This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Thyrotoxicosis Due to Elevated Serum Triiodothyronine Levels

Kenneth Sterling, MD; Samuel Refetoff, MD; Herbert A. Selenkow, MD

JAMA. 1970;213(4):571-575.

Abstract
Thyrotoxicosis may be caused by elevated serum triiodothyronine (T3) in the presence of normal thyroxine (T4) concentration. Of a series of 26 selected cases, 12 have been observed in patients with toxic nodular goiter, most typically with a solitary hyperfunctioning nodule, but also with multinodular goiters. The disorder has also been observed in seven patients with classical toxic diffuse goiter (Graves' disease) including two patients with typical infiltrative ophthalmopathy. The diagnosis of T3 thyrotoxicosis should be suspected when there are clinics and laboratory evidences of hypermetabolism in the presence of normal serum T4 and the absence of thyroxine-binding globulin (TBG) abnormalities. Until T3 measurement becomes more readily available, it is advisable to employ screening with the T3 suppression test, regardless of the initial 24-hour thyroidal radioactive iodine uptake value.

Author Affiliations
From the Protein Research Laboratory, Bronx Veterans Administration Hospital and the Department of Pathology, Columbia University College of Physicians and Surgeons and the Department of Medicine, Harlem Hospital Center, New York (Dr. Sterling) and the Department of Medicine, Peter Bent Brigham Hospital and Harvard Medical School, Boston (Drs. Refetoff and Selenkow). Dr. Refetoff is now with the University of Chicago, Pritzker School of Medicine, Chicago.

Footnotes
Reprint requests to 130 W Kingsbridge Rd, Bronx, NY 10468 (Dr. Sterling).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Case of Thyroxine Thyrotoxicosis
Blank and Tucci
Arch Intern Med 1987;147:863-864.
ABSTRACT  

Levels of Serum Thyroid-Stimulating Hormone in Hyperthyroidism
Smith et al.
Arch Intern Med 1979;139:757-760.
ABSTRACT  

Thyroid Physiology in Health and Disease
BROWN et al.
ANN INTERN MED 1974;81:68-81.
ABSTRACT  

Tachycardia-Aggravated Heart Disease
ENGEL et al.
ANN INTERN MED 1974;80:384-388.
ABSTRACT  

Triiodothyronine: Physiological and Clinical Significance
Gharib
JAMA 1974;227:302-304.
ABSTRACT  

Recurrent Hyperthyroidism Presenting as Triiodothyronine Toxicosis
SHENKMAN et al.
ANN INTERN MED 1972;77:410-413.
ABSTRACT  

Triiodothyronine Thyrotoxicosis
S.V.
JAMA 1971;218:438-439.
ABSTRACT  

"Triiodothyronine (T3) Toxicosis" Its Role in Graves' Disease
Ivy et al.
Arch Intern Med 1971;128:529-534.
ABSTRACT  

Eyelids, Lacrimal Apparatus, and Conjunctiva
Sexton
Arch Ophthalmol 1971;85:379-396.