Nécessité d'un nouveau test TSH pour le diagnostic précoce de l'hypothyroïdie

Diagnostic of thyroid dysfunction is largely based on TSH measurement in blood. Defining the upper reference limit of TSH values is of paramount importance to establish normal level of TSH. Ideally, accurate TSH measurement around the normal reference range should permit to determine which of the patients will undergo additional investigation and/or hormonal therapy. At present, there is a common agreement on the 0.4-4 mIU/L values but the upper limit range of TSH remains controversial. Work from the past 10 years has rather denied the proposal of lowering the threshold. TSH is a glycoprotein hormone for which the nature and circulating level may widely change depending on environmental and physiological factors. In addition, the hormone is composed of multiple glycoforms which display variable immunological behavior and thereby lead to altered TSH measurement. A call for tenders of the ANR allowed us to establish a bank of serum forward-looking and documented from the working hypotheses based on the implementation of a new calibration of TSH and/or the use of new formats (Ab of capture/Ab of revelation) to recognize TSH.