Download . Causes of an ↑ serum T4 in childhood and adolescence

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↑ T4
TSH ↓
Hyperthyroidism
*↑TSH Receptor Abs ↑hCG Iodine
• Diffuse toxic goiter • Pregnancy
(Graves’ disease)*
• Hydatidiform
mole
Intrinsic
•Functioning thyroid
adenoma
•Toxic multinodular
goiter
•Gain of function
mutation of TSH
receptor
•McCune –Albright
disease
TSH ↑
Thyrotoxicosis
without
hyperthyroidism
• chronic lymphocytic
thyroiditis
• Subacute
thyroiditis/painless
thyroiditis
• Thyroid hormone
ingestion
(‘thyrotoxicosis
factitia’)
TSH normal
• TSHproducing
pituitary
adenoma
•Thyroid
hormone
resistance
• Oral
contraceptive
therapy
• Pregnancy
• Inherited
TBG excess
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