A 53-year-old woman with an early form of de Quervain's disease involving both thyroid lobes was found to have her thyroid uptake of iodine suppressed, although the serum thyroid hormone concentrations were normal while the administration of TRH resulted in significant increase in the serum TSH concentrations. After administration of TSH the thyroid reserve was found to below. The diagnosis of sub-acute thyroiditis was confirmed on biopsy. The above data seem to indicate that the suppression of the thyroid uptake in the early stage of de Quervain's disease may be directly caused by the inflammatory condition of the gland, rather than, as is usually the case, by the excess of thyroid hormones and, consequently, by the suppression of pituitary TSH secretion.
SummaryBy comparing thyroid scans made with 99mTc and 131I in 40 euthyroid goiter patients large discrepancies were found in 20% of all cases. For example, “warm” nodules on 99mTc scans were found to be “cold” on 131I scans, or a “cold” nodule on a 99mTc scan was observed as a “warm” one on a 131I scan. The above discrepancies seem to result from the differences in the metabolism of the two radioisotopes in the thyroid and those in the time which elapsed between the administration of the radioisotope and the execution of the scan.Generally speaking 99mTc thyroid scintigraphy should not be recommended as a routine technique in adults, its usefulness being limited to the cases in which 131I scans were found to be illegible. “Cold” nodules on 99mTc scans should also be reexamined after T3 stimulation.
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