Low Remission After Therapy for Graves Disease

Wartofsky, Léonard

doi:10.1001/jama.1973.03230090011002

Cited by 61 publications

(5 citation statements)

References 5 publications

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“…There have been other studies as well which have also showed a higher remission rate, like one done by Ishtiaq et al ., which found remission rate of 41.9%,[ 3 ] and 43.3% by Vitti et al .,[ 4 ] 61% by Anagnostis et al . [ 2 ] However in a study done in 1973, remission rate was found to be 13.6%,[ 8 ] which was lower than the current study.…”

Section: Discussioncontrasting

confidence: 81%

“…[ 1 2 3 4 5 6 7 ] However, this may vary depending on factors like iodine status. [ 8 ] The role of 99m-technetium ( 99m Tc) pertechnate uptake thyroid scintigraphy scan at presentation in predicting remission and relapse has not been well studied. Few studies done in early 90 s have shown a higher radioiodine uptake can be useful in predicting relapse, but its role in predicting remission still remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Technetium uptake predicts remission and relapse in Grave's disease patients on antithyroid drugs for at least 1 year in South Indian subjects

Singhal

Pavithran

Bhavani

et al. 2016

Indian J Endocr Metab

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Context:Most of the information on remission related factors in Grave's disease are derived from Western literature. It is likely that there may be additional prognostic factors and differences in the postdrug treatment course of Grave's disease in India.Aim:To study factors which predict remission/relapse in Grave's disease patients from South India. Also to establish if technetium (Tc) uptake has a role in predicting remission.Subjects and Methods:Records of 174 patients with clinical, biochemical, and scintigraphic criteria consistent with Grave's disease, seen in our Institution between January 2006 and 2014 were analyzed. Patient factors, drug-related factors, Tc-99m uptake and other clinical factors were compared between the remission and nonremission groups.Statistical Analysis Used:Mann–Whitney U-test and Chi-square tests were used when appropriate to compare the groups.Results:Fifty-seven (32.7%) patients attained remission after at least 1 year of thionamide therapy. Of these, 11 (19.2%) patients relapsed within 1 year. Age, gender, goiter, and presence of extrathyroidal manifestations were not associated with remission. Higher values of Tc uptake were positively associated with remission (P- 0.02). Time to achievement of normal thyroid function and composite dose: Time scores were significantly associated with remission (P - 0.05 and P - 0.01, respectively). Patients with lower FT4 at presentation had a higher chance of remission (P - 0.01). The relapse rates were lower than previously reported in the literature. A higher Tc uptake was found to be significantly associated with relapse also (P - 0.009).Conclusion:The prognostic factors associated with remission in Graves's disease in this South Indian study are not the same as that reported in Western literature. Tc scintigraphy may have an additional role in identifying people who are likely to undergo remission and thus predict the outcome of Grave's disease.

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Section: Discussioncontrasting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Technetium uptake predicts remission and relapse in Grave's disease patients on antithyroid drugs for at least 1 year in South Indian subjects

Singhal

Pavithran

Bhavani

et al. 2016

Indian J Endocr Metab

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“…The present data suggest an iodine intake of the same order, and are also in accordance with the findings of Wayne et al (1964). An in¬ crease in dietary intake of iodine to above 200 pg/da.y in the last decade has been shown by several investigators in the United States (Wartofsky 1973 Nielsen 8c Friis 1973). Since the level of free T4 index in the present and in previous studies are found to be unaltered with increasing age the findings seem consistent with the assumption that T4 production decreases with ad¬ vancing age.…”

Section: Discussionmentioning

confidence: 90%

Age Dependent Changes in Iodine Metabolism and Thyroid Function

Skovsted

Siersbæk-Nielsen

1975

Acta Endocrinologica

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Absolute iodine uptake (AIU), serum thyroxine (T4), free T4 index and serum triiodothyronine (T3) were studied in 48 women and 63 men aged 20 to 90 years. AIU decreased with age in both sexes to values in the oldest age groups of about 60 % of the values in the youngest age groups. AIU values for females were about 75 % of the values for males. Free T4 index was found to be unaltered with increasing age but serum T3 decreased with age. These findings and the previous demonstrated decrease in T4 degradation rate seem consistent with the assumption that T4 and T3 production decreases with advancing age.

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“…Iodine excess reduces the effectiveness of antithyroid drug therapy and increases the recurrence of Graves' hyperthyroidism [2][3][4]. Recently, Jonckheer et al [5] found that hyperthyroid patients with relatively larger intrathyroidal iodine pools, measured by the fluorescence method, are more resistant to anti-thyroid drug treatment.…”

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confidence: 99%