KMID : 0356620120270020121
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Journal of Korean Society of Endocrinology 2012 Volume.27 No. 2 p.121 ~ p.125
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Differential Diagnostic Value of Total T3/Free T4 Ratio in Graves¡¯ Disease and Painless Thyroiditis Presenting Thyrotoxicosis
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Lee Sang-Min
Kim Soo-Kyoung Hahm Jong-Ryeal Jung Jung-Hwa Kim Ho-Su Chung Soon-Il Choi Bong-Hoi Jung Tae-Sik
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Abstract
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Background: It is important to differentiate Graves¡¯ disease from that of painless thyroiditis in patients with thyrotoxicosis. In this study, we evaluated the usefulness of total T3 to free T4 ratio in making a differential diagnosis between Graves¡¯ disease and painless thyroiditis.
Methods: We reviewed medical records of thyrotoxic patients, who had been diagnosed with Graves¡¯ disease or painless thyroiditis, from October 2009 to July 2011. We assessed clinical characteristics, serum levels of total T3, free T4, thyroid stimulating hormone, thyrotropin-binding inhibitory immunoglobulin, and findings of 99mTechnetium thyroid scan. We analyzed the total T3/free T4 ratios between Graves¡¯ disease and painless thyroiditis patients.
Results: A total of 76 untreated thyrotoxic patients "49 Graves¡¯ disease and 27 painless thyroiditis" were examined. The total T3, free T4 levels and the total T3/free T4 ratios were significantly higher in patients with Graves¡¯ disease than in those with painless thyroiditis (P < 0.001). In the total T3/free T4 ratio > 73, the possibility of Graves¡¯ disease was significantly higher than in painless thyroiditis (sensitivity, 75.5%; specificity, 70.3%). The sensitivity and specificity of the total T3/free T4 ratio in patients with free T4 < 3.6 ng/dL have been increased (sensitivity, 100%; specificity, 71.4%).
Conclusion: The total T3/free T4 ratios was useful for making a differential diagnosis between Graves¡¯ disease and painless thyroiditis.
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KEYWORD
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Graves¡¯ disease, Painless thyroiditis, Thyrotoxicosis, Total T3/free T4 ratio
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