Эндокринология и метаболический синдром
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Frequency of Discrepancy between Scintigraphy Reports and TSH Dosage

Schillaci O, Modoni S, Tavolozza M, Travascio L, Lacanfora A, Di Biagio D, Palombo E and Simonetti G

Objective: The purpose of the study was to analyze the discrepancy observed between scintigraphic reports and hormonal dosages.

Methods: Eighty-four consecutive patients undergone thyroid scan with 99mTc were included in this study. 6/84 pts also underwent a 131I scan to compare discordant TSH value and thyroid scan result.

Results: Discrepancy in our series due to the absence of focal areas of thyroid hyperfunction was found in 15/84 patients with subclinical hyperthyroidism, defined by standard free fractions (FT3 and FT4) and TSH inhibited or anyway substandard (18% of all cases, 48% of patients with low TSH). In 11/84 patients (13% of all cases, 21% of patients with normal TSH value) a “hot” nodule was found without hormonal values suggestive of a frank or subclinical hyperthyroidism.

Conclusion: In cases with TSH below the normal range as there is often in front of the non-detection of nodules functionally independent. Further studies are needed to identify the coexistence of factors other than those already known, that play a role in regulating TSH. On the other hand the unexpected feedback of “hot” nodules with hormonal tests perfectly normal suggest a low intake of iodine in the diet; infact a low intake of iodine cannot produce enough thyroid hormone so high as to trigger the pituitary feed-back, even in areas of functional autonomy.