Abstract | BACKGROUND: METHODS: We performed a retrospective chart review of hyperthyroid children who had both TSI estimation and (99m)Tc uptake assessment at presentation. Based on subsequent laboratory studies and follow-up, 37 had GD and 10 had non-GD thyroiditis. The TSI index was considered positive (TSI+) when it was above the upper limit of normal. (99m)Tc uptake was considered positive (Tc+) for any uptake >0.4% and negative (and low) (Tc-) for uptake ≤0.4%. RESULTS: Forty-seven youth (83% females), aged 12.3±4.6 years, presented with a suppressed thyrotropin (TSH) and elevated free thyroxine and total triiodothyronine. All 37 patients with GD were Tc+ (100% sensitivity and specificity). The sensitivity of TSI for diagnosing GD was 84%, and the specificity was 100%. Six patients with GD were discordant with Tc+ but TSI-. Elevated TSI correlated with Tc+ (p=0.01) with a degree of agreement (kappa) of 0.69. CONCLUSION: (99m)Tc has excellent specificity and sensitivity in diagnosing GD. Given additional costs of (99m)Tc (two and a half times as much as TSI), it is reasonable to reserve (99m)Tc uptake assessment for hyperthyroidism of unclear etiology and negative TSI.
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Authors | Charumathi Baskaran, Madhusmita Misra, Lynne L Levitsky |
Journal | Thyroid : official journal of the American Thyroid Association
(Thyroid)
Vol. 25
Issue 1
Pg. 37-42
(Jan 2015)
ISSN: 1557-9077 [Electronic] United States |
PMID | 25257665
(Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Immunoglobulins, Thyroid-Stimulating
- Triiodothyronine
- Technetium
- Thyroxine
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Topics |
- Adolescent
- Child
- Female
- Humans
- Hyperthyroidism
(blood, diagnosis)
- Immunoglobulins, Thyroid-Stimulating
- Male
- Retrospective Studies
- Technetium
- Thyroid Function Tests
- Thyroxine
(blood)
- Triiodothyronine
(blood)
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