scholarly journals Assessment of Factors Affecting the Treatment Efficacy of Radioactive Iodine (I-131) Therapy in Patients with Hyperthyroidism

2021 ◽  
Author(s):  
Ferhat Arık ◽  
Ferhat Gökay ◽  
Bade Erturk Arık
Keyword(s):  
Treatment Efficacy ◽  
Radioactive Iodine ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma ◽  
Adequate Treatment ◽  
Efficient Treatment ◽  
Factors Affecting ◽  
Iodine Treatment

Objective: Hyperthyroidism is an increase in hormone production in the thyroid gland and the exposure of tissues to the hormones of the thyroid glands in the circulation. The most common causes encountered are Graves’ Disease, Toxic Multinodular Goiter and Toxic Adenoma. The purpose of radioactive iodine treatment is to make patients become euthyroid or hypothyroid. Despite adequate treatment, hyperthyroidism persists or reccurs in some patients. The aim of our study is to investigate the factors affecting the efficacy of radioactive iodine treatment in hyperthyroidism. Methods: In this retrospective study, relevant clinical and laboratory data were recorded in database of Kayseri Training and Research Hospital, Endocrinology and Metabolism Diseases Outpatient Unit between 2013-2016. Results: A total of 79 cases including 17 (21%) male, and 62 (79%) female patients were enrolled in the study. There were 33 (42%) Graves’ disease 9 (11%) Toxic Multinodular Goitre and 37 (47%) Toxic Adenoma patients when grouped according to diagnoses. Mean age was 56.5 ± 16,80. Development of hypothyroidism or euthyroidism were accepted as efficient treatment, hyperthyroidism or recurrence were considered as treatment failure. In 71 (89%) patients, treatment efficiently resulted in hypothyroidism or euthyroidism, whereas in 8 (11%) patients, the treatment failed due to recurrence or persistent disease. Treatment was 100 % effective in Toxic Multinodular Goitre and Toxic Adenoma groups, while it was effective in 75.7 of patients with Graves’ Disease. Patients who did not use antithyroid drugs recovered faster than patients who did. Conclusion: Radioactive iodine therapy is an efficient treatment in patients with hyperthyroidism. It was determined that 1 mm increase in nodule size decreased the treatment efficacy by 1.07 times (p<0,05). However, there are many factors that affect the efficacy of this treatment. To elucidate these factors and improve clinical practice, prospective long-term studies providing more reliable data with larger samples needed.

scholarly journals A questionnaire survey concerning the most favourable treatment for Graves' disease in children and adolescents

2004 ◽  
pp. 155-156 ◽  
Author(s):  
GE Krassas ◽  
Z Laron
Keyword(s):  
Children And Adolescents ◽  
Radioactive Iodine ◽  
High Rate ◽  
Treatment Modalities ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Or Groups ◽  
The Usa ◽  
Toxic Goiter

Graves' disease (GD) is the most common cause of juvenile thyrotoxicosis in children and adolescents (1, 2). Three treatment modalities are now available for the treatment of Graves' thyrotoxicosis in childhood: antithyroid drugs (ATD), surgery and radioactive iodine (RAI). However, none of these treatments has been shown to be ideal or clearly superior to the others. Physicians in different countries have different approaches concerning the optimal treatment of juvenile GD.In a European questionnaire study (3), which was conducted by the European Thyroid Association in 1993 and in which 99 individuals or groups from 22 countries participated, it was found that 22 out of 99 physicians from nine countries would consider RAI treatment as the treatment of choice for children with recurrent thyrotoxicosis after surgery, or with recurrent thyrotoxicosis 2 years after ATD. However, RAI is preferred by only a small percentage of physicians for this group of patients in Europe. Hardly any of the respondents chose RAI for the patients with a toxic adenoma or a multinodular toxic goiter (3). On the other hand, in view of the difficulties with medical therapy in children and adolescents, including poor compliance, a high rate of relapse, drug toxicity and continued thyroid enlargement, some eminent American physicians emphasize the safety, simplicity and economic advantages of (131)I ablation which should be considered more commonly in children (4, 5).We had the opportunity to conduct a similar study during a pediatric thyroidology symposium, which was organized by Professors Buyugkebiz and Laron in Izmir (Smyrna) Turkey from 30 October to 1 November 2003. During the congress a questionnaire with the following four questions was circulated among the 120 participants from eight countries who were mainly paediatric endocrinologists. Most of them were from Turkey and the rest, except for one who came from the USA, were Europeans. Sixty-one out of the 120 physicians responded.

Type of operation for toxic adenoma, toxic multinodular goitre and Graves’ Disease

2015 ◽  
Vol 87 (1) ◽  
pp. 34-37 ◽  
Author(s):  
S. Lanitis ◽  
K. Karkoulias ◽  
G. Sourtse ◽  
V. Ganis
Keyword(s):  
Graves Disease ◽  
Multinodular Goitre ◽  
Toxic Adenoma

Radioactive Iodine, Surgery or Antithyroid Drugs in Treatment of Graves' Disease

1958 ◽  
Vol 23 (1) ◽  
pp. 78-86 ◽  
Author(s):  
F. Raymond Keating ◽  
Howard A. Patterson ◽  
Willard P. Vanderlaan
Keyword(s):  
Radioactive Iodine ◽  
Antithyroid Drugs ◽  
Graves Disease

Effect of glucocorticoids and oestrogen on interleukin-6 production by human thyrocytes from patients with Graves' disease and toxic multinodular goitre and from HTori3 cells

1997 ◽  
pp. 429-432 ◽  
Author(s):  
TH Jones ◽  
RL Kennedy ◽  
SK Justice ◽  
R Davies
Keyword(s):  
Interleukin 6 ◽  
Interleukin 1 ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroid Cell ◽  
Multinodular Goitre ◽  
Necrosis Factor Alpha ◽  
Serum Free ◽  
Thyroid Cell Culture ◽  
Serum Free Conditions

Interleukin-6 (IL-6) is a cytokine released by thyrocytes and is involved in disease processes such as autoimmune thyroid disease. The secretion of IL-6 can be stimulated by interleukin-1 (IL-1), tumour necrosis factor-alpha (TNF), serum, TSH and agents which increase intracellular cyclic AMP levels. Antithyroid drugs such as methimazole inhibit IL-6 production by thyrocytes but the effects of glucocorticoids and oestrogen have not been investigated. The effects of dexamethasone and 17 beta-oestradiol on IL-1-, TNF-, TSH-, forskolin- and phorbol 12-myristate 13-acetate (PMA)-stimulated IL-6 release in serum-free conditions were studied in human thyrocytes derived from patients with Graves' disease and toxic multinodular goitres, and in the immortalised human thyrocyte cell line, HTori3. Dexamethasone inhibited IL-6 production under stimulated conditions. In serum-free conditions, no basal release of IL-6 was assayable. In all but one of the primary thyroid cultures, TSH did not stimulate IL-6 release above the lower detectable limit of the assay. In Graves' and multinodular goitre thyrocytes, inhibition of IL-1 (100 U/ml)-stimulated IL-6 release by dexamethasone (100 nmol/l) was 62.51% +/- 10.43 (S.E.M.), and in HTori3 cells it was 78.35% +/- 3.9. The degree of IL-1 stimulation of IL-6 release and inhibition by dexamethasone was not significantly different in thyrocytes derived from either Graves' or multinodular glands. 17 beta-Oestradiol had no effect on IL-1-stimulated IL-6 release in either primary thyroid cell culture or in HTori3 cells.

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

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