Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland

Context: Establishing the etiology of thyrotoxicosis is of utmost importance to plan the appropriate line of therapy. However, certain scenarios such as absence of pathognomonic clinical features of Graves' disease in some patients, or non-availability of radionuclide scanning and newer generat...

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Autores principales:	Rukma Rajendra Narkar, Ipsita Mishra, Anoj Kumar Baliarsinha, Arun Kumar Choudhury
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer Medknow Publications 2021
Materias:	color-flow doppler ft3/ft4 ratio graves' disease thyroiditis t3/t4 ratio Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/d8dcdf8f259f46cfa78725ccb3cf8cc7
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spelling	oai:doaj.org-article:d8dcdf8f259f46cfa78725ccb3cf8cc72021-11-12T10:10:55ZRapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland2230-821010.4103/ijem.ijem_137_21https://doaj.org/article/d8dcdf8f259f46cfa78725ccb3cf8cc72021-01-01T00:00:00Zhttp://www.ijem.in/article.asp?issn=2230-8210;year=2021;volume=25;issue=3;spage=193;epage=197;aulast=Narkarhttps://doaj.org/toc/2230-8210Context: Establishing the etiology of thyrotoxicosis is of utmost importance to plan the appropriate line of therapy. However, certain scenarios such as absence of pathognomonic clinical features of Graves' disease in some patients, or non-availability of radionuclide scanning and newer generation TRAb assays especially in resource-poor settings, necessitates utilization of other, simple and effective measures to differentiate between the two common causes of thyrotoxicosis, Graves' disease (GD) and Destructive thyroiditis (DT). Aims: The aim of this work was to study the role of FT3/FT4 ratio, T3/T4 ratio and color flow Doppler ultrasound in treatment-naïve patients with thyrotoxicosis, in comparison to Tc-99m pertechnetate thyroid scanning in the differentiation of thyrotoxicosis due to GD and DT. Materials and Methods: Clinical data was collected from all study subjects. Thyroid function tests including FT3, FT4, T3, T4 and TSH, TSH Receptor Antibody (TRAb), Technetium Tc 99m pertechnetate scan and the mean peak systolic velocity in inferior thyroid artery (mean PSV-ITA) by color Doppler ultrasonography of thyroid gland was done in all patients. Results: A total of 83 treatment-naïve patients with thyrotoxicosis (61 with GD and 22 with DT) were studied. Mean PSV-ITA, T3/T4 ratio and FT3/FT4 ratio showed a sensitivity of 85.2%, 73.8%, and 77.04%, and a specificity of 90.9%, 72.7%, and 59.09%, respectively. The three parameters in combination yielded a positive predictive value of 100% in the diagnosis of Graves' disease. Conclusion: Results of this study show that inferior thyroid artery blood flow, T3/T4 ratio and FT3/FT4 ratio are useful parameters in the differentiation between GD and DT.Rukma Rajendra NarkarIpsita MishraAnoj Kumar BaliarsinhaArun Kumar ChoudhuryWolters Kluwer Medknow Publicationsarticlecolor-flow dopplerft3/ft4 ratiograves' diseasethyroiditist3/t4 ratioDiseases of the endocrine glands. Clinical endocrinologyRC648-665Diseases of the digestive system. GastroenterologyRC799-869ENIndian Journal of Endocrinology and Metabolism, Vol 25, Iss 3, Pp 193-197 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	color-flow doppler ft3/ft4 ratio graves' disease thyroiditis t3/t4 ratio Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	color-flow doppler ft3/ft4 ratio graves' disease thyroiditis t3/t4 ratio Diseases of the endocrine glands. Clinical endocrinology RC648-665 Diseases of the digestive system. Gastroenterology RC799-869 Rukma Rajendra Narkar Ipsita Mishra Anoj Kumar Baliarsinha Arun Kumar Choudhury Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
description	Context: Establishing the etiology of thyrotoxicosis is of utmost importance to plan the appropriate line of therapy. However, certain scenarios such as absence of pathognomonic clinical features of Graves' disease in some patients, or non-availability of radionuclide scanning and newer generation TRAb assays especially in resource-poor settings, necessitates utilization of other, simple and effective measures to differentiate between the two common causes of thyrotoxicosis, Graves' disease (GD) and Destructive thyroiditis (DT). Aims: The aim of this work was to study the role of FT3/FT4 ratio, T3/T4 ratio and color flow Doppler ultrasound in treatment-naïve patients with thyrotoxicosis, in comparison to Tc-99m pertechnetate thyroid scanning in the differentiation of thyrotoxicosis due to GD and DT. Materials and Methods: Clinical data was collected from all study subjects. Thyroid function tests including FT3, FT4, T3, T4 and TSH, TSH Receptor Antibody (TRAb), Technetium Tc 99m pertechnetate scan and the mean peak systolic velocity in inferior thyroid artery (mean PSV-ITA) by color Doppler ultrasonography of thyroid gland was done in all patients. Results: A total of 83 treatment-naïve patients with thyrotoxicosis (61 with GD and 22 with DT) were studied. Mean PSV-ITA, T3/T4 ratio and FT3/FT4 ratio showed a sensitivity of 85.2%, 73.8%, and 77.04%, and a specificity of 90.9%, 72.7%, and 59.09%, respectively. The three parameters in combination yielded a positive predictive value of 100% in the diagnosis of Graves' disease. Conclusion: Results of this study show that inferior thyroid artery blood flow, T3/T4 ratio and FT3/FT4 ratio are useful parameters in the differentiation between GD and DT.
format	article
author	Rukma Rajendra Narkar Ipsita Mishra Anoj Kumar Baliarsinha Arun Kumar Choudhury
author_facet	Rukma Rajendra Narkar Ipsita Mishra Anoj Kumar Baliarsinha Arun Kumar Choudhury
author_sort	Rukma Rajendra Narkar
title	Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
title_short	Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
title_full	Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
title_fullStr	Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
title_full_unstemmed	Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland
title_sort	rapid differential diagnosis of thyrotoxicosis using t3/t4 ratio, ft3/ft4 ratio and color doppler of thyroid gland
publisher	Wolters Kluwer Medknow Publications
publishDate	2021
url	https://doaj.org/article/d8dcdf8f259f46cfa78725ccb3cf8cc7
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Rapid differential diagnosis of thyrotoxicosis using T3/T4 ratio, FT3/FT4 ratio and color doppler of thyroid gland

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