SCREENING FOR THYROID-DISEASES IN OPEN CA RE MEDICAL PATIENTS OF A GENERAL-HOSPITAL - CONTRIBUTION OF SENSITIVE THYROTROPIN DETECTION

In 918 open care patients in the medical service of a general hospital we could prove that inspection and palpation of thyroid gland as well as clinical symptoms are unsuitable for the detection of thyroid dysf unctions. Therefore additional screening tests are needed. Sensitive t hyrotropin as an enzyme-immune-assay is shown to be well established a s a screening test for hyperthyroidism. Hypothyroidism is more or less sporadic and can only be detected as a primary form. Therefore sensit ivity of TSHs is markedly worse with regard to hypothyroidism than wit h regard to hyperthyroidism in clinical inpatients. Specificity of TSH s is restricted by a high rate of 9,5% of subclinical thyroid dysfunct ions, which, however, not always must be completely clarified, and onl y under rare circumstances need therapy.