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Euthyroid Hyperthyroxinemia

Euthyroid hyperthyroxinemia is defined as a condition in which the total serum or free thyroxine T4 concentration is abnormal without evidence of clinical thyroid disease.

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    Age / Sex of Euthyroid Hyperthyroxinemia

    Older men who are weak or delicate may manifest higher free thyroxine levels.

    Causes of Euthyroid Hyperthyroxinemia

    Physiological causes: Pregnancy, Delayed puberty, Estrogen intake
    Hereditary causes
    Drugs: Heroin, methadone, perphenazine, Heparin, propranolol etc.
    Thyroid  hormone resistance syndrome
    Hyperthyroxinemia of systemic illness like liver disease, acute psychosis, islet cell carcinoma, HIV
    Miscellaneous

    Sign and symptoms

    Thyroid hormone resistance signs include following:
    • Goiter
    • Nystagmus
    • Tachycardia
    • Increased metabolic rate
    • Deafness
    • Liver disease signs include the following:
    • Icterus
    • Hepatomegaly

    Investigations for Euthyroid Hyperthyroxinemia

    • Obtain a detailed clinical evaluation
    • Measurement of TSH by a third generation assay
    • Measurement of free T4

    Treatment

    The tumors, such as glucagonoma, islet cell tumors, or estrogen-secreting tumors, may be resectable.

    Prognosis

    • Most of the conditions are self-limiting.

    Differential diagnosis

    • Hyperthyroidism

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