“…The urinary iodine concentration has been reported to be useful for differentiating destructive thyroiditis from Graves' disease (18). In the present case, however, it was not tested because elevated urine iodine excretion after amiodarone treatment negates its diagnostic value (18,19). Although the FT3/FT4 ratio also has been reported to be helpful for differentiating painless thyroiditis from Graves' disease (20), the present patient's severe comorbid conditions, including lethal arrhythmia and heart failure, would have modified the FT3/FT4 ratio in this case.…”