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    Pemeriksaan Laboratorium Hormon Tiroid: Oleh: Dr. Diah Hermayanti, SPPK

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    Zulfan Rifqiawan
    This document discusses thyroid hormone laboratory testing. It provides information on testing for thyroid stimulating hormone (TSH) and free thyroxine (FT4) to determine thyroid status as normal, hypothyroid, or hyperthyroid. It also discusses additional tests that may be needed such as thyroid antibodies. Causes of hypothyroidism mentioned include Hashimoto's disease and goiter. Graves' disease is listed as a common cause of hyperthyroidism. Flow charts are provided outlining the laboratory testing process for evaluating hypothyroidism and hyperthyroidism.

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    Pemeriksaan Laboratorium Hormon Tiroid: Oleh: Dr. Diah Hermayanti, SPPK

    Uploaded by

    Zulfan Rifqiawan
    136 views16 pages
    This document discusses thyroid hormone laboratory testing. It provides information on testing for thyroid stimulating hormone (TSH) and free thyroxine (FT4) to determine thyroid status as normal, hypothyroid, or hyperthyroid. It also discusses additional tests that may be needed such as thyroid antibodies. Causes of hypothyroidism mentioned include Hashimoto's disease and goiter. Graves' disease is listed as a common cause of hyperthyroidism. Flow charts are provided outlining the laboratory testing process for evaluating hypothyroidism and hyperthyroidism.

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    Lab Tiroid

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    This document discusses thyroid hormone laboratory testing. It provides information on testing for thyroid stimulating hormone (TSH) and free thyroxine (FT4) to determine thyroid status as normal, hypothyroid, or hyperthyroid. It also discusses additional tests that may be needed such as thyroid antibodies. Causes of hypothyroidism mentioned include Hashimoto's disease and goiter. Graves' disease is listed as a common cause of hyperthyroidism. Flow charts are provided outlining the laboratory testing process for evaluating hypothyroidism and hyperthyroidism.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    136 views16 pages

    Pemeriksaan Laboratorium Hormon Tiroid: Oleh: Dr. Diah Hermayanti, SPPK

    Uploaded by

    Zulfan Rifqiawan
    This document discusses thyroid hormone laboratory testing. It provides information on testing for thyroid stimulating hormone (TSH) and free thyroxine (FT4) to determine thyroid status as normal, hypothyroid, or hyperthyroid. It also discusses additional tests that may be needed such as thyroid antibodies. Causes of hypothyroidism mentioned include Hashimoto's disease and goiter. Graves' disease is listed as a common cause of hyperthyroidism. Flow charts are provided outlining the laboratory testing process for evaluating hypothyroidism and hyperthyroidism.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 16

    PEMERIKSAAN LABORATORIUM

    HORMON TIROID

    Oleh :
    dr. Diah Hermayanti, SpPK
    GANGGUAN HORMON TIROID

    1.HIPOTIROID

    2.HIPERTIROID
    REKOMENDASI American thyroid association (ATA) :

    TSHs secara bersamaan


    free T4

    Status fungsi tiroid :


    normal
    hipotiroid
    hipertiroid
    subklinik
    primer / sekunder / tertier

    Bila perlu :
    TRH; TBG; antibodi (Thyroperoxidase-Ab,
    antimicrosomal-Ab, Thyroglobulin-Ab)
    HIPOTIROID

    Hipotiroidisme :
    kondisi akibat rendahnya produksi hormon tiroid

    Tanda dan gejala :


    kelemahan
    kulit kering
    berat badan meningkat
    depresi
    detak jantung menurun

    Penyebab :
    Hashimoto’s disease
    Goitre
    HASHIMOTO’S DISEASE

     autoimmune disease , kelenjar tiroid mengalami kerusakan  


    Pada awalnya tidak bergejala,
    lambat laun kelenjar membesar tanpa ada rasa sakit

    Terbanyak perempuan 30-50 th

    Pemeriksaan : TSH, free T4, T4, T3,


    Antibodi anti-tiroid
    anti-thyroid peroxidase antibodies (TPOAb)
    anti- thyroid binding globulin (TBG-Ab)
    https://www.celebritydiagnosis.com/wp-
    content/uploads/2014/10/Hashimotos-Thyroiditis-Symptoms-of-
    Hypothyroidism_01.gif
    GOITER

     Pembesaran/pembengkakan kelenjar tiroid

     Dapat hipotiroid ataupun hipertiroid

     Penyebab 90% karena defiseinsi iodine


    Foto struma/goiter

    https://upload.wikimedia.org/wikipedia/commons/0/0f/St
    ruma_001.jpg
    ALUR PEMERIKSAAN LABORATORIUM HIPOTIROID
    sTSH & FT4

    High sTHS, subnl FT4 High sTHS, nl FT4 nl/subnl sTHS, subnl FT4 nl sTHS, nl FT4
    clinically
    Primary hypothyroidism hipothyroid
    Subclinical Spurious TSH
    Prior radioiodine Hypothy (anti-m-Ig G)
    Thyroidectomy,
    External radiation ?
    TRH test TRH test
    no

    TPO –Ab, Tg Ab excessive nl no response

    (+) (-) nl

    Hashimoto Drug induced primary tertiary secondary


    Postpartum Hashimoto’s hypothyroidism
    Thyroiditis T4/T3 Synthesis
    defect peripheral resistance
    (Iodine deficiency) to thyroid hormones

    SCAN
    HIPERTIROID

    HIPERTIROIDISME :
    Kondisi akibat produksi hormon tiroid berlebihan
    Tanda & gejala :
    penurunan BB
    Kelemahan
    detak jantung ireguler
    sulit tidur
    hipertensi
    mata exophthalmus
    pembesaran kelenjar tiroid
    Penyebab tersering : Graves’ disease
    PENYEBAB HIPERTIROID

    Graves’ disease
    Kelebihan iodine
    Tiroiditis
    Tumor ovari
    Tumor tiroid, tumor kelenjar pituitari
    Overdosis obat tetraiodotironin
    PEMERIKSAAN LABORATORIUM

    Kolesterol , Trigliserid
    kolesterol dan trigliserid turun, karena
    meningkatnya metabolisme

    Free T4, T4, T3

    TSH
    GRAVES’ DISEASE

     Autoimmune disease
    antibodies to the receptor for thyroid-stimulating hormone.
    (Antibodies to thyroglobulin and
    to the thyroid hormones T3 and T4 may also be produced.)
    These antibodies cause hyperthyroidism because they bind
    to the TSHr and chronically stimulate it.
    The TSHr is expressed on the follicular cells of the thyroid
    gland (the cells that produce thyroid hormone),
    and the result of chronic stimulation is an abnormally high
    production of T3 and T4.
    Foto Graves disease

    http://medifitbiologicals.com/wp-
    content/uploads/2015/12/graves-disease-4.jpg
    https://image.slidesharecdn.com/endocrine2-1medic2013-
    130427052226-phpapp02/95/pathophysiology-of-the-thyroid-
    parathyroid-and-sexual-glands-24-638.jpg?cb=1367040375
    ALUR PEMERIKSAAN HIPERTIROID
    sTSH & FT4
    Undet sTSH, high FT4 subnl sTSH, nl FT4 high sTSH, high FT4 nl/ high sTSH, high FT4
    Clinically hyperthy Clinically eu/hypothy
    Hyperthyroidism
    T3/FT3 T3/FT3 T3/FT3

    nl highhigh high low

    Subclinical T3 Toxicosis (5-Deiodinase


    hyperthy defect)
    t/o sTSH artifact
    TP-Ab, TgAb T4Ab / T3Ab

    (+) (-) TSH α subunit (+) (-)

    Autoimmnune Toxic adenoma/ high nl FT4/FT3 TRH Test


    Graves disease Multinodular goiter artifact
    TRH TRH nl/high
    -Silent Subacute thyroiditis
    lymphocytic Factitious toxicosis no respons respons T3 supression RAIU
    -Postpatum Induced/iatrogenic
    thyroiditis Inappropriate Pituitary (-)
    secretion resistance to Generalized
    Low RAIU/SCAN High Pituitary tumor ? Thyroid hormone thyroid
    resistance

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