Toxic Multinodular Goiter with Low Radioactive Iodine Uptake

Toshio Kahara; Akiko Shimizu; Akio Uchiyama; Shintaro Terahata; Junichi Tajiri; Eijun Nishihara; Akira Miyauchi; Hitoshi Abo; Hisashi Sumiya; Kazuhide Ishikura; Rika Usuda; Hirofumi Noto

doi:10.2169/internalmedicine.50.5256

CASE REPORTS

Toxic Multinodular Goiter with Low Radioactive Iodine Uptake

Toshio Kahara, Akiko Shimizu, Akio Uchiyama, Shintaro Terahata, Junichi Tajiri, Eijun Nishihara, Akira Miyauchi, Hitoshi Abo, Hisashi Sumiya, Kazuhide Ishikura, Rika Usuda, Hirofumi Noto

Author information

Toshio Kahara
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan
Akiko Shimizu
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan
Akio Uchiyama
Department of Clinical Pathology, Toyama Prefectural Central Hospital, Japan
Shintaro Terahata
Department of Clinical Pathology, Toyama Prefectural Central Hospital, Japan
Junichi Tajiri
Tajiri Thyroid Clinic, Japan
Eijun Nishihara
Center for Excellence in Thyroid Care, Kuma Hospital, Japan
Akira Miyauchi
Center for Excellence in Thyroid Care, Kuma Hospital, Japan
Hitoshi Abo
Department of Radiology, Toyama Prefectural Central Hospital, Japan
Hisashi Sumiya
Department of Radiology, Toyama Prefectural Central Hospital, Japan
Kazuhide Ishikura
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan
Rika Usuda
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan
Hirofumi Noto
Department of Thoracic Surgery, Toyama Prefectural Central Hospital, Japan

Keywords: hyperthyroidism, toxic multinodular goiter, radioactive iodine uptake, SPECT, thyrotoxicosis, ^99mtechnetium

JOURNAL OPEN ACCESS

2011 Volume 50 Issue 16 Pages 1709-1714

DOI https://doi.org/10.2169/internalmedicine.50.5256

Details

Abstract

A 74-year-old woman was referred to our hospital for goiter and persistent thyrotoxicosis. She had no signs of ophthalmopathy. She was not taking thyroid hormone. Thyroid CT revealed multiple nodules. The thyroid gland was not detected on ^99mTc scintigraphy, ¹²³I uptake rate was 4.5% at 24 hours without hot nodules, and aberrant goiter was negative. After partial thyroidectomy, she was treated with levothyroxine. TRAb was undetectable during the disease course, and focal destructive change or chronic lymphocytic thyroiditis on the pathological specimens was not evident. We report a rare case of toxic multinodular goiter with low radioactive iodine uptake.

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