Long-term Methimazole is As Effective as Radioiodine Therapy for the Treatment of Toxic Multinodular Goiter

2019 ◽  
Vol 31 (5) ◽  
pp. 185-188
Author(s):  
Suneeta S. Ganji ◽  
David S. Cooper
Keyword(s):  
Multinodular Goiter ◽  
Radioiodine Therapy ◽  
Toxic Multinodular Goiter

scholarly journals Változások a pajzsmirigybetegségek radiojódkezelésében

2016 ◽  
Vol 157 (3) ◽  
pp. 83-88
Author(s):  
András Konrády
Keyword(s):  
Multinodular Goiter ◽  
Radioiodine Therapy ◽  
Treatment Protocol ◽  
Treatment Results ◽  
Radioiodine Uptake ◽  
Risk Patients ◽  
Toxic Multinodular Goiter ◽  
Prospective Trials ◽  
Immunogenic Hyperthyroidism ◽  
Recombinant Human Thyrotropin

Radioiodine therapy for benign and malignant thyroid diseases was introduced about 70 years ago, however, there is still a lack of consensus regarding indications, doses and procedure. This review covers treatment results in immunogenic hyperthyroidism including the problem of orbitopathy. Radioiodine therapy for toxic and non-toxic multinodular goiter is also discussed with striking possibility of enhanching the radioiodine uptake. In this respect the recombinant human thyrotropin should be mentioned. Thyroid cancer treatment protocol has changed, too, due to ineffectivity in low-risk patients. More attention is needed to the carcinogenecity of radioiodine. The numerous problems mentioned above require large and well-designed prospective trials to resolve the fundamental questions. The author emphasizes that radioiodine dose should be administered in doses as low as reasonably achievable. Orv. Hetil., 2016, 157(3), 83–88.

Treatment of Toxic Multinodular Goiter: Comparison of Radioiodine and Long-Term Methimazole Treatment

Thyroid ◽  
2019 ◽  
Vol 29 (5) ◽  
pp. 625-630 ◽  
Author(s):  
Fereidoun Azizi ◽  
Miralireza Takyar ◽  
Elham Madreseh ◽  
Atieh Amouzegar
Keyword(s):  
Multinodular Goiter ◽  
Toxic Multinodular Goiter

scholarly journals Treatment of thyrotoxicosis with radioiodine (аnalytical review of literature and own clinical data)

2020 ◽  
Vol 28 (3) ◽  
pp. 241-254
Author(s):  
N. I. Lukhovytska
Keyword(s):  
Thyroid Gland ◽  
Multinodular Goiter ◽  
Radioiodine Therapy ◽  
Severe Disease ◽  
Graves Disease ◽  
Radioiodine Treatment ◽  
Sources Of Information ◽  
Toxic Multinodular Goiter ◽  
Medical Radiology ◽  
Almost All

Background. Thyrotoxicosis syndrome is a severe disease of the thyroid that adversely affects functioning of almost all organs and body systems and can result in serious complications like ciliary arrhythmia, cardiovascular inefficiency, thyroid eye disease with visual deterioration, multi-organ failure. The choice of treatment strategy, its sequence and radioiodine therapy effectiveness in thyrotoxicosis and other non-oncological diseases of the thyroid gland is still a challenging issue in endocrinology and radiology. Purpose. To analyze the literature data regarding radionuclide treatment in patients with thyrotoxicosis and to present own experience-outcomes of radioiodine treatment administered to 146 patients with thyrotoxicosis symptoms and 9 patients with other non-oncological thyroid pathology at SO «Grigoriev Institute for Medical Radiology and Oncology» during 2010–2019. Materials and methods. The literature analysis involved 34 sources of information in the form of scientific articles, research papers, monographies, etc. Among them, 4 sources were domestic, 3 sources were Russian, the other 27 were taken from the foreign scientific journals. The evidence level of researching varies from І А to ІІІ С. The analysis of own findings has been carried out for the period from 2010 to the first half of 2020. Treatment with 131I-sodium iodide was provided in liquid or capsule form, per os; 155 patients in total underewnt treatment. Radioiodine activity per a course ranged from 185 MBq to 1110 MBq, the number of courses was chosen individually. Results and discussion. The analytical review of modern domestic and foreign literature has made it possible to define that radioiodine treatment still plays an important role in treatment of thyrotoxicosis, especially for patients with recurrent and resistant to thyrostatics disease form. Our own data showed that the treatment was reasonable to be administered via high radioiodine doses (600–1000 MBq), that resulted in curing the disease in 98 % (113 patients with Graves’ disease and 33 patients with toxic multinodular goiter). The effectiveness of radioiodine therapy for patients with AIT (2 cases) and in case of the retrosternal location of the thyroid gland (7 patients) has been proven. Conclusions. Radioiodine treatment remains a modern and effective way to overcome such conditions as Graves’ disease, TMNG (toxic multinodular goiter), retrosternal location of hyperplastic thyroid gland, AIT.

Long-term Effects of Radioiodine in Toxic Multinodular Goiter: Thyroid Volume, Function, and Autoimmunity

2020 ◽  
Vol 105 (7) ◽  
pp. e2464-e2470 ◽  
Author(s):  
Catarina Roque ◽  
Francisco Sousa Santos ◽  
Tania Pilli ◽  
Gilda Dalmazio ◽  
Maria Grazia Castagna ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Multinodular Goiter ◽  
Thyroid Volume ◽  
Population Based ◽  
Volume Reduction ◽  
Long Term Effects ◽  
Volume Function ◽  
Toxic Multinodular Goiter

Abstract Context Long-term studies evaluating the treatment of toxic multinodular goiter (TMNG) with fixed activities of radioiodine (RAI) are lacking. Objective The objective of this work is to describe the effects of 15 mCi on thyroid volume, function, and autoimmunity in the long term. Design and Setting A population-based, retrospective analysis with up to 12 years of follow-up was conducted in Siena, Italy. Participants Adult patients (n = 153) with TMNG, naive to RAI, were included. Methods Evaluation was performed of thyroid function, antithyroid antibodies, and ultrasound scans before and yearly after RAI. Main Outcome Measures Evaluations included hyperthyroidism cure, hypothyroidism, volume reduction, nadir and regain, and antibody titer change. Results The study revealed mean volume reductions greater than or equal to 50% at 3 years after RAI; the greatest annual reduction was observed during the first year (30 ± 17.8%; P < .001). Most patients (60%) achieved their volume nadir 3 to 6 years after RAI. Although 22% patients showed volume regain, the net reduction was statistically significant as late as 9 years after RAI (P = .005). The mean time to hypothyroidism was 2.7 ± 2.4 years, and it was associated with greater reductions in volume (P = .01). During the first 3 years after treatment, hyperthyroid patients decreased approximately by 50% per year without additional RAI. There was no statistically significant association of antibody titers with thyroid function except for antithyrotropin receptor antibodies and hyperthyroidism (P = .004). At the end of follow-up there were 61.6% euthyroid patients, 11% hyperthyroid (4.8% overt), and 27.4% hypothyroid patients (2.7% overt). Hyperthyroidism was cured in 89%. Conclusions The treatment of TMNG with 15 mCi of RAI induced low hypothyroidism rates while providing high cure rates and significant volume reduction, which was maintained in the long term.

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