The Present Status of the Diagnosis of Hyperthyroidism

Editorial1 January 1956THE PRESENT STATUS OF THE DIAGNOSIS OF HYPERTHYROIDISMROBERT E. BAUERROBERT E. BAUERSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-44-1-207 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe term Hyperthyroidism seems preferable to Exophthalmic Goiter, Graves's Disease, Basedow's Disease, or Thyrotoxicosis inasmuch as this disease may occur without exophthalmos, evident goiter, and occasionally without significant hypermetabolism.1The diagnosis of hyperthyroidism should be readily apparent in the presence of its typical features, notably goiter, exophthalmos, tremor, and tachycardia. Frequently, however, its true nature will be obscured by one of many clinical disguises. In a few of its more subtle masquerades, hyperthyroidism may appear as heart failure refractory to therapy, auricular fibrillation,2 insulin resistant diabetes, chronic diarrhea, hyperparathyroidism,3, 4 myasthenia gravis5 and even periodic paralysis.6On the other hand,...1 WernerHamilton SCH: Hyperthyroidism without apparent hypermetabolism, J. A. M. A. 146: 450-453, 1951. CrossrefMedlineGoogle Scholar2 BortinSilverYohalem MMSSB: Diagnosis of masked hyperthyroidism in cardiac patients with auricular fibrillation, Am. J. Med. 11: 40-43, 1951. CrossrefMedlineGoogle Scholar3 StanleyFazekas MAJ: Thyrotoxicosis simulating hyperparathyroidism, Am. J. Med. 6: 269-275, 1949. Google Scholar4 RoseBoles ERS: Hypercalcemia in thyrotoxicosis, Med. Clin. North America 37: 1715-1724, 1953. CrossrefGoogle Scholar5 MillikanHaines CHSF: The thyroid gland in relation to neuromuscular disease, A.M.A. Arch. Int. Med. 92: 5-39, 1953. CrossrefGoogle Scholar6 Linder MA: Periodic paralysis associated with hyperthyroidism: Report of three cases, Ann. Int. Med. 43: 241-254, 1955. LinkGoogle Scholar7 RoswitRosenkrantz BJA: Evaluation of diagnostic methods in diseases of thyroid function with particular reference to radioiodine tracer tests, Am. J. M. Sc. 223: 229-238, 1952. CrossrefMedlineGoogle Scholar8 SilverPorotaCrohn SBEB: Hypermetabolic states without hyperthyroidism, Arch. Int. Med. 85: 479-482, 1950. CrossrefGoogle Scholar9 BrugerHollander MVP: Extrathyroidal hypermetabolism: Classification and discussion including three illustrative case reports, Ann. Int. Med. 35: 1260-1275, 1951. LinkGoogle Scholar10 Skanse B: Radioactive iodine in the diagnosis of thyroid disease, Acta med. Scandinav., Suppl. 235: 1-186, 1949. Google Scholar11 ChamovitzSleisengerFreedberg DLNHAS: Thyrotoxicosis factitia, Am. J. Med. 11: 255-260, 1951. CrossrefGoogle Scholar12 Means JH: The thyroid and its diseases, Ed. 2, 1948, J. B. Lippincott, Philadelphia. Google Scholar13 Dubois EF: Basal metabolism in health and disease, Ed. 3, 1936, Lea & Febiger, Philadelphia. Google Scholar14 RapportCurtisSimcox RLGMSJ: The somnolent metabolic rate (SMR) as an aid in the differential diagnosis of thyroid dysfunction, Trans. Am. Goiter A. 124-138, 1951. Google Scholar15 Bartels EC: Basal metabolic rate and plasma cholesterol as aids in the clinical study of thyroid disease, J. Clin. Endocrinol. 10: 1126-1135, 1950. CrossrefGoogle Scholar16 MeckstrothRapportCurtisSimcox CVRLGMSJ: The laboratory diagnosis of extrathyroidal hypermetabolism, J. Clin. Endocrinol. 12: 1373-1379, 1952. CrossrefGoogle Scholar17 BauerGoodwinLibby FKWERL: Radioiodine in the diagnosis of thyroid disorders, J. A. M. A. 152: 1414-1417, 1953. MedlineGoogle Scholar18 CrispellParsonSprinkle KRWP: A simplified technique for the diagnosis of hyperthyroidism utilizing the 1-hour uptake of orally administered radioiodine, J. Clin. Endocrinol. 13: 221-224, 1953. CrossrefGoogle Scholar19 Greer MA: Correlation of the 24-hour radioiodine uptake of the human thyroid gland with the 6- and 8-hour uptakes and the accumulation gradient, J. Clin. Investigation 30: 301-304, 1951. CrossrefMedlineGoogle Scholar20 Evans TC: Radioactive iodine in the study of thyroid disorders, J. Iowa State M. Soc. 45: 179-184, 1955. MedlineGoogle Scholar21 Cunningham RM: Radioactive iodine in thyroid disease, Med. Illus. 8: 714-722, 1954. MedlineGoogle Scholar22 KeatingHainesPowerWilliams FRSFMHMM: The radioiodine accumulative function of the human thyroid gland as a diagnostic test in clinical medicine, J. Clin. Endocrinol. 10: 1425-1464, 1950. CrossrefGoogle Scholar23 WernerHamiltonLeiferGoodwin SCHBELD: An appraisal of the radioiodine tracer technique as a clinical procedure in the diagnosis of thyroid disorders, J. Clin. Endocrinol. 10: 1054-1076, 1950. CrossrefGoogle Scholar24 FreedbergChamovitzKurland ASDLGS: Thyroid function in normal and pathological states as revealed by radioactive iodine studies, Metabolism 1: 26-36, 1952. MedlineGoogle Scholar25 AstwoodStanley EBMM: Use of radioiodine in the study of thyroid function in man, West. J. Surg. 55: 625-639, 1947. Google Scholar26 Pochin EE: Investigation of thyroid function and disease with radioactive iodine, Lancet 2: 41-46, 84-92, 1950. CrossrefMedlineGoogle Scholar27 Myant NB: Tests of thyroid function with radioiodine (I131), Brit. M. Bull. 8: 141-147, 1952. CrossrefMedlineGoogle Scholar28 QuinbyMcCume EHDH: Uptake of radioiodine by the normal and disordered thyroid gland in children, Radiology 49: 201-205, 1947. CrossrefMedlineGoogle Scholar29 McArthurRawsonFluhartyMeans JWRWRGJH: The urinary excretion of radioiodine as an aid in the diagnosis of hyperthyroidism, Ann. Int. Med. 29: 229-237, 1948. LinkGoogle Scholar30 Slingerland DW: Factors influencing the uptake of iodine by the thyroid, J. Clin. Endocrinol. 15: 131-141, 1955. CrossrefGoogle Scholar31 Wiswell JG: Laboratory tests in common endocrine disorders, Md. State M. J. 2: 497-503, 1953. MedlineGoogle Scholar32 SilverYohalemNewburger SSBRA: Pitfalls in the diagnostic use of radioactive iodine, J. A. M. A. 159: 1-5, 1955. CrossrefMedlineGoogle Scholar33 WernerQuinbySchmidt SCEHC: The use of tracer doses of radioactive iodine (I131) in the study of normal and disordered thyroid function in man, J. Clin. Endocrinol. 9: 342-353, 1949. CrossrefGoogle Scholar34 BlomfieldMacGregorMillerWayne GWAGHEJ: Treatment of thyrotoxicosis with radioactive iodine, Brit. M. J. 2: 373-381, 1951. CrossrefMedlineGoogle Scholar35 BrauschHirschBenuaDobyns CCEZRSBM: Uptake of I131 in the thyroid of patients with impaired liver function, J. Clin. Endocrinol. 14: 1287-1299, 1954. CrossrefGoogle Scholar36 StarrSnipesLiebhold-Schueck PGR: Biologic effects of triiodothyronine in human subjects, J. Clin. Endocrinol. 15: 98-106, 1955. CrossrefGoogle Scholar37 ChaikoffTaurogReinhardt ILAWO: The metabolic significance of the protein-bound iodine of the plasma: A study of its concentration under various conditions and its rate of formation as measured with radioactive iodine, Endocrinology 40: 47-54, 1947. CrossrefMedlineGoogle Scholar38 MiddlesworthNurnbergerLipscomb LVCEA: A simplified sensitive test for thyroid function using PBI131 , J. Clin. Endocrinol. 14: 1056-1061, 1954. CrossrefGoogle Scholar39 ClarkMoeAdams DERHEE: The rate of conversion of administered inorganic radioactive iodine into protein-bound iodine of plasma as an aid in the evaluation of thyroid function, Surgery 26: 331-340, 1949. MedlineGoogle Scholar40 MacGregor AG: Diagnosis of thyrotoxicosis by a simple outpatient radioactive iodine technique, Brit. M. J. 2: 21-22, 1953. CrossrefMedlineGoogle Scholar41 SilverFeitelberg SS: Laboratory aids in the diagnosis of hyperthyroidism, J. Mt. Sinai Hosp. 19: 345-351, 1952. MedlineGoogle Scholar42 NewburgerSilverYohalemFeitelberg RASSBS: Thyroidal uptake and plasma level of radioiodine in the diagnosis of untreated hyperthyroidism, N.E. J. Med. 253: 127-130, 1955. CrossrefMedlineGoogle Scholar43 FeuerDickler IE: The use of radioiodine in the determination of thyroid function, Metabolism, Clin. and Exper. 4: 1-9, 1955. MedlineGoogle Scholar44 Cruchand S: Thyroid function and lipoid nephrosis, Schweiz. med. Wchnschr. 84: 478-481, 1954. MedlineGoogle Scholar45 WernerSpooner SCM: A new and simple test for hyperthyroidism employing 1-triiodothyronine and the 24-hour I131 uptake method, Bull. N. Y. Acad. Med. 31: 137-145, 1955. MedlineGoogle Scholar46 GreerSmith MAGE: A method for increasing the accuracy of the radioiodine uptake as a test of thyroid function by the use of desiccated thyroid, J. Clin. Endocrinol. 14: 1374-1384, 1954. CrossrefGoogle Scholar47 ZieveSkanseSchultz LBAL: Comparative value of the BMR, PBI, and radioiodine excretion or uptake in the diagnosis of borderline hyperthyroidism when used individually or in combination, J. Lab. and Clin. Med. 45: 281-285, 1955. MedlineGoogle Scholar48 JaffeeOttoman HLRE: Evaluation of radioiodine test for thyroid function, J. A. M. A. 143: 515-519, 1950. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT E. BAUER PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byTHE CLINICAL DIAGNOSIS OF THYROID DISEASEMasked Hyperthyroidism and Heart DiseaseDiagnosis of Occult and Borderline Disorders of the ThyroidBASAL METABOLIC RATE, PROTEIN-BOUND IODINE AND RADIOACTIVE IODINE UPTAKE: A COMPARATIVE STUDY*HUGH F. LUDDECKE, M.D.Clinical Applications of Radioactive IsotopesAn Appraisal of the Diagnostic Significance of the Radioactive Iodine Excretion Test and the Protein-Bound Iodine in the Serum in an Endemic Goitre Area1 1 January 1956Volume 44, Issue 1Page: 207-214KeywordsChronic diarrheaHeart failureHyperthyroidismInsulinTachycardia ePublished: 1 December 2008 Issue Published: 1 January 1956 PDF downloadLoading ...