Reasons for difficulties in the interpretation of thyroid scintigraphy results with 99mTc-pertechnetate in functional autonomy of thyroid nodules and Graves’ disease: a clinical case
https://doi.org/10.14341/ket12788
Abstract
Thyrotoxicosis is a condition caused by an excess of thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3), in the body, leading to corresponding clinical manifestations. One of the main challenges in the differential diagnosis of various forms of thyrotoxicosis is the similarity in the clinical presentation of diseases. Therefore, the main tools for accurate diagnosis verification in the wide spectrum of thyrotoxicosis nosologies are the correct sequence of laboratory and instrumental investigations and subsequent interpretation of the obtained results. Only accurately established disease etiology will allow for the selection of the most appropriate and effective treatment for a particular patient, as well as the avoidance of unjustified risks of possible complications. In this article, we will discuss the main difficulties that may arise during the differential diagnosis of various forms of thyrotoxicosis, as well as address some key aspects of proper diagnosis.
About the Authors
M. M. Gadzhimuradova
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Mansurat G. Gadzhimuradova, MD
Moscow
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи.
A. S. Bondarenko
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Axenia S. Bondarenko, MD
11, Dm. Ulyanova street, 117292, Moscow
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи.
P. A. Nikiforovich
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Petr A. Nikiforovich, MD, PhD
Moscow
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи.
D. G. Beltsevich
Endocrinology Research Centre
Russian Federation
Competing Interests:
Russian Federation
Dmitry G. Beltsevich, MD, PhD, professor
Moscow
Competing Interests:
Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи.
References
1. Troshina EA, Sviridenko NYu, Vanushko VE, et al. The federal clinical recommendations on diagnostics and treatment of toxic goiter. Problems of Endocrinology. 2014;60(6):67-77. (In Russ.). doi: https://doi.org/10.14341/probl201460667-77
2. Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis [published correction appears in Thyroid. 2017;27(11):1462]. Thyroid. 2016;26(10):1343-1421. doi: https://doi.org/10.1089/thy.2016.0229
3. Mel’nichenko GA, Lesnikova SV. Standartnye podkhody k lecheniyu sindromov tireotoksikoza i gipotireoza. Consilium Medicum. 2000;2(5):221-224. (In Russ.) Available from: https://consilium.orscience.ru/2075-1753/article/view/91324
4. Lee SY, Pearce EN. Hyperthyroidism: A Review. JAMA. 2023;330(15):1472-1483. doi: https://doi.org/10.1001/jama.2023.19052
5. Abdulkhabirova FM, Bezlepkina OB, Brovin DN, et al. Clinical practice guidelines “Management of iodine deficiency disorders”. Problems of Endocrinology. 2021;67(3):10-25. (In Russ.)]. Doi: https://doi.org/10.14341/probl12750
6. Blick C, Nguyen M, Jialal I. Thyrotoxicosis. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482216/
7. Smit MA, van Kinschot CMJ, van der Linden J, et al. Measurement of anti-TSH receptor antibodies: what is the correct cut-off value? Neth J Med. 2020;78(2):55-63. Available from: https://www.njmonline.nl/getpdf.php?id=2194
8. Rumyantsev PO, Degtyarev MV, Dzeytova DS, et al. Thyroid scintigraphy in diagnosis of nodular and diffuse thyroid pathology. Clinical and experimental thyroidology. 2019;15(4):138-147. (In Russ.)]. doi: https://doi.org/10.14341/ket12240
9. Lukinović J, Bilić M. Overview of Thyroid Surgery Complications. Acta Clin Croat. 2020;59(Suppl 1):81-86. doi: https://doi.org/10.20471/acc.2020.59.s1.10
10. Reschini E, Peracchi M. Thyroid scintigraphy during antithyroid treatment for autonomous nodules as a means of imaging extranodular tissue. Clin Nucl Med. 1993;18(7):597-600. doi: https://doi.org/10.1097/00003072-199307000-00013
11. Nygaard B. Changes in the thyroid technetium-99m scintigram after antithyroid and subsequent radioiodine treatment for solitary autonomous nodules. Thyroid. 1998;8(3):223-227. doi: https://doi.org/10.1089/thy.1998.8.223
12. Fewins J, Simpson CB, Miller FR. Complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am. 2003;36(1):189-x. doi: https://doi.org/10.1016/s0030-6665(02)00129-9
13. Andrysiak-Mamos E, Żochowska E, Kaźmierczyk-Puchalska A, et al. Treatment of severe life threatening hypocalcemia with recombinant human teriparatide in patients with postoperative hypoparathyroidism — a case series. Endokrynol Pol. 2016;67(4):403-412. doi: https://doi.org/10.5603/EP.a2016.0051
Supplementary files
|
|
1. Figure 1: Thyroid scintigraphy with Tc-99m-pertechnetate along with antithyroid therapy. | |
| Subject | ||
| Type | Исследовательские инструменты | |
View
(262KB)
|
Indexing metadata ▾ | |
|
|
2. Figure 2: Repeat thyroid scintigraphy with Tc-99m-pertechnetate after withdrawal of antithyroid therapy. | |
| Subject | ||
| Type | Исследовательские инструменты | |
View
(368KB)
|
Indexing metadata ▾ | |
Review
For citations:
Gadzhimuradova M.M., Bondarenko A.S., Nikiforovich P.A., Beltsevich D.G. Reasons for difficulties in the interpretation of thyroid scintigraphy results with 99mTc-pertechnetate in functional autonomy of thyroid nodules and Graves’ disease: a clinical case. Clinical and experimental thyroidology. 2023;19(4):13-17. (In Russ.) https://doi.org/10.14341/ket12788
Views:
408
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
