Ikekubo K, Hino M, Ito H, Koh T, Ishihara T, Kurahachi H, Kasagi K, Hidaka A, Mori T
Department of Nuclear Medicine and Medicine, Kobe City General Hospital, Japan.
Ann Nucl Med. 1990 Jul;4(2):43-8. doi: 10.1007/BF03164594.
We saw 24 thyrotoxic Graves' patients with normal thyroidal uptake of technetium-99m pertechnetate (99mTc) out of 201 untreated thyrotoxic Graves' patients seen over 4 years. The clinical and laboratory findings for these patients were studied and analysed. Thyroid uptake and scintigraphic examinations by means of 99mTc, TBII and TSab activity measurement clearly distinguished these patients from other thyrotoxic disorders (destruction-induced thyrotoxicosis and autonomously functioning thyroid lesions). Different from other disorders, these patients had not lower but normal thyroid uptake and also showed diffuse and discrete trapping into the enlarged glands. These patients had significantly smaller goiters, a lower serum thyroid hormone level, and lower TBII and TSab activity, when compared with other high 99mTc uptake groups with Graves' disease, and their condition could be easily controlled with small amounts of antithyroid drugs. Our study indicates that thyrotoxic Graves' disease with normal 99mTc uptake exists and 99mTc uptake study and TBII activity measurement is very useful for the diagnosis. The normal 99mTc uptake thyrotoxic Graves' patient might be early stage patients with general Graves' disease and their early discrimination from general Graves' patients is very advantageous for treatment and prognosis.
在4年期间诊治的201例未经治疗的甲状腺毒症性格雷夫斯病患者中，我们发现24例患者的甲状腺对99m锝高锝酸盐（99mTc）摄取正常。对这些患者的临床和实验室检查结果进行了研究和分析。通过99mTc进行的甲状腺摄取和闪烁扫描检查、促甲状腺素受体抗体（TBII）和甲状腺刺激抗体（TSab）活性测定，可将这些患者与其他甲状腺毒症性疾病（破坏性甲状腺毒症和自主性甲状腺病变）明确区分开来。与其他疾病不同，这些患者的甲状腺摄取并非降低而是正常，并且在肿大的腺体中也显示出弥漫性和散在性摄取。与其他99mTc摄取高的格雷夫斯病组相比，这些患者的甲状腺肿明显较小，血清甲状腺激素水平较低，TBII和TSab活性也较低，并且使用少量抗甲状腺药物就能轻松控制病情。我们的研究表明，存在99mTc摄取正常的甲状腺毒症性格雷夫斯病，99mTc摄取研究和TBII活性测定对诊断非常有用。99mTc摄取正常的甲状腺毒症性格雷夫斯病患者可能是普通格雷夫斯病的早期患者，早期将他们与普通格雷夫斯病患者区分开来对治疗和预后非常有利。
