sodium-pertechnetate-tc-99m and Puerperal-Disorders

A 32-year-old woman with a history of Graves' disease had an episode of thyrotoxicosis 2.5 months after her first childbirth. Because of low thyroidal uptake of Tc-99m pertechnetate, a diagnosis of postpartum painless thyroiditis was made and the patient was observed without medication. After the normalization of serum levels of thyroid hormones, a second wave of thyrotoxic symptoms emerged. This time, the Tc-99m uptake was slightly elevated and the patient was diagnosed to have a relapse of Graves' disease. This case underscores the previously reported notion that thyroidal uptake was indispensable to distinguish these two causes of postpartum thyrotoxicosis.

Topics: Adult; Female; Graves Disease; Humans; Pregnancy; Pregnancy Complications; Puerperal Disorders; Radionuclide Imaging; Recurrence; Sodium Pertechnetate Tc 99m; Thyroid Gland; Thyroiditis; Thyrotoxicosis

The term "thyroiditis" refers to several syndromes of differing etiology. Chronic or Hashimoto's thyroiditis (HT), an autoimmune disorder that is manifested by goiter and hypothyroidism, is by far the most common of these syndromes. Subacute thyroiditis (SAT) encompasses two distinct syndromes: subacute granulomatous thyroiditis (SAGT) and subacute lymphocytic thyroiditis (SLT). SAGT is viral in origin and usually presents with neck tenderness and hyperthyroid symptoms, while SLT, which is likely to be an autoimmune entity, results in goiter and transient hyperthyroidism. SLT is often seen in the postpartum period and is referred to as postpartum thyroiditis (PPT). Less common forms of thyroiditis include Riedel's struma, which is characterized by extensive fibrosis of the thyroid gland, and acute suppurative thyroiditis, which is a bacterial infection. Twenty patients with goiter were evaluated by thyroid scintigraphy. They were ultimately diagnosed as having either HT (14), SAGT (3), SLT (1), or PPT (2). Their scan findings were correlated with both clinical presentations as well as in vitro laboratory analysis.

Topics: Adult; Female; Humans; Iodine Radioisotopes; Male; Middle Aged; Puerperal Disorders; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroid Function Tests; Thyroid Gland; Thyroiditis, Autoimmune; Thyroiditis, Subacute

Topics: Female; Humans; Pregnancy; Puerperal Disorders; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyrotoxicosis

A 35-yr-old patient developed severe acute tubular necrosis requiring hemodialysis. A [99mTc]dimercaptosuccinic acid scan of the kidneys showed no renal uptake at 4 or 24 hr, but the patient subsequently recovered normal renal function as judged by a normal serum creatinine. Based on this case report and a review of the literature, one cannot assume irreversible loss of function in patients with acute renal failure, based on the absence of radiopharmaceutical uptake by the kidneys.

Topics: Acute Kidney Injury; Adult; Blood Urea Nitrogen; Creatinine; Female; Hemorrhage; Humans; Hysterectomy; Kidney; Kidney Tubular Necrosis, Acute; Postoperative Complications; Pregnancy; Puerperal Disorders; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stomach; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Measurements were made of the activity in samples of breast milk obtained from a patient with postpartum thyroiditis following administration of [123I]sodium iodide and subsequently [99mTc]pertechnetate 24 hr later. Both 123I and 99mTc were found to be excreted exponentially with an effective half-life of 5.8 hr and 2.8 hr, respectively. Less than 10% of the activity was incorporated into breast-milk protein. After administration of [123I]sodium iodide breast feeding should be discontinued for 24-36 hr to reduce the absorbed dose to the child's thyroid.

Topics: Adult; Female; Humans; Iodine Radioisotopes; Milk, Human; Pregnancy; Puerperal Disorders; Radiation Dosage; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Thyroiditis