Graves' disease other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Overview

Radioactive iodine uptake which shows increased homogenous uptake is the diagnostic tool for graves' disease. Thyroid ultrasound and color flow doppler are other useful methods to narrow down the differential list of diagnosis.

Radioactive iodine uptake

24-hr radioactive iodine uptake (RAIU) is a diagnostic measure for Graves' disease which shows increased homogeneous uptake.[1]

  • RAIU is generally increased in Graves' disease because of the action of stimulating TRAbs.
  • Normal values for RAIU 24 h after the administration of a tracer dose of radioiodine are 20% in iodine sufficient and 40% in iodine deficient areas.

Thyroid ultrasound

  • Typically, the thyroid pattern in Graves' disease is hypoechoic.
  • Thyroid ultrasound gives an accurate estimation of the thyroid size, which is important in planning the therapeutic management, and allows the detection of thyroid nodules that may not be palpable on physical examination.

Color flow Doppler

  • Color flow Doppler (CFD) estimates the blood flow which, in hyperthyroid Graves' disease patients is typically increased within the thyroid gland.
  • CFD can be useful in the differential diagnosis of Graves' disease and other causes of thyrotoxicosis characterized by a low blood flow to the thyroid, such as factitious thyrotoxicosis, painless and subacute thyroiditis, and type 2 amiodarone-induced thyrotoxicosis.[2]

References

  1. Terry J. Smith & Laszlo Hegedus (2016). "Graves' Disease". The New England journal of medicine. 375 (16): 1552–1565. doi:10.1056/NEJMra1510030. PMID 27797318. Unknown parameter |month= ignored (help)
  2. Kahaly GJ, Bartalena L, Hegedüs L (2011). "The American Thyroid Association/American Association of Clinical Endocrinologists guidelines for hyperthyroidism and other causes of thyrotoxicosis: a European perspective". Thyroid. 21 (6): 585–91. doi:10.1089/thy.2011.2106.ed3. PMID 21663420.

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