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Euthyroid Hyperthyroxinemia

GEORGE C. BORST, M.D.; CHARLES EIL, M.D., Ph.D.; and KENNETH D. BURMAN, M.D.
[+] Article and Author Information

Grant support: in part by project CIC 80-06-1288, Bureau of Medicine and Surgery, Navy Department, Washington, D. C.

The opinions and assertions expressed are the private ones of the authors and are not to be construed as official or reflecting the view of the Navy Department, the Naval service at large, or of the Department of Defense.

▸Requests for reprints should be addressed to George C. Borst, M.D.; 1201 Christopher Drive; Ashland, KY 41101


Bethesda, Maryland; and Washington, D.C.


Ann Intern Med. 1983;98(3):366-378. doi:10.7326/0003-4819-98-3-366
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An increasing number of disorders that may cause hyperthyroxinemia without thyrotoxicosis have been recognized in recent years. These include acquired and inherited abnormalities of serum thyroid-hormone-binding proteins, peripheral resistance to thyroid hormones, acute nonthyroidal illness, acute psychiatric illness, and some drug-induced conditions associated with nonthyrotoxic elevations of serum thyroxine. In addition to the laboratory finding of elevated serum thyroxine levels, many of these syndromes are also accompanied by abnormalities in triiodothyronine and free thyroid hormone levels, as well as unresponsiveness of thyroid-stimulating hormone to thyrotropin-releasing hormone, all of which further erroneously indicate a diagnosis of thyrotoxicosis. An awareness of these syndromes and alterations in the results of thyroid function tests that accompany them is important to prevent a misdiagnosis of hyperthyroidism and inappropriate therapy.

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