Scintigraphic Features of Autoimmune Thyroiditis

Intenzo, Charles; Capuzzi, David M.; Jabbour, Serge; Kim, Sung M.; dePapp, Ann E.

doi:10.1148/radiographics.21.4.g01jl17957

Cited by 35 publications

(12 citation statements)

References 11 publications

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“…Na doença de Graves constata-se um aumento difuso da captação de iodo, 11,15 como se confirmou no caso descrito, no bócio nodular tóxico hiperfuncionante uma captação localizada de iodo e na tiroidite subaguda habitualmente não se verifica aumento da captação de iodo, uma vez que não ocorre aumento da síntese das hormonas tiroideias -apenas um aumento da sua libertação e o tratamento é apenas sintomático. 16 As potenciais consequências do hipertiroidismo não tratado são as arritmias (nomeadamente fibrilhação auricular), hipertensão pulmonar, hipertrofia do ventrículo esquerdo e insuficiência cardíaca. 9 O tratamento da doença de Graves, em primeira linha, passa pelo recurso a fármacos antitiroideus (preferencialmente metibasol 5mg -exceto no primeiro trimestre da gravidez -no máximo até 60mg/dia, dependendo da gravidade da doença) 10 e beta-bloqueantes para contro-lo dos sintomas adrenérgicos (e.g., propranolol, atenolol, bisoprolol) em utentes com FC em repouso > 90bpm ou com doença cardiovascular coexistente.…”

Section: Quadro I Resultados Do Estudo Efetuadounclassified

Hipertensão arterial secundária no adulto jovem: um caso clínico

Oliveira

Neves

Tomaz

et al. 2018

RPMGF

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USF do Minho INTRODUÇÃO A hipertensão arterial (HTA) secundária resulta de uma causa identificável e potencialmente tratável. Os dados epidemiológicos mais recentes apontam para uma prevalência de hipertensão de 26,9% em Portugal, sendo mais elevada no sexo feminino (29,5%) do que no sexo masculino (23,9%). 1 Não há dados relativos à prevalência da hipertensão secundária em Portugal. Outros estudos apontam para uma prevalência de HTA secundária que varia entre 5-10% dos casos de HTA. 2-4 No entanto, dada a elevada prevalência de hipertensão, é provável que seja uma situação frequentemente diagnosticada ao nível dos cuidados de saúde primários, cujo diagnóstico e terapêutica atempadas podem influenciar o prognóstico dos utentes.

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Section: Quadro I Resultados Do Estudo Efetuadounclassified

Hipertensão arterial secundária no adulto jovem: um caso clínico

Oliveira

Neves

Tomaz

et al. 2018

RPMGF

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Hypothyroidism is manifested by a low Free T4 and an elevated TSHb. Our study shows that symptoms of hypothyroidism can occur in patients with antithyroid antibodies that are below the level usually considered to be clinically significant.…”

Section: Discussionmentioning

confidence: 99%

Value of Low Levels of Anti-TPO Antibodies in Patients With Suspicion of Hashimoto Thyroiditis

Eising¹,

Jentzen²,

Freudenberg³

et al. 2007

The Endocrinologist

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In clinical practice, many patients do not show the full symptoms of Hashimoto thyroiditis. The titer of the anti-TPO antibodies (ATAB) is often detectable but not pathologically elevated. This study evaluates the clinical status of patients with low ATAB titers.Sixty-eight consecutive patients (55 female, 13 male; age: 24 -84 years; mean: 55.4 years) with detectable titers of ATAB were investigated by clinical status, ultrasound, and thyroid scintigraphy with Tc-99m.Eighteen patients had pathologically elevated titers of ATAB. Fifty-eight patients with detectable ATAB titers had clinical symptoms, 46 hypoechoic tissue by ultrasound, 17 a decrease in thyroid gland volume, and 14 a thyroid-stimulating hormone Ͼ2.5 mU/L.Patients with low titers of ATAB and thyroid-stimulating hormone values in the upper reference interval (Ͼ2.5 mU/L) can have symptoms compatible with thyroid dysfunction and deserve a trial of therapy. (The Endocrinologist 2007;17: 83-84) T he National Academy of Clinical Biochemistry has altered the upper bound of the normal range of thyroid-stimulating hormone (TSHb) in their guidelines from 4.0 mU/L down to 2.5 mU/L. 1 The natural history of patients with findings typical for Hashimoto thyroiditis is described in this paper. MATERIALS AND METHODS PatientsSixty-eight consecutive patients (55 female, 13 male; age: 24 -84 years; mean: 55.4 years) who presented with detectable titers of anti-TPO antibodies (ATAB) were studied with regard to clinical status, ultrasound (US), and thyroid scintigraphy (TS) with Tc-99m. Fifty healthy subjects served as controls. MethodsThyroid-related symptoms, prior thyroid history of surgery, radioiodine therapy, or medication were recorded together with the clinical thyroid examination.Inclusion criteria are no intravenous contrast media in the last 2 months, no preceding thyroid surgery, detectable amount of ATAB, absence of focal autonomous nodules, and findings defined during a physical examination of the thyroid gland, including scintigraphy.Free thyronine (fT3), free thyroxine (fT4), TSHb, and ATAB were measured. Two subgroups were defined by the range of ATAB titers:• Group 1: ATAB detectable but less than 60 U/mL • Group 2: ATAB Ͼ60 U/mLThe level of anti-TSH-receptor antibody (TRAB) was determined in 45 cases.Ultrasonography was performed with a convex 5-MHz probe using a Picker LC 7000A scanner. The thyroid volume was calculated using length ϫ width ϫ depth ϫ 0.5. A decrease in thyroid volume was considered to be 6 mL or more in female patients and 9 mL or more in male patients. 2 TS was performed 20 minutes after the i.v. injection of 60 MBq of technetium-99m pertechnetate. The images were acquired in the sitting position over 5 minutes. SPSS Rel. 11 was used on a personal computer. The level of significance was set at 0.05 (2-tailed P). Nonparametric correlation coefficients (Spearman) were applied to nonparametric data. RESULTSEighty-six percent of the patients in the group with minimally elevated ATAB titers were symptomatic (Table 1). A decrease in ech...

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“…Postpartum thyroiditis, usually considered a subtype of silent thyroiditis, occurs in 5% to 10% of pregnancies. 2 Low RAIU can also be seen in Hashimoto's thyroiditis, thyroid hormone ingestion, excess dietary iodine, recent iodinated contrast, and with some medications. These can easily be distinguished from subacute or silent thyroiditis, because they are biochemically euthyroid or hypothyroid.…”

Section: Subacute Silent and Postpartum Thyroiditismentioning

confidence: 99%

Radionuclide Imaging of the Thyroid Gland: Patterns, Pearls, and Pitfalls

Smith¹,

Oates²

2004

Clinical Nuclear Medicine

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Optimal thyroid scintigraphy requires an understanding of 1) the embryology, anatomy, and physiology of the thyroid gland; and 2) the properties of the 2 common imaging agents, technetium-99m pertechnetate (Tc-99m) and radioiodine (1-123). The normal gland has a characteristic scintigraphic pattern with these tracers and its uptake can be quantified with 1-123. Thyroid diseases often produce characteristic abnormal patterns. These abnormal patterns could be described as diffuse or focal, homogeneous or heterogeneous, increased or decreased. "Extrathyroidal" localization can be seen with esophageal activity, ectopic tissue, thyroglossal duct cyst, and substernal goiter. Thyroid scintigraphy of neonates, as a follow up to abnormal blood screening, demonstrates typical etiologic patterns. The first step in evaluating a patient with suspected thyroid disease is correlating the normal or abnormal scintigraphic pattern with available biochemical data, clinical history, and physical examination. By integrating the interpretive and technical "pearls" and "pitfalls" outlined in this article, the radiologist can be more confident in establishing a proper diagnosis.

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Scintigraphic Features of Autoimmune Thyroiditis

Cited by 35 publications

References 11 publications

Hipertensão arterial secundária no adulto jovem: um caso clínico

Hipertensão arterial secundária no adulto jovem: um caso clínico

Value of Low Levels of Anti-TPO Antibodies in Patients With Suspicion of Hashimoto Thyroiditis

Radionuclide Imaging of the Thyroid Gland: Patterns, Pearls, and Pitfalls

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