Differentiating Graves' Disease from Subacute Thyroiditis Using Ratio of Serum Free Triiodothyronine to Free Thyroxine

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2016 Aug 30

PMID 27570620

Citations 17

Authors

Chutintorn Sriphrapradang

Adikan Bhasipol

Affiliations

Soon will be listed here.

Abstract

Background: The measurement of free thyroid hormone, instead of the total form, is more commonly used in current practice. We aimed to evaluate the usefulness of the ratio of serum free triiodothyronine (FT3, pg/mL) to free thyroxine (FT4, ng/dL) for differentiating Graves' disease from subacute thyroiditis.

Materials And Methods: Medical records of thyrotoxic patients aged >15 years who had measurement of FT3, FT4 and thyrotropin on the first diagnosis of thyrotoxicosis before initiating treatment were retrospectively reviewed. Data were collected from all clinics, and were not limited to the endocrine clinic. Pregnant women were excluded.

Results: A total of 548 patients (468 with Graves' disease, 40 with subacute thyroiditis and 40 with toxic adenoma/multinodular goiter) were recruited. Mean age was 43.9 ± 15.4 years. Most were female 434 (79.2%), and goiter was present in 55.3%. Prevalence of T3-toxicosis and T4-toxicosis were 5.6% and 6.6%, respectively. Mean FT3/FT4 ratios were 4.62 ± 2 (10(-2) pg/ng) in patients with Graves' disease and 2.73 ± 0.5 in subacute thyroiditis. The area under the ROC curve of the FT3/FT4 ratio for diagnosis of Graves' disease was 0.83 (95%CI, 0.76-0.91). Cutoff level of this ratio >4.4 offered sensitivity of 47.2% and specificity of 92.8%.

Conclusions: FT3/FT4 ratio of >4.4 (10(-2) pg/ng) may help in differentiating the cause of thyrotoxicosis.

Citing Articles

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Triiodothyronine/Free Thyroxine Ratio as a Criterion for the Differentiation Between Graves' Disease and Subacute Thyroiditis.

Alidrisi H, Thamer N, Radhi M, Hammadi S, Abdulaziz F Cureus. 2024; 16(6):e63083.

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Zhang Y, Wang Y, Liu M, Wei L, Huang J, Dong Z Front Endocrinol (Lausanne). 2023; 14:1148174.

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Rapid Differential Diagnosis of Thyrotoxicosis Using T3/T4 Ratio, FT3/FT4 Ratio and Color Doppler of Thyroid Gland.

Narkar R, Mishra I, Baliarsinha A, Choudhury A Indian J Endocrinol Metab. 2021; 25(3):193-197.

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