Further testing

Additional testing should directly address the possibility of Grave's disease and should also determine the nature of the nodule associated with the thyroid (testing so far has been inconclusive regarding the nodule). Grave's disease is strongly associated with the presence of anti-thyroid microsomal antibodies, while other antibodies against thyroid epitopes (e.g., thyroglobulin) occur in Hashimoto's thyroiditis. Furthermore, the thyroid hyperfunction that occurs in Grave's disease can be assessed directly by measuring the rate radio-iodine uptake into the thyroid gland.

Serum was obtained for anti-thyroid antibody testing and the following results were obtained:

                          Patient         Normal
Antithyroglobulin Ab.      neg.            neg.
Antimicrosomal Ab.         pos. (1:1280)   neg.

A thyroid scan to evaluate the uptake of radioactive iodine into the thyroid gland showed 68% uptake at 6 hr and 54% uptake at 24 hr after treatment with iodine-123 (normal 5 - 28% uptake at these time points). The radio-iodine uptake was homogeneously increased over the entire gland except in the area of the palpable nodule, where uptake was decreased.

Further testing

Questions