IS THE DETERMINATION OF THYROGLOBULIN (TG) INDICATED IN NONMALIGNANT THYROID-DISORDERS

There is no in vitro parameter, which correlates with Thyroglobulin (Tg). The Tg-determination is without question indicated as tumormarker for follow-up studies of patients with differentiated thyroid carcinoma after total thyroidectomy and/or 131 l-therapy. Tg is also a helpful parameter for the diagnosis of connatal athyroidism and of thyrotoxicosis factitia. Due to recent reports in international journals Tg seems to be helpful also for diagnosis and follow-up studies of patients with benign thyroid disorders. Besides the established in vitro and in vivo parameters the repeated Tg-determination allows to judge the effect of therapeutic regimens in Graves' disease, subacute thyroiditis, diffuse and nodular goiter with benign regressive or autonomous lesions. However, these indications are still matter of controverse discussions. Even though in view of the pathophysiological and methodical limitations Tg is in the hands of experienced thyroidologists an important parameter for the diagnosis and follow-up of benign thyroid disorders, before a general use of this cost effective test one should await for results of additional studies in iodine deficient areas such as Germany in comparison to the so far convincing reports from USA and Japan. The data available indicate, that Tg allows important additional information in patients with benign thyroid disorders. Therefore, one is to be astonished, that authors, who use Tg as a sensitive parameter for follow-up of patients with thyroid cancer, still disapprove the use of Tg in benign thyroid disorders.