SynthesisClinical endocrinology2025
PEG Precipitation to Detect Macro-TSH in Clinical Practice: A Systematic Review.
Synthesis in Clinical endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2026 ETA guideline on interference in immunoassay measurements used in assessment of thyroid function.European thyroid journal · 2026Guideline
- Laboratory Identification of Pseudohypercalcemia Induced by Hyperglobulinemia in Multiple Myeloma: A Case Report.Journal of clinical laboratory analysis · 2026Article
- Low-affinity IgG-mediated macro-TSH: diagnostic limitations of peak-based gel filtration chromatography-a case report with review of literature.Endocrine journal · 2026Review
- Macrohormones in endocrinology: prevalence, clinical impact, and diagnostic approaches.Frontiers in endocrinology · 2026Review
- Exploration of post-PEG precipitation TSH recovery in hypothyroid patients.Frontiers in endocrinology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Macro-thyroid-stimulating hormone (macro-TSH) is a complex formed by monomeric TSH with anti-TSH antibodies, causing falsely elevated TSH levels and potential misdiagnosis of hypothyroidism. Identification of macro-TSH is essential for proper treatment and patient follow-up. Its diagnostic gold standard is gel filtration chromatography (GFC), which is very expensive, time-consuming, and rarely available. Polyethylene glycol (PEG) precipitation is more accessible and inexpensive. The aim of the study was to review evidence on PEG precipitation for the detection of macro-TSH to standardize its application in clinical practice.
methodsAccording to PRISMA guidelines, we conducted up to August 2024 a comprehensive search of PubMed and Scopus databases, using terms related to macro-TSH and PEG precipitation.
resultsWe included 23 studies with 4476 subjects, encompassing 10 observational studies and 13 case series/reports. All studies showed a low risk of bias. They were conducted in tertiary centres and included newborns to elderly subjects. The most of evidence about the procedure has been achieved with PEG concentrations of 12.5%. The PEG-precipitable TSH of the macro-TSH cases was always higher than 75% ranging on average from 81% to 90%. No-macro-TSH cases (controls) showed a PEG-precipitable TSH percentage ranging from 44.1% to 61.8%.
conclusionsPEG precipitation can be taken into account as a useful diagnostic tool for macro-TSH. However, it is necessary to perform PEG precipitation in cases with a highly suspicious clinical picture and at the same time perform all available ancillary tests. PEG-precipitable TSH > 75% can be considered a reliable diagnostic threshold for macro-TSH cases.
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Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.