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CPE-001 · synthetic case FX-005
Pregnancy context with mild TSH elevation and Anti-TPO positivity
Pregnant, TSH 3.1 against a pregnancy range, Anti-TPO positive.
Purpose: Route to pregnancy-specific pathway and prevent universal TSH >2.5 rule.
Inputs the engine received
Patient
- Age and sex
- 31, female
Context
- Pregnant
- Yes
Symptoms
- Fatigue
- Present
Laboratory
- TSH
- 3.1 mIU/L (ref 0.1–4)
- FT4
- 1 ng/dL (ref 0.8–1.8)
- ANTI-TPO
- 160 IU/mL (ref 0–35)
What the engine reports
Special Population Pathway
Pregnancy context identified. Use pregnancy-specific, trimester- and assay-appropriate interpretation where available. Do not apply a universal automatic treatment decision from the general engine.
Detected clinical pattern
No Biochemical Evidence of Current Thyroid Dysfunction from Entered TSH and FT4
Thyroid-function tests entered are within their reported laboratory reference intervals.
- Etiology / context: Autoimmune Thyroiditis Supported
Why this pattern was identified
- TSH and FT4 within reference. TSH 3.1 mIU/L (ref 0.1–4) and FT4 1 ng/dL (ref 0.8–1.8).
- Autoantibody positive. Antibody positivity with normal TSH and FT4 does not itself indicate thyroid hormone treatment.
- Pregnancy with Anti-TPO positivity and TSH 2.5–4.0. ATA guidance allows consideration of treatment in this range; the decision stays with the obstetric/endocrine physician.
Context modules routed
CTX-HT-PREG Pregnancy Thyroid Context
Use trimester- and assay-specific reference intervals. No universal automatic treatment rule at TSH > 2.5. In TPO-positive pregnancy, ATA guidance recommends treatment above TSH 4.0 and allows consideration between 2.5 and 4.0, within a physician-managed obstetric/endocrine pathway.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Monitor thyroid function over time based on clinical context; antibody positivity alone is not a reason for thyroid hormone.
Evidence and rule trace · 2 rules
PR-HT-06Autoimmune Thyroiditis with Euthyroid Function
Inputs: ANTI-TPO 160 IU/mL (ref 0–35) · TSH 3.1 mIU/L (ref 0.1–4) · FT4 1 ng/dL (ref 0.8–1.8)
Autoimmune thyroiditis supported without current functional failure.
CTX-HT-PREGPregnancy Thyroid Context
Context module routed.
Evidence
- EV-ATA-PREG · American Thyroid Association. Hypothyroidism in Pregnancy; based on ATA pregnancy guidance.
- EV-ATA-HASHIMOTO · American Thyroid Association. Hashimoto's Thyroiditis.
Physician adjudication required. For clinician review only. This output identifies clinical patterns and safety considerations from the documented inputs. It does not establish an autonomous diagnosis or treatment plan. Physician confirmation is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Thyroid-function testsMove the sliders or type values
- below range
- within range
- above range
- below range
- within range
- above range
Zones are drawn from your reference intervals. The engine, not the map, decides the pattern.
Laboratory values and reference rangesUse your lab's own interval
µIU/mL and mIU/L are numerically identical.
Interpreted against the reporting assay's upper limit.
Only used in the thyrotoxicosis pathway.
Patient context
Medications and exposures
Symptoms and physical findingsSupportive only: never classify on their own
Symptoms
Signs and decompensation red flags
More thyroid cases
FX-001
Overt primary hypothyroidism with autoimmune support
A 54-year-old with fatigue, cold intolerance and a TSH of 18.4.
FX-002
Antibody positive with euthyroid function
Strongly positive antibodies, but TSH and FT4 are both normal.
FX-003
Mild subclinical pattern with positive Anti-TPO
Mildly high TSH, normal FT4, positive Anti-TPO.
FX-004
TSH at or above 10 with normal FT4
TSH of 12 with a normal FT4 in a woman of 57.
FX-006
Preconception infertility context
Trying to conceive, TSH 4.8, Anti-TPO positive.
FX-007
Central hypothyroidism after traumatic brain injury
Fatigue and low libido after a head injury. TSH 1.4, FT4 0.5.
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