{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:42:16Z","timestamp":1792622536529,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,4,15]],"date-time":"2007-04-15T00:00:00Z","timestamp":1176595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> Differentiation between destruction\u2010induced thyrotoxicosis and Graves\u2019 thyrotoxicosis is important for selection of proper therapy. It is, however, often difficult to make this distinction without measurement of radioactive iodine uptake. We investigated the possibility that assessment of thyroid blood flow would allow differentiation between the two entities.<\/jats:p><jats:p><jats:bold>Patients and measurements\u2002<\/jats:bold> One hundred and fourteen untreated patients with thyrotoxicosis (56 Graves\u2019 disease, 28 painless thyroiditis, 30 subacute thyroiditis) and 25 normal controls were examined. Serum levels of freeT4 (FT4), freeT3 (FT3) and TSH were measured by chemiluminescent immunoassay, and anti\u2010TSH receptor antibodies (TSH\u2010binding inhibitory immunoglobulin, TBII) were measured by enzyme\u2010linked immunosorbent assay. Thyroid volume and blood flow (TBF) were measured quantitatively by ultrasonography.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> TBF was significantly higher in Graves\u2019 disease (mean\u00a0\u00b1 1SD: 14\u00b79\u00a0\u00b1\u00a06\u00b74%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b70001) than in painless thyroiditis (0\u00b78\u00a0\u00b1 0\u00b75%), subacute thyroiditis (0\u00b79\u00a0\u00b1\u00a00\u00b77%) and in normal controls (0\u00b78\u00a0\u00b1\u00a00\u00b75%). All patients with Graves\u2019 disease had TBF values of more than 4% and all patients with painless thyroiditis and subacute thyroiditis had TBF values less than 4%. TBF values significantly correlated with values of radioactive iodine uptake (RAIU) either at 3\u00a0h (<jats:italic>r<\/jats:italic>\u00a0=\u00a00\u00b7492, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701) or 24\u00a0h (<jats:italic>r<\/jats:italic>\u00a0=\u00a00\u00b7762, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001) within the Graves\u2019 disease and painless thyroiditis groups. There was no relationship between TBF values and thyroid volumes or values of TBII in the Graves\u2019 disease group. All patients with Graves\u2019 disease had positive TBII of 15% or more. Three of 28 patients with painless thyroiditis and one of 30 patients with subacute thyroiditis had positive TBII.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> TBF was quantitatively measured by power Doppler ultrasonography and was more effective than TBII for differentiation between destruction\u2010induced thyrotoxicosis (painless or subacute thyroiditis) and Graves\u2019 thyrotoxicosis. TBF values of less than 4% in untreated thyrotoxic patients are laboratory signals of destruction\u2010induced thyrotoxicosis and if these are determined, the radioactive iodine uptake test can be omitted for differential diagnosis of these two types of thyrotoxicosis.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2007.02832.x","type":"journal-article","created":{"date-parts":[[2007,5,1]],"date-time":"2007-05-01T13:29:27Z","timestamp":1178026167000},"page":"41-45","source":"Crossref","is-referenced-by-count":99,"title":["Quantitative measurement of thyroid blood flow for differentiation of painless thyroiditis from Graves\u2019 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