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Year : 2008  |  Volume : 5  |  Issue : 1  |  Page : 11-15

The relevance of 99m Tc04 - thyroid scan in the management of patients with thyroiditis

Department of Nuclear Medicine, P. D. Hinduja National Hospital andMRC, Mumbai, India

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B A Krishna
Department of Nuclear Medicine, P. D. Hinduja National Hospital andMRC, Mumbai
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Source of Support: None, Conflict of Interest: None

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The role of thyroid scintigraphy in ruling out thyroiditis in patients with thyrotoxicosis is well known. However its role in prognostic decision-making with regards to lifelong thyroxin replacement has not been critically evaluated. We undertook a retrospective analysis in this regard. Totally 62 patients of thyroiditis were retrospectively evaluated with respect to clinical findings, thyroid hormonal profile, thyroid scan findings and long term follow-up to 5 yrs. The thyroid scan was performed with 99m TcO ~. The scan appearances varied from low uptake to very high intense uptake. Those with low uptake were classified as acute thyroiditis while those with high intense uptake were classified as resolving phase of thyroiditis. 46 of 62 patients had thyrotoxic hormonal profile and scan showed low uptake pattern. While in remaining 16 patients the scan showed high tracer uptake with raised TSH value suggesting resolving phase of thyroiditis. In this group, 4 patients (25%) with high uptake on thyroid scan and high TSH values did not undergo thyroxin replacement therapy during 1 to 3 years of follow up. This is an intriguing finding and raises critical question about life long thyroxin replacement in these patients based only on TSH values. Our study suggests that patients with high TSH values and high uptake on thyroid scan would need clinical observation without the thyroxin replacement therapy on the routine basis.

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