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September 3, 1955, Vol 159, No. 1 >
ARTICLE | September 3, 1955

PITFALLS IN DIAGNOSTIC USE OF RADIOACTIVE IODINE FREE

Solomon Silver, M.D.; Stephen B. Yohalem, M.D.; Robert A. Newburger, M.D.
[+] Author Affiliations

The radioactive iodine (I131) used in this study was supplied on allocation by the United States Atomic Energy Commission.


New York

From the Andre Meyer Department of Physics and the departments of medicine and chemistry, Mount Sinai Hospital.


JAMA. 1955;159(1):1-5. doi:10.1001/jama.1955.02960180003001
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References

The relatively recent introduction of the use of tracer doses of radioactive iodine (I131) in diagnosis of thyroid disorders has had widespread acceptance. It is not our purpose to deprecate the usefulness of this procedure, but we are convinced that its limitations must be considered. Uncritical reliance upon techniques using I131 has led to the abandonment of older diagnostic procedures that have stood the test of time. We have particular reference to the disrepute into which the determination of the basal metabolic rate has fallen. This desuetude is, in our opinion, unjustified, even if one gives full weight to all the errors inherent in this test. We also wish to emphasize that the diagnosis of the presence or absence of thyroid disease is the province solely of the clinician and the only function of the laboratory is to give him data that he must then evaluate with all the

REFERENCES

1 +
Silver, S., and Fieber, M. H.:  Blood Levels of I131 After Tracer Doses in the Diagnosis of Hyperthyroidism , Proc. Soc. Exper. Biol. & Med. 75:570, 1950;.
2 +
Silver, S.; Fieber, M. H., and Yohalem, S. B.:  Blood Levels After Tracer Doses of Radioactive Iodine in the Diagnosis of Thyroid Disorders . Am. J. Med. 13:725, 1952;.
3 +
Hamilton, J. G., and Soley, M. H.:  Studies in Iodine Metabolism by the Use of A New Radioactive Isotope of Iodine , Am. J. Physiol. 127:557, 1939;.
4 +
Hamilton, J. G.; Soley, M. H.; Reilly, W. A., and Eichorn, K. B.:  Radioactive Iodine Studies in Childhood Hypothyroidism , Am. J. Dis. Child. 66:495, 1943;.
5 +
Lerman, J.; Jones, H. W., and Calkins, E.:  Studies on 2 Sporadic Cretinous Brothers with Goiter, Together with Some Remarks on the Relation of Hyperplasia to Neoplasia , Ann. Int. Med. 25:677, 1946;.
6 +
Soley, M. H.: Miller, E. R., and Foreman, N.:  Graves' Disease: Treatment with Radioiodine (I131) , J. Clin. Endocrinol. 9:29, 1949;.
7 +
Werner, S. C.; Quimby, E. H., and Schmidt, C.:  The Use of Tracer Doses of Radioactive Iodine, I131, in the Study of Normal and Disordered Thyroid Function in Man , J. Clin. Endocrinol. 9:342, 1949;.
8 +
Stanbury, J. B., and Hedge, A. N.:  A Study of a Family of Goitrous Cretins , J. Clin. Endocrinol. 10:1471, 1950;.
9 +
Keating, F. R., Jr.; Haines, S. F.; Power, M. H., and Williams, M. M. D.:  The Radioiodine-Accumulating Function of the Human Thyroid Gland as a Diagnostic Test in Clinical Medicine , J. Clin. Endocrinol. 10:1425, 1950;.
10 +
Werner, S. C.; Hamilton, H. B.; Leifer, E., and Goodwin, L. D.:  An Appraisal of the Radioiodine Tracer Technic as a Clinical Procedure in the Diagnosis of Thyroid Disorders: Uptake Measurement Directly over Gland and Note on Use of Thyrotropin (T. S. H.) , J. Clin. Endocrinol. 10:1054, 1950;.
11 +
Blomfield, G. W., and others:  Treatment of Thyrotoxicosis with Radioactive Iodine , Brit. M. J. 2:373, 1951;.
12 +
Recant, L., and Riggs, D. S.:  Thyroid Function in Nephrosis , J. Clin. Invest. 31:789, 1952;.
13 +
Hubble, D.:  Familial Cretinism , Lancet 1:1112, 1953;.
14 +
Drummy, W. W., Jr.:  The Use of Radioactive Iodine in the Detection of Thyroid Dysfunction , New England J. Med. 249:970, 1953;.
15 +
Blom, P. S., and Terpstra, J.:  High PBI131 Concentration in the Blood of Patients with Myxedema: Preliminary Report , J. Clin. Endocrinol. 13:989, 1953;.
16 +
Morgans, M. E., and Trotter, W. R.:  Two Cases of Myxedema Attributed to Iodide Administration , Lancet 2:1335, 1953;.
17 +
Monroe, R. A.; Rust, J. H., and Trum, B. F.:  Sublethal Total Body Irradiation and I131 Metabolism in the Rat Thyroid , Science 119:65, 1954;.
18 +
Hutchison, J. H., and McGirr, E. M.:  Hypothyroidism as an Inborn Error of Metabolism , J. Clin. Endocrinol. 14:869, 1954;.
19 +
Berson, S. A.: Personal communication to the authors.

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1 +
Silver, S., and Fieber, M. H.:  Blood Levels of I131 After Tracer Doses in the Diagnosis of Hyperthyroidism , Proc. Soc. Exper. Biol. & Med. 75:570, 1950;.
2 +
Silver, S.; Fieber, M. H., and Yohalem, S. B.:  Blood Levels After Tracer Doses of Radioactive Iodine in the Diagnosis of Thyroid Disorders . Am. J. Med. 13:725, 1952;.
3 +
Hamilton, J. G., and Soley, M. H.:  Studies in Iodine Metabolism by the Use of A New Radioactive Isotope of Iodine , Am. J. Physiol. 127:557, 1939;.
4 +
Hamilton, J. G.; Soley, M. H.; Reilly, W. A., and Eichorn, K. B.:  Radioactive Iodine Studies in Childhood Hypothyroidism , Am. J. Dis. Child. 66:495, 1943;.
5 +
Lerman, J.; Jones, H. W., and Calkins, E.:  Studies on 2 Sporadic Cretinous Brothers with Goiter, Together with Some Remarks on the Relation of Hyperplasia to Neoplasia , Ann. Int. Med. 25:677, 1946;.
6 +
Soley, M. H.: Miller, E. R., and Foreman, N.:  Graves' Disease: Treatment with Radioiodine (I131) , J. Clin. Endocrinol. 9:29, 1949;.
7 +
Werner, S. C.; Quimby, E. H., and Schmidt, C.:  The Use of Tracer Doses of Radioactive Iodine, I131, in the Study of Normal and Disordered Thyroid Function in Man , J. Clin. Endocrinol. 9:342, 1949;.
8 +
Stanbury, J. B., and Hedge, A. N.:  A Study of a Family of Goitrous Cretins , J. Clin. Endocrinol. 10:1471, 1950;.
9 +
Keating, F. R., Jr.; Haines, S. F.; Power, M. H., and Williams, M. M. D.:  The Radioiodine-Accumulating Function of the Human Thyroid Gland as a Diagnostic Test in Clinical Medicine , J. Clin. Endocrinol. 10:1425, 1950;.
10 +
Werner, S. C.; Hamilton, H. B.; Leifer, E., and Goodwin, L. D.:  An Appraisal of the Radioiodine Tracer Technic as a Clinical Procedure in the Diagnosis of Thyroid Disorders: Uptake Measurement Directly over Gland and Note on Use of Thyrotropin (T. S. H.) , J. Clin. Endocrinol. 10:1054, 1950;.
11 +
Blomfield, G. W., and others:  Treatment of Thyrotoxicosis with Radioactive Iodine , Brit. M. J. 2:373, 1951;.
12 +
Recant, L., and Riggs, D. S.:  Thyroid Function in Nephrosis , J. Clin. Invest. 31:789, 1952;.
13 +
Hubble, D.:  Familial Cretinism , Lancet 1:1112, 1953;.
14 +
Drummy, W. W., Jr.:  The Use of Radioactive Iodine in the Detection of Thyroid Dysfunction , New England J. Med. 249:970, 1953;.
15 +
Blom, P. S., and Terpstra, J.:  High PBI131 Concentration in the Blood of Patients with Myxedema: Preliminary Report , J. Clin. Endocrinol. 13:989, 1953;.
16 +
Morgans, M. E., and Trotter, W. R.:  Two Cases of Myxedema Attributed to Iodide Administration , Lancet 2:1335, 1953;.
17 +
Monroe, R. A.; Rust, J. H., and Trum, B. F.:  Sublethal Total Body Irradiation and I131 Metabolism in the Rat Thyroid , Science 119:65, 1954;.
18 +
Hutchison, J. H., and McGirr, E. M.:  Hypothyroidism as an Inborn Error of Metabolism , J. Clin. Endocrinol. 14:869, 1954;.
19 +
Berson, S. A.: Personal communication to the authors.

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