Graves disease

Case contributed by Ammar Ashraf


Easy fatigability and 20 kg weight loss in two months.

Patient Data

Age: 20 years
Gender: Male

Tc-99m thyroid scan

Nuclear medicine

Radiopharmaceutical:  Tc-99m pertechnetate.

Technique:  The study performed after intravenous injection of 199 MBqs of Tc-99m pertechnetate.  Planar images in anterior, left anterior oblique and right anterior oblique projections were acquired 20 minutes post injection.

Description:  The study revealed enlarged thyroid gland with homogeneously increased radiotracer distribution all over the imaged thyroid.  There is no area of reduced radiotracer uptake anywhere in the imaged thyroid gland to suggest cold nodule.  Thyroid uptake function is 8.1% (normal=0.4-4%).

Conclusion: Scan findings are suggestive of diffuse goiter with significantly increased thyroid uptake function, likely due to the Graves disease.

Case Discussion

Laboratory investigations showed:

  • TSH= <0.01 (normal range: 0.35-4.94 mIU/L)

  • Free T4=31.2 (normal range: 9-19 pmol/L)  

Patient was treated with antithyroid medication (methimazole 10 mg OD).

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