THE ROLE OF A HIGHLY SENSITIVE AMPLIFIED ENZYME IMMUNOASSAY FOR THYROTROPHIN IN THE EVALUATION OF THYROTROPH FUNCTION IN HYPOPITUITARY PATIENTS

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Abstract
SUMMARY: Using a highly sensitive amplified enzyme‐linked immunoassay (A E I A) for thyrotrophin (T S H), we have assessed the ability of a single basal measurement of T S H to predict the subsequent response of T S H to TRH in a group of 11 patients with known pituitary pathology and some evidence of hypopituitarism. All patients were clinically euthyroid. Basal levels of A E I A‐T S H ranged from <0‐2 mU/1 (‘undetectable’) to 0–9 mU/1; within this range there was no correlation with the subsequent T S H levels at 30 min in the TRH test. The T S H response in the TRH test did not correlate with the direct measurements of prevailing thyroid hormone levels (Total T4 or Free T4).We suggest that in patients with pituitary disease, the formal TRH test yields additional information regarding residual thyrotroph function that cannot reliably be predicted by a single basal T S H value, even when measured by a sensitive method. The current and potential thyroid status in patients with hypopituitarism must continue to rest on the overall picture provided by clinical assessment, direct measurement of thyroid hormones and the TRH test response. A basal T S H alone gives little useful information regarding thyroid status in such patients.

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