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

Purpose: To observe the short-term dynamic change in serum CXC chemokine ligand-10 (CXCL10) levels in patients with Graves' disease (GD) before and after iodine therapy and to analyze the relationship between CXCL10 levels and clinical disease indices. Methods: ELISA was used to determine serum levels of CXCL10 in 43 patients with GD shortly before radioiodine therapy and on days six, 14, and 60, post-therapy. Results: Patients with newly diagnosed GD showed significantly higher levels of serum CXCL10 compared with the control group (P < 0.01). The serum CXCL10 level increased slightly on day six after treatment of radioactive iodine (P < 0.01). There was no significant statistical difference in serum CXCL10 levels pre-treatment and on day 14 post-treatment. A significant reduction in serum CXCL10 level was observed on day 60 (P < 0.01). GD patients with exophthalmia showed higher serum CXCL10 level than GD patients without exophthalmia. No correlation was found between levels of CXCL10 and FT3, FT4 or TSH at any time point, but significant positive correlation was shown between thyroid peroxidase antibodies (TPOAb) and CXCL10 (r=0.50, P < 0.01). Conclusion: CXCL10 participates in the early inflammatory response after radioactive iodine therapy in patients with Graves’ disease and shows a strong association with the autoimmune process.

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Predictive factors for early hypothyroidism following the radioactive iodine therapy in Graves’ disease patients

BMC Endocrine Disorders ◽

10.1186/s12902-020-00557-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Rui-Ting Hu ◽

De-Shan Liu ◽

Bin Li

Keyword(s):

Predictive Factors ◽

Radioactive Iodine ◽

Graves Disease ◽

Radioactive Iodine Therapy

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Suppurative Lymphadenitis after Radioactive Iodine Therapy for Graves’ Disease: A Rare Complication?

European Thyroid Journal ◽

10.1159/000503457 ◽

2019 ◽

Vol 8 (6) ◽

pp. 324-327 ◽

Cited By ~ 2

Author(s):

Shi Hui Junice Wong

Keyword(s):

Radioactive Iodine ◽

Rare Complication ◽

Cervical Lymphadenopathy ◽

Symptomatic Treatment ◽

Graves Disease ◽

Radioactive Iodine Therapy ◽

Short Term ◽

Cervical Lymphadenitis ◽

Incision And Drainage ◽

Radiation Induced

Background: Radioiodine (RAI) therapy for Graves’ disease is a well-accepted and effective treatment with a good side effect profile. Short-term adverse effects can occasionally include radiation-induced thyroiditis. To my knowledge, cervical lymphadenitis associated with RAI therapy for Graves’ disease has not been reported before. Case Report: A 38-year-old woman initially presented with uncontrolled thyrotoxicosis secondary to Graves’ disease. She subsequently received RAI therapy for her condition. Within a week, she developed painful bilateral cervical lymphadenopathy that progressed to abscess formation requiring incision and drainage. No other causes (neoplastic or infective) were found. Symptomatic treatment was instituted, and within 2 months the lymphadenitis resolved completely. Discussion: RAI therapy for Graves’ disease can sometimes cause radiation-induced thyroiditis but associated cervical lymphadenopathy or lymphadenitis has not been described. This may represent a continuum of the proinflammatory state induced by RAI manifesting as a rare but potentially morbid complication.

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Factors Affecting and Outcome of Radioactive Iodine Therapy in Hyperthyroidism: A study at Institute of Nuclear Medicine & Allied Sciences (INMAS), Sylhet

Bangladesh Journal of Nuclear Medicine ◽

10.3329/bjnm.v19i1.35568 ◽

2018 ◽

Vol 19 (1) ◽

pp. 19-23

Author(s):

Kamrun Nahar ◽

Papia Akhter

Keyword(s):

Radioactive Iodine ◽

Antithyroid Drug ◽

Nodular Goiter ◽

Fixed Dose ◽

Graves Disease ◽

Radioactive Iodine Therapy ◽

Cure Rate ◽

Toxic Adenoma ◽

Significant Difference ◽

One Year

Objective: Radioactive iodine therapy (RIT) is the most commonly used modality to treat hyperthyroidism and is indeed in most cases, the treatment of choice. The aim of this study was to assess the clinical outcome one year after radioactive Iodine-131 (RAI -131) therapy and to identify the factors associated with response of the therapy.Patients and Methods: A total 107 hyperthyroid patients were included in this study. All patients were pre-treated with anti-thyroid drugs (ATD). A fixed dose of 8 mCi of radioiodine was given to the patients with Graves’ disease, 12 mCi to patients with single toxic adenoma and 15 mCi to patients with toxic multi-nodular goiter . The patients were done serum FT4 initially and followed up with serum T3, T4, and TSH at three months , six months and one year of RAI therapy . The clinically and biochemically euthyroid and hypothyroid patients were considered as cure of the disease.Results : The cure rate was about 94.7% seen in female patients and 93.8% in male ( P=0.92), 93.6% in younger age group (below 40 years) and 95.0% of the older patients ( P=1.51), 95.5% of the patients who were taking ATD for more than one year and 92.7% of the patients who were taking ATD for less than one year before therapy( P=1.95), 95.4 % of the patients who had initial FT4 level less than 35 pmol/L and 92.7 % of the patients who had high initial FT4 ( P=1.54). Cure rate of Graves’ disease was 45/53 (92.5%), multi-nodular goiter 41/43 (95.3% ) and for single toxic adenoma was 11/11 (100% ) (P= 0.65). The incidence of radioiodine induced hypothyroidism was 6.5 % at three months, 13.1 % at six months and 15.0 % at one year. Overall incidence of cure rate of RAI therapy after one year was 101 (94.4 %).Conclusion: No statistically significant difference was found in the cure rate when sex, age, duration of pretreatment with antithyroid drug, initial FT4 level and cause of hyperthyroidism were considered. From this study it can be concluded that cure rate of RAI therapy is quite good and the pretreatment factors have little influence on the final outcome.Bangladesh J. Nuclear Med. 19(1): 19-23, January 2016

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