Cardiovascular Outcomes of Thyroidectomy or Radioactive Iodine Ablation for Graves’ Disease

2020 ◽  
Vol 256 ◽  
pp. 486-491 ◽  
Author(s):  
Austin Gibson ◽  
Atman Dave ◽  
Craig Johnson ◽  
Anupam Kotwal ◽  
Abbey L. Fingeret
Keyword(s):  
Radioactive Iodine ◽  
Cardiovascular Outcomes ◽  
Graves Disease ◽  
Radioactive Iodine Ablation

When thyroid labs do not add up, physicians should ask patients about biotin supplements

2020 ◽  
Vol 13 (3) ◽  
pp. e231337
Author(s):  
Michael S Lundin ◽  
Ahmad Alratroot ◽  
Fawzi Abu Rous ◽  
Saleh Aldasouqi
Keyword(s):  
Thyroid Function ◽  
Dose Adjustment ◽  
Radioactive Iodine ◽  
Graves Disease ◽  
Thyroid Function Tests ◽  
Medication List ◽  
Function Tests ◽  
Extensive Evaluation ◽  
History Of ◽  
Radioactive Iodine Ablation

A 69-year-old woman with a remote history of Graves’ disease treated with radioactive iodine ablation, who was maintained on a stable dose of levothyroxine for 15 years, presented with abnormal and fluctuating thyroid function tests which were confusing. After extensive evaluation, no diagnosis could be made, and it became difficult to optimise the levothyroxine dose, until we became aware of the recently recognised biotin-induced lab interference. It was then noticed that her medication list included biotin 10 mg two times per day. After holding the biotin and repeating the thyroid function tests, the labs made more sense, and the patient was easily made euthyroid with appropriate dose adjustment. We also investigated our own laboratory, and identified the thyroid labs that are performed with biotin-containing assays and developed strategies to increase the awareness about this lab artefact in our clinics.

scholarly journals Change in BMI after radioactive iodine ablation for graves disease

2017 ◽  
Vol 2017 (1) ◽  
Author(s):  
Melinda Chen ◽  
Matthew Lash ◽  
Todd Nebesio ◽  
Erica Eugster
Keyword(s):  
Radioactive Iodine ◽  
Graves Disease ◽  
Radioactive Iodine Ablation

scholarly journals Graves’ Disease Causing Pancytopenia and Autoimmune Hemolytic Anemia at Different Time Intervals: A Case Report and a Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Peyman Naji ◽  
Geetika Kumar ◽  
Shabana Dewani ◽  
William A. Diedrich ◽  
Ankur Gupta
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Radioactive Iodine ◽  
Graves Disease ◽  
Time Intervals ◽  
Thyroid Stimulating Immunoglobulins ◽  
Thyroid Uptake ◽  
Antithyroid Treatment ◽  
Positive Direct ◽  
Radioactive Iodine Ablation

Graves’ disease (GD) is associated with various hematologic abnormalities but pancytopenia and autoimmune hemolytic anemia (AIHA) are reported very rarely. Herein, we report a patient with GD who had both of these rare complications at different time intervals, along with a review of the related literature. The patient was a 70-year-old man who, during a hospitalization, was also noted to have pancytopenia and elevated thyroid hormone levels. Complete hematologic workup was unremarkable and his pancytopenia was attributed to hyperthyroidism. He was started on methimazole but unfortunately did not return for followup and stopped methimazole after a few weeks. A year later, he presented with fatigue and weight loss. Labs showed hyperthyroidism and isolated anemia (hemoglobin 7 g/dL). He had positive direct Coombs test and elevated reticulocyte index. He was diagnosed with AIHA and started on glucocorticoids. GD was confirmed with elevated levels of thyroid stimulating immunoglobulins and thyroid uptake and scan. He was treated with methimazole and radioactive iodine ablation. His hemoglobin improved to 10.7 g/dL at discharge without blood transfusion. Graves’ disease should be considered in the differential diagnosis of hematologic abnormalities. These abnormalities in the setting of GD generally respond well to antithyroid treatment.

Thyroid Storm after Radioactive Iodine Ablation for Graves Disease

2011 ◽  
pp. P1-691-P1-691
Author(s):  
Adonis Jabbour ◽  
Abdul W Nuristani ◽  
Mohamad Hosam Horani ◽  
Waseem Allabban
Keyword(s):  
Radioactive Iodine ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Radioactive Iodine Ablation

scholarly journals Iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a concurrent diagnosis of primary hyperaldosteronism

2015 ◽  
Vol 2015 ◽  
Author(s):  
V Larouche ◽  
L Snell ◽  
D V Morris
Keyword(s):  
Radioactive Iodine ◽  
Psychiatric Symptoms ◽  
Adrenal Adenoma ◽  
Primary Hyperaldosteronism ◽  
Graves Disease ◽  
List Type ◽  
Adrenal Hyperplasia ◽  
Bilateral Adrenal Hyperplasia ◽  
Acute Hypothyroidism ◽  
Radioactive Iodine Ablation

Summary Myxoedema madness was first described as a consequence of severe hypothyroidism in 1949. Most cases were secondary to long-standing untreated primary hypothyroidism. We present the first reported case of iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a second concurrent diagnosis of primary hyperaldosteronism. A 29-year-old woman presented with severe hypothyroidism, a 1-week history of psychotic behaviour and paranoid delusions 3 months after treatment with radioactive iodine ablation for Graves' disease. Her psychiatric symptoms abated with levothyroxine replacement. She was concurrently found to be hypertensive and hypokalemic. Primary hyperaldosteronism from bilateral adrenal hyperplasia was diagnosed. This case report serves as a reminder that myxoedema madness can be a complication of acute hypothyroidism following radioactive iodine ablation of Graves' disease and that primary hyperaldosteronism may be associated with autoimmune hyperthyroidism. Learning points Psychosis (myxoedema madness) can present as a neuropsychiatric manifestation of acute hypothyroidism following radioactive iodine ablation of Graves' disease. Primary hyperaldosteronism may be caused by idiopathic bilateral adrenal hyperplasia even in the presence of an adrenal adenoma seen on imaging. Adrenal vein sampling is a useful tool for differentiating between a unilateral aldosterone-producing adenoma, which is managed surgically, and an idiopathic bilateral adrenal hyperplasia, which is managed medically. The management of autoimmune hyperthyroidism, iatrogenic hypothyroidism and primary hyperaldosteronism from bilateral idiopathic adrenal hyperplasia in patients planning pregnancy includes delaying pregnancy 6 months following radioactive iodine treatment and until patient is euthyroid for 3 months, using amiloride as opposed to spironolactone, controlling blood pressure with agents safe in pregnancy such as nifedipine and avoiding β blockers. Autoimmune hyperthyroidism and primary hyperaldosteronism rarely coexist; any underlying mechanism associating the two is still unclear.

scholarly journals Severe cholestatic hyperbilirubinaemia secondary to thyrotoxicosis complicated with bile cast nephropathy treated with plasma exchange and haemodialysis

2019 ◽  
Vol 12 (6) ◽  
pp. e229097
Author(s):  
Anthony J Ocon ◽  
Matthew Rosenblum ◽  
James Desemone ◽  
Richard Blinkhorn
Keyword(s):  
Plasma Exchange ◽  
Young Woman ◽  
Radioactive Iodine ◽  
Renal Recovery ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Cast Nephropathy ◽  
Radioactive Iodine Ablation

Thyrotoxicosis rarely presents as cholestatic hyperbilirubinaemia, and severe bilirubin elevation may lead to bile cast nephropathy. We present a case of a young woman with newly diagnosed Graves’ disease with thyrotoxicosis who developed severe hyperbilirubinaemia and bile cast nephropathy. Serial plasma exchange and temporary haemodialysis led to full renal recovery. After treatment of her thyrotoxicosis with antithyroid medication and radioactive iodine ablation, her bilirubin normalised.

scholarly journals Graves’ Disease-Related Pancytopenia Improved after Radioactive Iodine Ablation

2020 ◽  
Vol 13 (1) ◽  
pp. 295-298 ◽  
Author(s):  
Omnia A. Hamid ◽  
Afraa M. Fadul ◽  
Tala B. Batia ◽  
Mohamed A. Yassin
Keyword(s):  
Radioactive Iodine ◽  
Blood Product ◽  
Spontaneous Recovery ◽  
Rare Complication ◽  
Young Patients ◽  
Graves Disease ◽  
Thyroid Cells ◽  
Radioiodine Ablation ◽  
Thyroid Glands ◽  
Radioactive Iodine Ablation

Graves’ disease is an autoimmune disease that affects the thyroid glands which often results in enlarged thyroid glands, and it is the most common cause of clinical hyperthyroidism especially in young patients. Radioiodine ablation is a radiation therapy in which radioactive iodine is administered to destroy or ablate thyroid cells. It is commonly used for the treatment of Graves’ disease. We report on a 39-year-old male, who presented with Graves’ disease, found to have pancytopenia and hypocellular bone marrow. Pancytopenia is a rare complication of thyrotoxicosis that is usually not severe and does not require supportive blood product transfusions. Our patient was treated with antithyroid medications followed by radioactive iodine ablation followed by a spontaneous recovery of pancytopenia.

Abstract #1116 Radioactive Iodine Therapy for Graves Disease: What Predicts Failure?

2018 ◽  
Vol 24 ◽  
pp. 281-282
Author(s):  
Kalyani Regeti ◽  
Rajinikanth Yatavelli ◽  
Harsha Karanchi ◽  
Binod Pokhrel
Keyword(s):  
Radioactive Iodine ◽  
Graves Disease ◽  
Radioactive Iodine Therapy
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