Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 317  
ORIGINAL ARTICLE
Year : 2012  |  Volume : 11  |  Issue : 1  |  Page : 7-11

Radioiodine Thyroid Ablation in Graves' Hyperthyroidism: Merits and Pitfalls


1 Service Central de Biophysique et de Médecine Nucléaire, CHU de la Timone; 264 Rue Saint, Pierre 13385 Marseille Cedex 5, France; Service de Médecine Nucléaire, Hôpital Général de Yaoundé; BP: 5408 Yaoundé, Cameroun
2 Service Central de Biophysique et de Médecine Nucléaire, CHU de la Timone; 264 Rue Saint, Pierre 13385 Marseille Cedex 5, France
3 Service d'Epidémiologie, CHU de la Timone; 264 Rue Saint, Pierre 13385 Marseille Cedex 5, France
4 Service de Médecine Nucléaire, Hôpital Général de Yaoundé; BP: 5408 Yaoundé, Cameroun

Correspondence Address:
J F Nwatsock
Department of Nuclear Medicine, Yaounde General Hospital, BP: 5408, Yaounde, Cameroun

Login to access the Email id


DOI: 10.4103/1450-1147.98731

Rights and Permissions

Ablative approaches using radioiodine are increasingly proposed for the treatment of Graves' disease (GD) but their ophthalmologic and biological autoimmune responses remain controversial and data concerning clinical and biochemical outcomes are limited. The aim of this study was to evaluate thyroid function, TSH-receptor antibodies (TRAb) and Graves' ophthalmopathy (GO) occurrence after radioiodine thyroid ablation in GD. We reviewed 162 patients treated for GD by iodine-131 (131 I) with doses ranging from 370 to 740 MBq, adjusted to thyroid uptake and sex, over a 6-year period in a tertiary referral center. Collected data were compared for outcomes, including effectiveness of radioiodine therapy (RIT) as primary endpoint, evolution of TRAb, and occurrence of GO as secondary endpoints. The success rate was 88.3% within the first 6 months after the treatment. The RIT failure was increased in the presence of goiter (adjusted odds ratio = 4.1, 95% confidence interval 1.4-12.0, P = 0.010). The TRAb values regressed with time (r = −0.147; P = 0.042) and patients with a favorable outcome had a lower TRAb value (6.5 ± 16.4 U/L) than those with treatment failure (23.7 ± 24.2 U/L, P < 0.001). At the final status, 48.1% of patients achieved normalization of serum TRAb. GO occurred for the first time in 5 patients (3.7%) who were successfully cured for hyperthyroidism but developed early and prolonged period of hypothyroidism in the context of antithyroid drugs (ATD) intolerance (P = 0.003) and high TRAb level (P = 0.012). On the basis the results of this study we conclude that ablative RIT is effective in eradicating Graves' hyperthyroidism but may be accompanied by GO occurrence, particularly in patients with early hypothyroidism and high pretreatment TRAb and/or ATD intolerance. In these patients, we recommend an early introduction of LT4 to reduce the duration and the degree of the radioiodine-induced hypothyroidism.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed3661    
    Printed254    
    Emailed0    
    PDF Downloaded950    
    Comments [Add]    
    Cited by others 9    

Recommend this journal