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Our objectives were: (a) to calculate the accuracy of TH in discriminating between Graves\u2019 and non-Graves\u2019 thyrotoxicosis, compared to ALBTs, NEU and Graves\u2019 orbitopathy (GO); (b) to explore the outcome of GD-associated\u00a0TH and non-GD-associated TH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We prospectively analyzed consecutive adult patients with newly diagnosed thyrotoxicosis from January 2018 to June 2023. TH was detected via neck ultrasound (nUS) then confirmed and followed by magnetic resonance imaging (MRI). For GD vs non-GD clinical sensitivity (SE) and specificity (SPEC), accuracy, positive predictive value (PPV) and negative predictive value (NPV) of GO, TH, ALBTs and NEU were calculated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>264 thyrotoxic patients were included. TH was found in 16.4% (20\/122) of GD vs 1.4% (2\/142) in non-GD (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). SE, SPEC, accuracy, PPV and NPV of the four extrathyroidal manifestations of GD were as follows, respectively: GO 26%, 100%, 66%, 100%, 61%; ALBTs 41%, 89%, 69%, 76%, 66%; NEU 5%, 100%, 56%, 100%, 55%; TH 16%, 98%, 61%, 91%, 98%. In 18 of them, TH regressed within 12\u00a0months after achieving euthyroidism under anti-thyroid drug therapy, while in the remaining 2, TH regressed 6 months after thyroid surgery. In the two non-GD patients with TH, thymus disappeared along with euthyroidism.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>TH in the hyperthyroidism scenario provides a high PPV for GD. A conservative approach for the diagnostic work\u2010up and initial management of thyrotoxicosis-associated TH should be adopted.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s40618-024-02355-w","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T04:27:01Z","timestamp":1711772821000},"page":"2487-2497","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Thymic hyperplasia is accurate to detect new-onset Graves\u2019 hyperthyroidism and resolves after restoring euthyroidism"],"prefix":"10.1007","volume":"47","author":[{"given":"L.","family":"Scappaticcio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Caruso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Di Martino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ferrazzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Clemente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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