[Economical and rational in vivo and in vitro diagnosis in Basedow hyperthyroidism]

Immunogenic hyperthyroidism (Graves' disease) is a life-long ailment. A widespread diagnostic evaluation is essential for unbiased initial values prior to therapy. The major goals of initial investigation are to determine a functional disturbance of the organ, its pathogenesis and morphology. Even a suppressed ultrasensitive bTSH value represents no evidence of overt hyperthyroidism; a positive diagnosis can only be established by the additional presence of increased parameters of circulating free thyroid hormones (fT3, fT4). Evidence of any immunogenic pathogenesis is given by positive thyroid antibody values (TRAK, MAK, TAK). Moreover, the use of sonography (with poor diffuse echo and increased thyroid depth) as well as Tc-99m scan indicating primary autonomy, thyroxine induced hyperthyroidism or painless thyroiditis) may both prove rather useful in a rational and economical diagnosis of Graves' disease.