Case Author(s): Edward Pinkus,M.D. and Jerold Waliis,M , 12/24/01 . Rating: #D., #Q.
Diagnosis: Grave disease
Brief history:
43 year old female with exophtalmus,agitated,elevated Free T-4,undetectable TSH level was presented to evaluate thyroid pathology.
And to differentiate thyroiditis vs. Grave's disease.
Images:
thyroid scintiigraphy
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Full history/Diagnosis is available below
Diagnosis: Grave disease
Full history:
43 year old female with exophtalmus, agitated, elevated free T4, undetectable TSH was presented to evaluate thyroud pathalogy and differentiate thyroiditis vs. Grave disease. Thyroid gland on physical exam 35-40 grams.
Radiopharmaceutical:
10.1 mci Tc-99m pertechnetate i.v.
Findings:
Uniformly increased activity in the both lobes of the enlarged thyroid gland. There is no evidence of nodular increased activity to suggest a toxic nodular goiter, nor decreased uptake to suggest thyroiditis.
Findings consistent with hyperthyroidism due to Grave disease.
Discussion:
Grave disease is of autoimmune origin. It presents with thyromegaly, uniform distribution of incresed activity throughout the tyroid gland, and with prominent pyramidal lobe. On Tc-99m petechnetate scan,the thyroid has increased activity, and salivary glands are difficukt to identify. 24-hour iodine uptake usually in the range of 40-70%.
Followup:
On 2/28/02 24-hour radioactive iodine uptake was 66%.
She was treated with 7.1 mci of I-131.
ACR Codes and Keywords:
References and General Discussion of Thyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Metabolic, endocrine, toxic)
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Case number: tr012
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