JOEL I. HAMBURGER, M.D.
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To the editor: Shenkman and associates (1) remind us that an elevated serum triiodothyronine (T3) concentration need not mean hyperthyroidism. Nonsuppressible 24-hour 131I uptake may be seen in euthyroid patients with autonomously functioning adenomas, multinodular goiter, or Graves's disease. Thus the principal laboratory criteria for the diagnosis of T3 toxicosis are not specific for hyperthyroidism. Shenkman's 10 patients seem bona fide, since all have elevated 131I uptake values and histories of previous toxicity. Patients in other published cases have had normal uptake values, non-suppressible, to be sure, with diagnosis based chiefly on the elevated serum T3 level (2). Since elevated
HAMBURGER JI. Triiodothyronine in Diagnosis. Ann Intern Med. 1973;78:156–157. doi: https://doi.org/10.7326/0003-4819-78-1-156
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Published: Ann Intern Med. 1973;78(1):156-157.
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