Abnormal endocrine tests in a hemodialysis patient.
A home hemodialysis patient with abnormal thyroid function tests and hyperprolactinemia is presented. Abnormal thyroid tests included low total triiodothyronine and low total thyroxine and free thyroxine; the latter was documented by the use of both RIA and direct dialysis equilibrium techniques. Serum thyroid-stimulating hormone was normal, and the thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation was in the low-normal range. Serum prolactin was elevated to more than twice the normal level, and the prolactin response to thyrotropin-releasing hormone was also blunted. The interpretation, pathogenesis, physiologic significance, and management of these abnormalities are discussed.
Hochstetler
L A
LA
Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242.
Flanigan
M J
MJ
Lim
V S
VS
D003937:Diagnosis, Differential; D005067:Euthyroid Sick Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006437:Hemodialysis, Home; D006801:Humans; D006966:Hyperprolactinemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007037:Hypothyroidism / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011388:Prolactin / Q000378:metabolism; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000172:deficiency; D013972:Thyrotropin / Q000378:metabolism; D013973:Thyrotropin-Releasing Hormone
D013963:Thyroid Hormones; D013973:Thyrotropin-Releasing Hormone; D011388:Prolactin; D013972:Thyrotropin