{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:41:37Z","timestamp":1777610497701,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A differential diagnosis of thyrotoxicosis is crucial as the treatment of the main causes of this condition can vary significantly. Recently published diagnostic guidelines on thyrotoxicosis embrace the presence of thyrotropin receptor (TSH\u2010R) antibodies (TRAb) as the primary and most important diagnostic step. The application of diagnostic algorithms to aid in the treatment of hyperthyroidism supports using thyroid radionuclide scintigraphy (TRSt) in baffling clinical scenarios, when TRAb are absent or when third\u2010generation TRAb are not available. First\u2010generation TRAb measurement may have limitations. Consequently, patients with thyrotoxicosis and first\u2010generation TRAb results may be misdiagnosed and consequently improperly treated. Our purpose was to compare first\u2010generation TRAb values to TRSt in the differential diagnosis of hyperthyroidism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study of 201 untreated outpatients with overt or subclinical hyperthyroidism on whom first\u2010generation TRAb and TRSt had been performed at the time of diagnosis. Histological specimens were analysed in patients who had previously undergone thyroid surgery at our centre. SPSS 20.0 was used in statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010three out of 201 (36.3%) patients had positive TRAb. A diffuse uptake was present in 83.5% (61\/73), whereas 13.7% (10\/73) had a heterogeneous uptake and 2.7% (2\/73) had an absent uptake. Thirty out of 91 (33%) patients with diffuse uptake were negative for positive TRAb and were diagnosed with Graves\u2019 disease. Analysis of 37 histological specimens indicated that TRSt had greater accuracy (81% vs 75.7%) and specificity (79.2% vs 57.1%) when compared to TRAb in the differential diagnosis of thyrotoxicosis. However, TRSt sensitivity was inferior to TRAb (84.6% vs 92.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study endorses that initial differential diagnosis of thyrotoxicosis should not be based solely on first\u2010generation TRAb as this approach may leave nearly 20% of the patients misdiagnosed and, consequently, improperly treated. Our results underscore that thyroid scintigraphy should also be performed when only first\u2010generation TRAb assays are available during the initial differential diagnosis of thyrotoxicosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14308","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T07:23:32Z","timestamp":1596785012000},"page":"466-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of the role of thyroid scintigraphy in the differential diagnosis of thyrotoxicosis"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-0581","authenticated-orcid":false,"given":"Carolina M.","family":"Perdomo","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Garc\u00eda\u2010Go\u00f1i","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1666-072X","authenticated-orcid":false,"given":"Lidia","family":"Sancho","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"J. Paricio","sequence":"additional","affiliation":[{"name":"Department of Pathology Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda D.","family":"Lozano","sequence":"additional","affiliation":[{"name":"Department of Pathology Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"de la Higuera","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Curr\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition Cl\u00ednica Universidad de Navarra  Pamplona 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