scholarly journals Radioiodine Treatment of Hyperthyroidism—Prognostic Factors for Outcome

2001 ◽  
Vol 86 (8) ◽  
pp. 3611-3617 ◽  
Author(s):  
Amit Allahabadia ◽  
Jacquie Daykin ◽  
Michael C. Sheppard ◽  
Stephen C. L. Gough ◽  
Jayne A. Franklyn
Keyword(s):  
Single Dose ◽  
Prognostic Factors ◽  
Nodular Goiter ◽  
Fixed Dose ◽  
Graves Disease ◽  
Cure Rate ◽  
Toxic Nodular Goiter ◽  
Large Size ◽  
Lower Cure Rate ◽  
Lower Cure

There is little consensus regarding the most appropriate dose regimen for radioiodine (131I) in the treatment of hyperthyroidism. We audited 813 consecutive hyperthyroid patients treated with radioiodine to compare the efficacy of 2 fixed-dose regimens used within our center (185 megabequerels, 370 megabequerels) and to explore factors that may predict outcome. Patients were categorized into 3 diagnostic groups: Graves’ disease, toxic nodular goiter, and hyperthyroidism of indeterminate etiology. Cure after a single dose of 131I was investigated and defined as euthyroid off all treatment for 6 months or T4 replacement for biochemical hypothyroidism in all groups. As expected, patients given a single dose of 370 megabequerels had a higher cure rate than those given 185 megabequerels, (84.6% vs. 66.6%, P < 0.0001) but an increase in hypothyroidism incidence at 1 yr (60.8% vs. 41.3%, P < 0.0001). There was no difference in cure rate between the groups with Graves’ disease and those with toxic nodular goiter (69.5% vs. 71.4%; P, not significant), but Graves’ patients had a higher incidence of hypothyroidism (54.5% vs. 31.7%, P< 0.0001). Males had a lower cure rate than females (67.6% vs. 76.7%, P = 0.02), whereas younger patients (<40 yr) had a lower cure rate than patients over 40 yr old (68.9% vs. 79.3%, P < 0.001). Patients with more severe hyperthyroidism (P < 0.0001) and with goiters of medium or large size (P < 0.0001) were less likely to be cured after a single dose of 131I. The use of antithyroid drugs, during a period 2 wk before or after 131I, resulted in a significant reduction in cure rate in patients given 185 megabequerels 131I (P < 0.01) but not 370 megabequerels. Logistic regression analysis showed dose, gender, goiters of medium or large size, and severity of hyperthyroidism to be significant independent prognostic factors for cure after a single dose of 131I. We have demonstrated that a single fixed dose of 370 megabequerels 131I is highly effective in curing toxic nodular hyperthyroidism as well as Graves’ hyperthyroidism. Because male patients and those with more severe hyperthyroidism and medium or large-sized goiters are less likely to respond to a single dose of radioiodine, we suggest that the value of higher fixed initial doses of radioiodine should be evaluated in these patient categories with lower cure rates.

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

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

SEQUENTIAL OCCURRENCE OF TOXIC NODULAR GOITER FOLLOWED BY GRAVES' DISEASE

1998 ◽  
Vol 4 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Alan H. Seplowitz, MD ◽  
Beth Ann Ditkoff, MD ◽  
Anastasios D. Papadopoulos, MD ◽  
Paul Lo Gerfo, MD
Keyword(s):  
Nodular Goiter ◽  
Graves Disease ◽  
Toxic Nodular Goiter

HLA antigens in Greek patients with thyrotoxicosis (Graves’ disease and toxic nodular goiter)

1984 ◽  
Vol 7 (4) ◽  
pp. 283-286 ◽  
Author(s):  
C. Papasteriades ◽  
Maria N. Alevizaki-Harhalaki ◽  
J. Economidou ◽  
D. G. Ikkos
Keyword(s):  
Hla Antigens ◽  
Nodular Goiter ◽  
Graves Disease ◽  
Toxic Nodular Goiter

Graves' Disease and Toxic Nodular Goiter Are Both Associated with Increased Mortality But Differ with Respect to the Cause of Death: A Danish Population-Based Register Study

Thyroid ◽  
2013 ◽  
Vol 23 (4) ◽  
pp. 408-413 ◽  
Author(s):  
Frans Brandt ◽  
Marianne Thvilum ◽  
Dorthe Almind ◽  
Kaare Christensen ◽  
Anders Green ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Nodular Goiter ◽  
Population Based ◽  
Register Study ◽  
Graves Disease ◽  
Danish Population ◽  
Toxic Nodular Goiter

scholarly journals Continuous Methimazole Therapy and Its Effect on the Cure Rate of Hyperthyroidism Using Radioactive Iodine: An Evaluation by a Randomized Trial

2006 ◽  
Vol 91 (8) ◽  
pp. 2946-2951 ◽  
Author(s):  
Steen Joop Bonnema ◽  
Finn Noe Bennedbæk ◽  
Annegrete Veje ◽  
Jens Marving ◽  
Laszlo Hegedüs
Keyword(s):  
Thyroid Volume ◽  
Nodular Goiter ◽  
131I Therapy ◽  
Cure Rate ◽  
Free T4 ◽  
Toxic Nodular Goiter ◽  
131I Uptake ◽  
Concomitant Reduction ◽  
Duration Of Disease ◽  
Continuous Use

Abstract Background: A randomized clinical trial was performed to clarify whether continuous use of methimazole (MTZ) during radioiodine (131I) therapy influences the final outcome of this therapy. Design: Consecutive patients with Graves’ disease (n = 30) or a toxic nodular goiter (n = 45) were rendered euthyroid by MTZ and randomized to stop MTZ 8 d before 131I (−MTZ; n = 36) or to continue MTZ until 4 wk after 131I (+MTZ; n = 39). Calculation of the 131I activity included an assessment of the 131I half-life and the thyroid volume. Results: The 24-h thyroid 131I uptake was lower in the +MTZ group than in the −MTZ group (44.8 ± 15.6% vs. 62.1 ± 9.9%, respectively; P < 0.001). At 3 wk after therapy, no significant change in serum free T4 index was observed in the +MTZ group (109 ± 106 vs. 83 ± 28 nmol/liter at baseline; P = 0.26), contrasting an increase in the −MTZ group (180 ± 110 vs. 82 ± 26 nmol/liter; P < 0.001). The number of cured patients was 17 (44%) and 22 (61%) in the +MTZ and −MTZ groups, respectively (P = 0.17). Cured patients tended to have a lower 24-h thyroid 131I uptake (50.1 ± 13.8% vs. 56.4 ± 17.1%; P = 0.09). By adjusting for a possible interfactorial relationship through a regression analysis (variables: randomization, 24- and 96-h thyroid 131I uptake, type and duration of disease, age, gender, presence of antithyroid peroxidase antibodies, thyroid volume, dose of MTZ), only the continuous use of MTZ correlated with treatment failure (P = 0.006), whereas a low 24-h thyroid 131I uptake predicted a better outcome (P = 0.006). Conclusion: Continuous use of MTZ hinders an excessive increase of the thyroid hormones during 131I therapy of hyperthyroid diseases. However, such a strategy seems to reduce the final cure rate, although this adverse effect paradoxically is attenuated by the concomitant reduction of the thyroid 131I uptake.

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