Rapid Differential Diagnosis of Graves'Disease and Destractive Thyroiditis in Untreated Patients with Thyrotoxicosis
| Autor: | Nakano, Ayuko, Suzuki, Kunihiro, Tomizawa, Atsuko, Hirama, Noriko, Banba, Nobuyuki, Hattori, Yoshiyuki, Kasai, Kikuo |
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| Jazyk: | japonština |
| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Dokkyo journal of medical sciences. 36(2):105-108 |
| ISSN: | 0385-5023 |
| Popis: | [目的]バセドウ病 (GD) と破壊性甲状腺炎 (DT) の迅速鑑別法にはTSHレセプター抗体の有無,甲状腺エコー検査,遊離T3/T4 (FT3/FT4),総T3/T4比 (T3/T4),総ALP (T-ALP),甲状腺血流が有用とされている.そのうち最も鋭敏な指標となりうる項目を検討した.[方法]2007年から未治療で当科を受診したGD:15名,無痛性甲状腺炎(PT):8名,亜急性甲状腺炎( SAT):10名( DT:18名) を対象として,FT3/FT4,T3/T4,T-ALP,上甲状腺動脈平均血流速度( mean velocity STA) を測定した.[結果]年齢:GD51.2± 18.8歳,DT49.3±21.0歳,FT3/FT4:GD3.3±1.0,DT2.9±1.9,T3/T4:GD15.9±4.7,DT15.2± 3.3,T-ALP( U/l):GD431.3 ±196.6,DT299.1±163.2,mean velocitySTA( cm/s):GD65.0±8.7,DT41.0± 7.0,(P < 0.0001).[結論]今回の検討ではmean velocity STA がGD とDT の鑑別に最も有用であった. It is important to make a rapid differentialdiagnosis of Graves'Diseases (GD) and Destructive Thyroiditis(DT). However, it is often difficult to make a distinctionwithout measurement of radioactive iodine uptake(RAIU). Instead of measurement of RAIU, measuringFreeT3/FT4ratio (FT3/FT4), totalT3/T4ratio (T3/T4),total alkaline phosp hatase activity( T-ALP), blood flow inthe thyroid, is useful for differential diagnosis. We searchedfor the parameters is most sensitive parameter for rapiddifferential diagnosis.Patients and Methods:We investigated on 33 patientswith untreated hyperthyroidism (15 with GD and 18 withDT). When 33 patients were first seen in our hospital, wemeasured FT3/FT4, T3/T4, T-ALP, and mean velocity inthe superior thyroid arteries( STA).Results:In comparison between GD and DT, mean velocitySTA was significantly increased in patients with GD.In the group of GD, FT3/FT4 and T-ALP tend to be higherin patients with GD but without statistical significance.Conclusion:Mean velocity STA might be the most sensitiveparameter for rapid differential diagnosis of GD andDT. |
| Databáze: | OpenAIRE |
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