Technetium-99m thyroid scan; does it have a diagnostic aid in sub-clinical auto-immune thyroid disease in systemic lupus erythematosus patients?
OBJECTIVE
Technetium-99m (Tc-99m) thyroid scintigraphy is a well known diagnostic tool that shows the entire gland in a single image. We aimed to evaluate its additive diagnostic value in subclinical autoimmune thyroid disease (S-AITD) in systemic lupus erythematosus (SLE) patients.


METHODS
We investigated 100 systemic lupus erythematosus (SLE) patients without overt thyroid involvement (eight men and 92 women; mean age 40±6.5 years) and 50 age and sex matched controls. All were subjected to thyroid evaluation using anti-thyroglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies; hormones (FT3; FT4 and TSH) and Tc-99m thyroid scintigraphy.


RESULTS
14/100 (14%) and none (0%) were positive for S-AITD in SLE and control groups, respectively (P = 0.0001). They were classified by thyroid scintigraphy and hormonal profile into 2/14 Hashimoto; 10/14 atrophic thyroiditis and 2/14 Graves' disease. Anti-TPO was elevated in 12 SLE cases, while anti-TG was elevated in only 2/14 (P = 0.0001). Thyroid scintigraphy showed statistically significant associations with FT4, TSH and anti-TPO.


CONCLUSIONS
Tc-99m thyroid scintigraphy may have an additional diagnostic role in S-AITD among SLE patients, with an impact on patient management. This potential needs to be further evaluated in a larger series on a multicenter basis.
Nuclear Medicine Department, Faculty of Medicine, Cairo University, Egypt.
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Amin
Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt alkhatib_alkemary@yahoo.com.
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Alkemary
Rheumatology Department, Faculty of Medicine, Cairo University, Egypt.
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Abdo
Nuclear Medicine Department, Faculty of Medicine, Cairo University, Egypt.
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Salama
D000328:Adult; D001323:Autoantibodies / Q000378:metabolism; D001327:Autoimmune Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000037:antagonists & inhibitors / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000379:methods; D013667:Technetium; D013959:Thyroid Diseases / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D013961:Thyroid Gland / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D013963:Thyroid Hormones / Q000378:metabolism
D001323:Autoantibodies; D013963:Thyroid Hormones; C006606:anti-thyroglobulin; D013667:Technetium; D007453:Iodide Peroxidase
Systemic lupus erythematosus; Tc-99m; auto-immune thyroiditis; thyroid scan