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G H McLellan

Publications and source records attributed to G H McLellan.

10 recordsLinked to original sources
PubMed1987

Euthyroid hyperthyroxinaemia in acute psychiatric admissions.

Of 98 patients studied prospectively during admission to the psychiatric ward of a general hospital, 13% showed an initial transient elevation of the serum thyroxine (T4) level (range 142-174 nmol/l) with the incidence increasing to 15% on serial testing at days five and fourteen. There was no clinical evidence of a thyrometabolic disorder and, as the mild hyperthyroxinaemia normalised rapidly, recourse to other thyroid function tests was not required. The possible causes of the transient hyperthyroxinaemia are discussed, but examination of the hyperthyroxinaemic patients' diagnoses did not reveal anything in common. These data indicate that the results of routine thyroid function tests in acute psychiatric admissions should be interpreted with care, and that historical and physical examination remains the primary avenue of diagnosis of thyroid disorders.

Adult↗
PubMed1987

Application of an immunoradiometric assay for thyrotrophin in evaluation of thyroidal and nonthyroidal disease states.

We evaluated an immunoradiometric assay for serum TSH (IRMA-TSH) and compared it with established indices of thyroid function in 208 patients with either frank thyroid disease, conditions of abnormal thyroxine protein binding, or conditions which are known to produce discordant thyroid results, viz. pregnancy or estrogen treatment and nonthyroidal illness (NTI). As expected, a wide scatter of TSH results was found in treated thyroid disease: 53 patients (53%) from both groups (initially hypo- or hyperthyroid) had TSH values less than 0.5 mU/l, but only one was considered to be clinically mildly toxic. All the pregnant, estrogen-treated and abnormal thyroxine protein-binding patients had TSH results within the reference range 0.5-6.0 mU/l, except one familial dysalbuminemic hyperthyroxinemia (FDH) patient (T4 level, 178 nmol/l) lost to follow-up with a TSH level of 8.5 mU/l, and one euthyroid, low-TBG patient being treated inappropriately with thyroxine, with a TSH level less than 0.5 mU/l. All the untreated thyrotoxic patients and 15 (26.3%) of the NTI patients had TSH results of 0.5 mU/l or lower. Because of this high incidence of low TSH levels in euthyroid NTI, we cannot recommend this IRMA-TSH as the initial test of thyroid function.

Estrogens↗
PubMed1987

Cardiac enzyme changes in myxedema coma.

A 74-year-old man with myxedema and hypothermia had increased activities in plasma of creatine kinase (CK; EC 2.7.3.2), aspartate aminotransferase (AST; EC 2.6.1.1), and lactate dehydrogenase (LD; EC 1.1.1.27) and increased proportions of CK-MB (up to 20% of total CK) and LD1 isoenzymes, but no clinical or investigational evidence of associated myocardial infarction. This case illustrates that plasma enzyme activity and isoenzyme profiles in such clinical settings should be interpreted with caution, because increases in CK-MB and LD1 may relate to myxedema coma or hypothermia (or both) rather than to myocardial infarction.

Aged↗
PubMed1975

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Australia↗