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Name : Ms. KHUSHI Patient UID.

: 4250322
Age/Gender : 21 Yrs/Female Visit No. : 00232401240010
Referred Client : LDPL005-SS Collected on : 24-Jan-2024 10:00AM
Referred By :KFB Received on : 24-Jan-2024 03:22PM
Doctor Name : Reported on : 24-Jan-2024 04:11PM
Sample Type : Serum - 13697576

BIOCHEMISTRY
Test Name Results Unit Bio. Ref. Interval
BILIRUBIN -TOTAL
BILIRUBIN TOTAL 1.16 mg/dL 0.10 - 1.20
Methodology: Diazonium Ion Blanked
The American Academy of Pediatrics uses a newborn jaundice level chart to determine if a baby needs treatment.
The chart is based on your baby’s total serum bilirubin level and age.
Jaundice in newborns is normal. It usually develops by their second or third day of life. In formula-fed babies, jaundice typically goes away on its own within two weeks. In
breastfed babies, jaundice can last a month or longer.
Total serum bilirubin (TSB) level to determine treatment Age of newborn
Above 10 milligrams Less than 24 hours old
Above 15 milligrams 24 to 48 hours old
Above 18 milligrams 49 to 72 hours old
Above 20 milligrams Older than 72 hours.

CLINICAL NOTES
Bilirubin is a waste product primarily produced by the normal breakdown of heme. Heme is a component of hemoglobin. Bilirubin is ultimately processed by the liver to allow its
elimination from the body .RBCs normally degrade after about 120 days in circulation. As heme is released from hemoglobin, it is converted to bilirubin. This form of bilirubin is
also called unconjugated bilirubin. Unconjugated bilirubin is converted to form conjugated bilirubin in liver. Conjugated bilirubin enters the bile and passes from the liver to the
small intestines; there, it is further broken down by bacteria and eventually eliminated in the stool. Thus, the breakdown products of bilirubin give stool its characteristic brown
color.A small amount (approximately 250 to 350 milligrams) of bilirubin is produced daily in a normal, healthy adult.

CLINICAL SIGNIFICANCE
Unconjugated bilirubin may be increased when there is an unusual amount of RBC destruction (hemolysis) or when the liver is unable to process bilirubin (i.e., with liver diseases
such as cirrhosis or inherited problems). Conversely, conjugated bilirubin can increase when the liver is able to process bilirubin but is not able to pass the conjugated bilirubin to
the bile for removal; when this happens, the cause is often acute hepatitis or blockage of the bile ducts.

Increased total and unconjugated bilirubin levels are relatively common in newborns in the first few days after birth. This finding is called "physiologic jaundice of the newborn"
and occurs because the newborn's liver is not mature enough to process bilirubin yet. Usually, physiologic jaundice of the newborn resolves itself within a few days. However, in
hemolytic disease of the newborn, RBCs may be destroyed because of blood incompatibilities between the baby and the mother; in these cases, treatment may be required
because high levels of unconjugated bilirubin can damage the newborn's brain.

A rare (about 1 in 10,000 births) but life-threatening congenital condition called biliary atresia can cause increased total and conjugated bilirubin levels in newborns. This
condition must be quickly detected and treated, usually with surgery, to prevent serious liver damage that may require liver transplantation within the first few years of life. Some
children may require liver transplantation despite early surgical treatment.

*** End Of Report ***

Page 1 of 2
Name : Ms. KHUSHI Patient UID. : 4250322
Age/Gender : 21 Yrs/Female Visit No. : 00232401240010
Referred Client : LDPL005-SS Collected on : 24-Jan-2024 10:00AM
Referred By :KFB Received on : 24-Jan-2024 03:22PM
Doctor Name : Reported on : 24-Jan-2024 04:02PM
Sample Type : Serum - 13697576

IMMUNOLOGY
Test Name Results Unit Bio. Ref. Interval
THYROID PROFILE : T3, T4 & TSH(TFT)
TRIODOTHYRONINE TOTAL (T3) 1.19 ng/mL 0.70-2.04
Methodology: ECLIA
THYROXINE TOTAL (T4) 7.56 ug/dl 5.1-14.1
Methodology: ECLIA
THYROID STIMULATING HORMONE (TSH) 3.020 µIU/ml 0.35-5.50
Methodology: ECLIA
NOTE-TSH levels are subject to circardian variation,reaching peak levels between 2-4 AM and min between 6-10 PM. The variation is the order of 50% hence time of the day has influence on the
measures serum TSH concentration.Dose and time of drug intake also influence the test result.
Transient increase in TSH levels or abnormal TSH levels can be seen in some non thyroidal conditions,simoultaneous measurement of TSH with free T4 is useful in evaluating differantial diagnosis.

INTERPRETATION-Ultra Sensitive 4th generation assay


1.Primary hyperthyroidism is accompanied by ↑serum T3 & T4 values along with ↓ TSH level.
2.Low TSH,high FT4 and TSH receptor antibody(TRAb) +ve seen in patients with Graves disease
3.Low TSH,high FT4 and TSH receptor antibody(TRAb) -ve seen in patients with Toxic adenoma/Toxic Multinodular goiter
4.HighTSH,Low FT4 and Thyroid microsomal antibody increased seen in patients with Hashimotos thyroiditis
5.HighTSH,Low FT4 and Thyroid microsomal antibody normal seen in patients with Iodine deficiency/Congenital T4 synthesis deficiency
6.Low TSH,Low FT4 and TRH stimulation test -Delayed response seen in patients with Tertiary hypothyroidism
7.Primary hypothyroidism is accompanied by ↓ serum T3 and T4 values & ↑serum TSH levels
8.Normal T4 levels accompanied by ↑ T3 levels and low TSH are seen in patients with T3 Thyrotoxicosis
9.Normal or↓ T3 & ↑T4 levels indicate T4 Thyrotoxicosis ( problem is conversion of T4 to T3)
10.Normal T3 & T4 along with ↓ TSH indicate mild / Subclinical Hyperthyroidism .
11.Normal T3 & ↓ T4 along with ↑ TSH is seen in Hypothyroidism .
12.Normal T3 & T4 levels with ↑ TSH indicate Mild / Subclinical Hypothyroidism .
13.Slightly ↑ T3 levels may be found in pregnancy and in estrogen therapy while ↓ levels may be encountered in severe illness , malnutrition , renal failure and during therapy with drugs like
propanolol.
14.Although ↑ TSH levels are nearly always indicative of Primary Hypothroidism ,rarely they can result from TSH secreting pituitary tumours.

DURING PREGNANCY - REFERENCE RANGE for TSH IN uIU/mL (As per American Thyroid Association)
1st Trimester : 0.10-2.50 uIU/mL
2nd Trimester : 0.20-3.00 uIU/mL
3rd Trimester : 0.30-3.00 uIU/mL
The production, circulation, and disintegration of thyroid hormones are altered throughout the stages of pregnancy.

REMARK-Assay results should be interpreted in context to the clinical condition and associated results of other investigations. Previous treatment with corticosteroid therapy may result in lower TSH
levels while thyroid hormone levels are normal. Results are invalidated if the client has undergone a radionuclide scan within 7-14 days before the test. Abnormal thyroid test findings often found in
critically ill patients should be repeated after the critical nature of the condition is resolved.TSH is an important marker for the diagnosis of thyroid dysfunction.Recent studies have shown that the
TSH distribution progressively shifts to a higher concentration with age ,and it is debatable whether this is due to a real change with age or an increasing proportion of unrecognized thyroid disease in
the elderly.

*** End Of Report ***

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