Endocrinology and Metabolism

Case Report

Thyroid
Thyroid Dysfunction Associated with Administration of the Long-Acting Gonadotropin-Releasing Hormone Agonist: Eun Jin Han, Ha Do Song, Ji Hoon Yang, So Young Park, Sung Hoon Kim, Hyun Koo Yoon, Chang Hoon Yim; Endocrinol Metab. 2013;28(3):221-225. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.221

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Gonadotropin-releasing hormone (GnRH) agonist has been used in the treatment of a wide variety of sex-hormone-related diseases, as the administration of GnRH agonist can alter the secretion of gonadotropin and sex hormones. Recently, we found that the long-acting GnRH agonist aggravated hyperthyroidism and induced painless thyroiditis. This is the first report to demonstrate the association of thyroid dysfunction with GnRH agonist injection in Korea. Here, we report three cases and emphasize the clinical importance of this aggravating factor in autoimmune thyroid disease.

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Original Article

Differential Diagnostic Value of Total T3/Free T4 Ratio in Graves' Disease and Painless Thyroiditis Presenting Thyrotoxicosis.: Sang Min Lee, Soo Kyoung Kim, Jong Ryeal Hahm, Jung Hwa Jung, Ho Su Kim, Sungsu Kim, Soon Il Chung, Bong Hoi Choi, Tae Sik Jung; Endocrinol Metab. 2012;27(2):121-125. Published online June 20, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.2.121

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Abstract PDF

BACKGROUND
It is important to differentiate Graves' disease from that of painless thyroiditis in patients with thyrotoxicosis. In this study, we evaluated the usefulness of total T3 to free T4 ratio in making a differential diagnosis between Graves' disease and painless thyroiditis. METHODS: We reviewed medical records of thyrotoxic patients, who had been diagnosed with Graves' disease or painless thyroiditis, from October 2009 to July 2011. We assessed clinical characteristics, serum levels of total T3, free T4, thyroid stimulating hormone, thyrotropin-binding inhibitory immunoglobulin, and findings of 99mTechnetium thyroid scan. We analyzed the total T3/free T4 ratios between Graves' disease and painless thyroiditis patients. RESULTS: A total of 76 untreated thyrotoxic patients "49 Graves' disease and 27 painless thyroiditis" were examined. The total T3, free T4 levels and the total T3/free T4 ratios were significantly higher in patients with Graves' disease than in those with painless thyroiditis (P < 0.001). In the total T3/free T4 ratio > 73, the possibility of Graves' disease was significantly higher than in painless thyroiditis (sensitivity, 75.5%; specificity, 70.3%). The sensitivity and specificity of the total T3/free T4 ratio in patients with free T4 < 3.6 ng/dL have been increased (sensitivity, 100%; specificity, 71.4%). CONCLUSION: The total T3/free T4 ratios was useful for making a differential diagnosis between Graves' disease and painless thyroiditis.

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Comparison of 99mTc Pertechnetate Thyroid Uptake Rates by Gamma Probe and Gamma Camera Methods for Differentiating Graves’ Disease and Thyroiditis
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Nuclear Medicine and Molecular Imaging.2022; 56(1): 42. CrossRef
Interpretation of puzzling thyroid function tests
Jee Hee Yoon, Ho-Cheol Kang
Journal of the Korean Medical Association.2018; 61(4): 241. CrossRef
The High Proportion of Painless Thyroiditis as a Cause of Thyrotoxicosis in Korea
Sang Il Mo, A Jeong Ryu, Yeo Joo Kim, Sang Jin Kim
Journal of Korean Thyroid Association.2015; 8(1): 61. CrossRef

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