Incidence of Hypothyreoidism after Radioactive Iodine-I131 Treatment in Dependance of Hyperthyreoidism Etiology and Therapy Dose

Bešlić, Nermina; Licina, Sabrina; Šadija, Amera; Milardović, Renata

doi:10.5455/medarh.2017.71.270-273

Cited by 10 publications

(11 citation statements)

References 8 publications

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“…Our study showed that the average age of the patients was 45.07 ± 12.59 years and the ratio of male to female was 1:4.78, which was similar to the previous reports. In the literatures, the incidence of hypothyroidism after RAI therapy ranged from 8.5 to 90% [20][21][22][23][24]. Our results indicated that the early hypothyroidism occurred in 218 (69.87%) patients, and only nine patients (2.88%) achieved euthyroidism, which was consistent with a recent study conducted in Singapore [25].…”

Section: Discussionsupporting

confidence: 91%

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

2020

BMC Endocr Disord

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Background: Radioactive iodine (RAI) therapy is an important treatment option for Graves' disease (GD), the main side effect of RAI treatment is hypothyroidism, and the factors resulting in hypothyroidism are still controversial. The purpose of this retrospective study was to clarify the possible risk factors of early hypothyroidism after RAI therapy in Graves' disease. Methods: We reviewed 312 GD patients treated with RAI between January 2017 to December 2018, collected the potential risk factors, and analyzed the relationship between these variables and early hypothyroidism. Results: After 6 months' follow-up, 218 (69.87%) patients were evaluated as early hypothyroid. Male gender, shorter duration of disease, smaller thyroid weight, lower 2-h radioactive iodine uptake (RAIU), 6-h RAIU, 24-h RAIU and 6/ 24-h uptake ratio, lower administered dosages were significantly associated with early hypothyroidism. Logistics regression analysis showed that male gender, smaller thyroid weight and lower 6-h RAIU were associated with early hypothyroidism. Multi-factors combined ROC curve analysis suggested that the predictive power of male gender, smaller thyroid weight and lower 6-h RAIU for early hypothyroidism was 0.711. Conclusions: Our results show that RAI is an effective therapy for GD and most of the cured patients became to hypothyroid within 6 months. Male gender, smaller thyroid weight and lower 6-h RAIU are the main risk factors for early hypothyroidism.

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Section: Discussionsupporting

confidence: 91%

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

2020

BMC Endocr Disord

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“…A higher dose-1 has imparted euthyroid outcome in patients with female gender, GD,or the receiver of two instances of RAIT in this series. This fact is unique and draws attention to some reported determinants of post-RAIT hypothyreosiswhich are female gender and administered dose > 600 MBq (>16.21 mCi), (19).The incidences of post-RAIT hypothyreosis from GD, STN and MNG were 61%, 67% and 35%in the current serieswhile those from another 3-years series were 89.5%, 26.8% and 57.1% respectively (20). Thus the goal of attaining hypothyroidism by RAIT in patients with GD and STN (21) was successful in this series with the rest remained euthyroid, indicating favorable treatment outcome which in turn indicates the appropriate standard of institutional practice.…”

Section: Discussionmentioning

confidence: 54%

Biochemical Outcome of Repeated Radioactive Iodine Therapy in Patients with Primary Hyperthyroidism– Follow Up of a Decade

Reza

Sarker

Haque

et al. 2021

Bangladesh J. Nuclear Med.

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Background: Whileradioactive iodine therapy (RAIT) in patients with primary hyperthyroidism results in euthyreosis or hypothyreosis, requirement of repeated therapy in a proportion of patients is a clinical reality. This study describesbiochemical outcomeof patients requiring repeated RAIT and the dose profiles across the demographic traits. Patients and Methods: The study retrospectively included the patients who underwent RAIT for Primary hyperthyroidism from January to December of 2006, using a modified fixed dose protocol following an institutional guideline which was adopted as the national guideline in 2007. Persistence of biochemical features of hyperthyroidism six months after RAIT was an indication for repeated therapy. Follow up data of eligible patients till December of 2016 was included in the descriptive statistics. Results: One, Two, three and four instances of RAIT were given to 83%, 14%, 2% and ≤ 1% of patients resulting in hypothyroidism to 58%, 67%, 67% and 100% of patients after each instance of therapy with incremental dose. Apparently more females than males ended up as biochemically hypothyroid, though not significant (OR 1.15, p=0.56).Younger females became significantly hypothyroid (p = 0.03).Patients with euthyroid outcome received higher dose-1of RAIT (P=0.007) which was found significant in females (p=0.005), in patients with Graves’ disease (GD) (p=0.018) and in patients receiving two instances of RAIT (p=0.03). Among the patients with GD, Single Toxic Nodule (STN) and Multi-Nodular Goiter (MNG), the proportion of hypothyroid outcome were 61%, 67% and 35%, at ten years following first dose. GD and STN required RAIT for up to four instances.MNG received an apparently higher mean of dose -1 and apparently less steep increment of doses, in comparison to GD and STN. Conclusion: Thisobservationof patient outcome over a decade was a scope to compare the mentioned guideline’s performance with the targets set by influential guidelines and recent reports around the globe. Bangladesh J. Nuclear Med. 22(2): 119-124, Jul 2019

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“…In some respects, this bilateral symmetrical pattern of uptake is similar to the situation in Graves' disease in people, where the hyperplastic thyrocytes of both thyroid lobes take up 131 I diffusely and hypothyroidism is almost inevitable. 28 , 29 , 42 Our observation that cats with an asymmetrical (heterogeneous) 99m TcO 4 − uptake pattern were less likely to develop 131 I‐induced hypothyroidism likely relates to the lower radiation dose delivered to the thyroid nodule with less intense 131 I uptake, which may help preserve more of the dormant or normal thyrocytes within that adenomatous lobe.…”

Section: Discussionmentioning

confidence: 94%

Predicting outcomes in hyperthyroid cats treated with radioiodine

Peterson

Rishniw

2021

Veterinary Internal Medicne

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Background Radioiodine ( 131 I) is the treatment of choice for cats with hyperthyroidism. After 131 I, however, euthyroidism is not always achieved, with 5% to 10% of cats remaining persistently hyperthyroid and 20% to 50% developing iatrogenic hypothyroidism. Objectives To identify pretreatment factors that may help predict persistent hyperthyroidism and iatrogenic hypothyroidism after treatment of cats using a novel 131 I dosing algorithm. Animals One thousand and four hundred hyperthyroid cats treated with 131 I. Methods Prospective, before‐and‐after study. Pretreatment predictors (clinical, laboratory, scintigraphic, 131 I dose, 131 I uptake measurements) of treatment failure or iatrogenic hypothyroidism were identified by multivariable logistic regression analysis. Results Cats that developed iatrogenic hypothyroidism were more likely to be older (odds ratio [OR] = 1.10; 95% confidence interval [CI], 1.04‐1.17; P = .001), female (OR = 2.04; 95% CI, 1.54‐2.70; P < .001), have detectable serum thyroid‐stimulating hormone (TSH) concentrations (OR = 4.19; 95% CI, 2.0‐8.81; P < .001), have bilateral thyroid nodules (OR = 1.57; 95% CI, 1.19‐2.08; P < .001), have homogeneous, bilateral distribution of 99m Tc‐pertechnetate uptake (OR = 2.93; 95% CI, 2.05‐4.19; P < .001), have milder severity score (OR = 0.62; 95% CI, 0.49‐0.79; P < .001), and have higher 131 I uptake (OR = 2.40; 95% CI, 1.75‐3.28; P < .001). In contrast, cats remaining persistently hyperthyroid were more likely to be younger (OR = 0.81; 95% CI, 0.72‐0.92; P < .001), have higher severity score (OR = 1.87; 95% CI, 1.51‐2.31; P < .001), and have lower 131 I uptake (OR = 3.50; 95% CI, 1.8‐6.80; P < .001). Conclusions and Clinical Importance Age, sex, serum TSH concentration, bilateral and homogeneous 99m Tc‐pertechnetate uptake on scintigraphy, severity score, and percent 131 I uptake are all factors that might help predict outcome of 131 I treatment in hyperthyroid cats. Cats with persistent hyperthyroidism had many predictive factors that directly contrasted those of cats that developed 131 I‐induced hypothyroidism.

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Incidence of Hypothyreoidism after Radioactive Iodine-I131 Treatment in Dependance of Hyperthyreoidism Etiology and Therapy Dose

Cited by 10 publications

References 8 publications

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

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

Biochemical Outcome of Repeated Radioactive Iodine Therapy in Patients with Primary Hyperthyroidism– Follow Up of a Decade

Predicting outcomes in hyperthyroid cats treated with radioiodine

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