Fatores associados com recidiva precoce do hipertireoidismo após tratamento com radioiodoterapia

Abstract

RESUMOObjetivos: Avaliar os fatores associados com persistência ou recorrência do hipertireoidismo após tratamento com 131 I. Metodologia: Análise retrospectiva de prontuários de todos os pacientes com hipertireoidismo tratados com dose fixa de 400MBq de 131 I em um centro especializado (1992 a 1997 From the 104 patients treated during that period, six had a multinodular goitre and one, a toxic adenoma; 96 were taking thionamide preparations, which were discontinued 7 days prior to radioiodine administration. Results: Early progression to hypothyroidism was observed at a median of 88 days (22-214) in 60 patients (57.7%). Persistence or early recurrence of hyperthyroidism was observed in 13 (12.5%) and was positively correlated with age (p<0.007), although unrelated to underlying diagnosis. There was a higher prevalence of persistent disease in those treated with propylthiouracil rather than carbimazol prior to radioiodine (35% vs. 8%; p<0.006). Conclusions: This study suggests that the blocking effect of thionamides on radioiodine uptake may be more prolonged in older people. It also suggests that the effect of propylthiouracil may last longer than that of carbimazol. (Arq Bras Endocrinol Metab 2003;47/6:701-704) Keywords: Iodine; Radioiodine; Hyperthyroidism; Graves; Recurrence A DMINISTRAÇÃO ORAL de 131 I é largamente aceita como um tratamento simples, efetivo e aparentemente seguro para hipertireoidismo. Doses menores, tituladas e repetidas têm sido advogadas para reduzir a incidência de hipotireoidismo (1), entretanto têm-se discutido seu baixo custo-benefí-

A inserção do farmacêutico na radiofarmácia: com ênfase no iodeto de sódio para fins de diagnóstico e tratamento de disfunções na tireoide / The insertion of the pharmacist in radiopharmacy: with emphasis on sodium iodide for the purposes of diagnosis and treatment of thyroid dysfunction

“…O 131I é composto por partículas beta e gama, altamente energéticas, o radiofármaco atua atravessando os tecidos, ionizando as células cancerígenas, ocasionando o efeito deletério, resultando em reações e desintegrações celulares, processos nos quais ocorre um rearranjo da configuração provocando a morte das células tumorais. A finalidade da terapia é promover a ablação por emissão da radiação de todos os possíveis microfocos do tecido tireoidiano e tratar possíveis micro metástases (ARAUJO et al, 2007;MAGLIANO, 2019).…”

Embolização de artérias tireoidianas como opção terapêutica para o hipertireoidismo: série de casos

“…Among the thera-Radiol Bras. 2013 Mar/Abr;46(2):83-88 content, previous utilization of iodinated contrast agents and thionamides for control, concomitance or not of utilization of antithyroid drug during iodine administration and gastrointestinal tract integrity (1)(2)(3) . Main contraindications include pregnancy and lactation (absolute contraindications) and active Graves' ophthalmopathy classified as intense (relative contraindication).…”

“…Main contraindications include pregnancy and lactation (absolute contraindications) and active Graves' ophthalmopathy classified as intense (relative contraindication). However, this definitive therapeutic procedure is widely utilized nowadays (2)(3)(4)(5)(6)(7) .…”

“…resolution of hyperthyroidism, but it may present complications caused by anesthesia, and fail in the control of the clinical condition (particularly in attempts of partial resection of the gland), besides being an invasive procedure involving risks for injuries to the recurrent laryngeal nerve and cervical vessels, and possibility of hypoparathyroidism. Currently, with improvements in operative techniques and in the knowledge on corticosteroid preparation for surgery, the complication rates have decreased (2) .…”

“…The radioactive iodine therapy causes actinic lesions which culminate in atrophy of the thyroid tissue. Such an effect, however, presents a variable response, depending upon several factors such as thyroid gland volume, dose delivered, dietary iodine peutic modalities, three are currently feasible, namely, antithyroid drugs, radioactive iodine and surgery (2,3) .…”