Radioiodine Therapy of Benign Thyroid Diseases: Graves’ Disease, Plummer’s Disease, Non-toxic Goiter and Nodules

2012 ◽  
pp. 281-314
Author(s):  
Cumali Aktolun ◽  
Muammer Urhan
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Diseases ◽  
Graves Disease ◽  
Plummer's Disease ◽  
Toxic Goiter ◽  
Plummer’S Disease ◽  
Benign Thyroid

Guideline for radioiodine therapy for benign thyroid diseases (version 3)

2004 ◽  
Vol 43 (06) ◽  
pp. 217-220 ◽  
Author(s):  
J. Dressler ◽  
F. Grünwald ◽  
B. Leisner ◽  
E. Moser ◽  
Chr. Reiners ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Volume ◽  
Thyroid Diseases ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Co Morbidity ◽  
History Of ◽  
Individual Decisions ◽  
Prophylactic Use ◽  
Benign Thyroid

SummaryThe version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves’ disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves’ disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient’s preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients’ preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3rd version.

Clinical Efficacy of A Single Dose Radioiodine Therapy for Hyperthyroidism

2015 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Zabah Muhammed Jawa ◽  
Rufai Isa Ahmed ◽  
Aisha Ismail
Keyword(s):  
Single Dose ◽  
Clinical Efficacy ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Antithyroid Drug ◽  
Radioactive Iodine Therapy ◽  
Toxic Adenoma ◽  
Plummer's Disease ◽  
Plummer’S Disease ◽  
Post Therapy

<p><strong>Objective</strong>: Radioiodine is a safe, cheap, and recognized permanent treatment option for patients with hyperthyroidism. Despite, the extensive use of radioiodine therapy in hyperthyroidism there is no consensus regarding the optimal dose of radioiodine. To evaluate the clinical efficacy and our clinical experience with the use of a single dose radioiodine therapy for hyperthyroidism in our institution.</p><p><strong>Methods:</strong> A total of 274 patients who received a single dose of radioactive iodine therapy for hyperthyroidism at our institution between 2007-2015 were retrospectively reviewed. Of these, 186 patients had Graves’ disease (GD), 73 patients had Plummer’s disease (PD), and 15 patients had a single toxic adenoma (STA). All patients received between 10-30mCi of oral radioiodine capsule. The efficacy of therapy was determined 3 months post-therapy using serum thyroid function test, weight and heart rate measurements. Therapy success refers to patients whose outcome was euthyroidism and hypothyroidism post-therapy and treatment failure where patients still manifested with persistent hyperthyroidism.</p><p><strong>Results:</strong>  The efficacy of a single dose of radioiodine 3months post-therapy varies with the type of hyperthyroidism, 96% for Graves’s disease, 92% for Plummer’s disease and 100% in single toxic adenoma.</p><p><strong>Conclusion:</strong> Our study showed that a single dose of radioactive iodine therapy 3 months post-therapy is 96% efficient in all types of hyperthyroidism. However, we observed that patients at risk of therapy failure 3month post-therapy included, large thyroid gland prolong antithyroid drug usage and male gender.</p><p> </p>

scholarly journals PROBABILITY OF CANCER DETECTION DURING REPEATED OPERATIONS IN PATIENTS WITH BENIGN THYROID DISEASES

2019 ◽  
Vol 21 (1) ◽  
pp. 94-98
Author(s):  
A F Romanchishen ◽  
A V Gostimsky ◽  
A L Akinchev ◽  
I V Karpatsky
Keyword(s):  
Malignant Lesion ◽  
Needle Aspiration ◽  
Thyroid Diseases ◽  
Endocrine Surgery ◽  
Thyroid Remnant ◽  
Recurrent Goiter ◽  
Surgical Tactics ◽  
Toxic Goiter ◽  
Probability Of Cancer ◽  
Benign Thyroid

Introduction. Suspected malignant growth in patients with recurrent goiter is one of the main causes of repeated operations. Focuses of carcinoma can be detected in patients operated on for multinodular goiter with compression of the organs of the neck, recurrent diffuse toxic goiter. Objective of investigation is to assess the risk of a malignant lesion of the thyroid remnant in patients with recurrent goiter, to justify the surgical tactics in this group of patients. Material and methods. In the St. Petersburg Center of Endocrine Surgery and Oncology 28138 patients with various thyroid diseases were operated on for the period from 1973 till 2016. Results. In a retrospective analysis of the group consisting of 1106 patients with recurrent goiter, a new thyroid disease was detected in 156 (14.1%) cases. Thyroid cancer in thyroid remnant was detected in 57 (36.5%) cases or 5.2% of all the patients with recurrent goiter. The work describes the risk of malignant lesion of the thyroid remnant in patients with recurrent goiter and surgical tactics in this group of patients. Conclusion. Cancer of the thyroid gland, as a new disease of the thyroid remnant, in patients previously operated on for benign thyroid pathology, is found in 5.2% of observations. The possibilities of fine-needle aspiration biopsy in this group are reduced. Active surgical tactics in cases of multinodular transformation of the thyroid remnant is justified. The operation of choice is reresection up to thyroidectomy. Careful intraoperative study of removed tissue and close cooperation with the morphological service helps to reduce the number of diagnostic and tactical errors in patients with both recurrent and ordinary multi-node goiter.

scholarly journals Impact of different approaches to calculation of treatment activities on achieved doses in radioiodine therapy of benign thyroid diseases

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Jochen Hammes ◽  
Lutz van Heek ◽  
Melanie Hohberg ◽  
Manuel Reifegerst ◽  
Simone Stockter ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Thyroid Diseases ◽  
Benign Thyroid

Management of thyrotoxicosis in children and adolescents: 35 years’ experience in 304 patients

2018 ◽  
Vol 31 (2) ◽  
pp. 159-165 ◽  
Author(s):  
Fereidoun Azizi ◽  
Atieh Amouzegar
Keyword(s):  
Children And Adolescents ◽  
Treatment Modality ◽  
Radioiodine Therapy ◽  
Thyroid Stimulating Hormone ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
The Mean ◽  
Toxic Goiter ◽  
Original Treatment

Abstract Background: Diffuse toxic goiter accounts for about 15% of all childhood thyroid diseases. There is great controversy over the management of Graves’ disease in children and adolescents. This article reports our experience in 304 children and juvenile patients with Graves’ disease. Methods: Between 1981 and 2015, 304 patients aged 5–19 years with diffuse toxic goiter were studied, of whom 296 patients were treated with antithyroid drugs (ATD) for 18 months. Patients with persistent or relapsed hyperthyroidism who refused ablative therapy with surgery or radioiodine were managed with continuous methimazole (MMI) treatment. Results: In 304 patients (245 females and 59 males), the mean age was 15.6±2.6 years. After 18 months of ATD therapy, 37 remained in remission and of the 128 who relapsed, two, 29 and 97 patients chose surgery, continuous ATD and radioiodine therapy, respectively. Of the 136 patients who received radioiodine, 66.2% became hypothyroid. Twenty-nine patients received continuous ATD therapy for 5.7±2.4 years. The mean MMI dose was 4.6±12 mg daily, no serious complications occurred and all of them remained euthyroid during the follow-up. Less abnormal thyroid-stimulating hormone (TSH) values were observed in these patients, as compared to patients who were on a maintenance dose of levothyroxine after radioiodine induced hypothyroidism. Conclusions: Original treatment with ATD and subsequent radioiodine therapy remain the mainstay of treatment for juvenile hyperthyroidism. Continuous ATD administration may be considered as another treatment modality for hyperthyroidism.

scholarly journals Does Marine Lenhart Syndrome really exist?

2021 ◽  
Vol 4 (5) ◽  
pp. 01-05
Author(s):  
Essien Francis ◽  
Jacocks Charles ◽  
Elkins Blake ◽  
Tate Joshua
Keyword(s):  
Thyroid Nodules ◽  
Graves Disease ◽  
Autoimmune Phenomenon ◽  
Common Causes ◽  
Toxic Multinodular Goiter ◽  
Immunogenic Hyperthyroidism ◽  
Plummer's Disease ◽  
Definition Of ◽  
Plummer’S Disease ◽  
Primary Hyperthyroidism

Primary hyperthyroidism is the result of overproduction of thyroid hormone resulting in the classic symptoms of tachycardia, weight loss, diaphoresis, and hyperdefecation. There are multiple common causes to include Graves’ disease, toxic multinodular goiter, and solitary toxic adenomas. Marine Lenhart Syndrome (MLS) is a rare cause of hyperthyroidism, caused by a coexistence of constitutively active thyroid nodules and Graves’ disease. In the original document of Marine and Lenhart, there is no distinction made between the autoimmune phenomenon of Graves’ disease and the solitary toxic nodule of Plummer’s disease. Rather they are both considered to be the manifestation of the same disease. However, in the current era of radionuclide technology, a clear distinction of MLS can be seen with diffuse uptake in the thyroid gland and focused enhancement in the toxic nodules. Therefore what was previously described as one entity is now distinct as Graves’ disease and Plummer’s disease. It is also becoming increasingly clear within the literature that there is also a new phenomenon of post-radioiodine immunogenic hyperthyroidism in patients with toxic nodules and elevated autoantibodies. Therefore in order to properly treat and manage patients, a new definition of MLS may need to be proposed.

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