Thyreoglobulin – mehr als ein Nachsorgeparameter?

Zusammenfassung

Thyreoglobulin ist das vorherrschende Protein der Schilddrüse und essenzieller Bestandteil der Schilddrüsenhormonsynthese. Während mit unempfindlichen historischen Bestimmungsmethoden Thyreoglobulin nur selten im Serum von Patienten nachgewiesen werden konnte, erlauben aktuelle, hochsensitive Bestimmungsmethoden den Nachweis schon geringster Thyreoglobulinkonzentrationen im Serum. Diese Übersicht gibt einen Überblick über die Entwicklung der aktuellen Bestimmungsmethoden und deren Limitationen. Zudem wird neben der etablierten klinischen Anwendung in der Nachsorge des differenzierten, nicht-medullären Schilddrüsenkarzinoms die Rolle des Thyreoglobulins bei der Einschätzung von Schilddrüsenknoten, der Abklärung einer ätiologisch unklaren Hyperthyreose, der kongenitalen Hypothyreose, als Monitoring-Parameter von Krankheitsbildern mit erhöhter Schilddrüsenfollikeldestruktion und als Biomarker der Iodversorgung betrachtet.

Abstract

Thyroglobulin is the predominant protein of the thyroid and an essential molecule for the synthesis of thyroid hormones. Historically, using insensitive tests, thyroglobulin was only occasionally found in the sera of patients with thyroid disorders. Nowadays, highly sensitive assays enable the detection of minuscule amounts of thyroglobulin in patient’s sera. This review elucidates the development and limitations of current Tg-assays. Aside from the established clinical use of thyroglobulin as the most relevant parameter for the follow-up of non-medullary differentiated thyroid cancer the role of thyroglobulin for the assessment of thyroid nodules, hyperthyroidism of unclear etiology, or congenital hypothyroidism as well as monitoring parameter in thyroid disorders accompanied by increased destruction of thyroid follicles and as a biomarker of the iodine nutrition status is discussed.

Schlüsselwörter

Thyreoglobulin - differenziertes Schilddrüsenkarzinom - Hyperthyreose - Hypothyreose - Schilddrüsenfollikeldestruktion - Iodversorgung

Key words

thyroglobulin - differentiated thyroid carcinoma - hyperthyroidism - hypothyroidism - destruction of thyroid follicles - iodine status

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