 5,400 uUI/mL
  • 11 a 15 anos : 0,500 a 4,900 uUI/mL
  • Adultos : 0,500 a 5,000 uUI/mL
  • Limite de detecção : 0,008 uUI/ml
 

Laboratório Bioclinico

Exames de Rotina