Radioiodine-induced thyroid storm

McDermott, Michael T.; Kidd, Gerald S.; Dodson, Leonard E.; Hofeldt, Fred D.

doi:10.1016/0002-9343(83)91217-2

Cited by 127 publications

(19 citation statements)

References 26 publications

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“…The use of thionamide drugs to establish euthyroidism prior to I 131 treatment is controversial, especially in a young patient without cardiovascular disease [9,10]. While rare, severe hyperthyroidism and even thyroid storm have been described following I 131 treatment of Graves disease [11]. …”

Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Disease with Fluctuating Thyroid Function

Alzahrani¹,

Aldasouqi²,

Salam³

et al. 2005

PLoS Med

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Section: Discussionmentioning

confidence: 99%

Autoimmune Thyroid Disease with Fluctuating Thyroid Function

Alzahrani¹,

Aldasouqi²,

Salam³

et al. 2005

PLoS Med

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“…Also, there is anecdotal evidence that patients maintained on antithyroid drugs for many years before being treated with 131 I (as in our case) often fail to respond to repeated doses of 400 MBq (11 mCi) or more. [171819] This apparent radioresistance is likely to be a consequence of a relative iodine deficiency within the gland and resultant increase in thyroidal iodine turnover rate, reducing the anticipated dose of radiation. [17181920212223242526] The duration of therapy required to involve such a mechanism is not known, but presumably will also depend upon the iodine status of the population being treated.…”

Section: Discussionmentioning

confidence: 99%

Resistant thyrotoxicosis: A case of sarcoidosis of thyroid

Yanamandra

Kotwal

Menon

et al. 2013

Indian J Endocr Metab

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Autoimmune endocrinopathies and, less commonly, thyroid autoimmune disease have been reported in patients with sarcoidosis. Similarities exist in the pathogenesis of these two conditions. Concomitant sarcoidosis in the thyroid gland in patients with Graves’ disease may contribute to the resistance to antithyroid drugs and radioiodine therapy. We present the clinical, laboratory, imaging, and pathologic findings of a patient with Graves’ disease who was unresponsive to medical management. This 37-year-old man presented with thyrotoxicosis. Thyroid hormone assays and 99mTechnitium findings were consistent with Graves’ disease. He was also found to have hilar lymphadenopathy. Patient failed to achieve remission with high doses of antithyroid drugs and 2 sessions of radioiodine ablative therapy. Histopathology of lymph nodesdisclosed noncaseating granulomas, consistent with sarcoidosis. Patient's thyrotoxicosis subsided only following steroid administration. The histopathology of the thyroid gland on aspiration and the subsidence of symptoms with steroids reiterate the possibility of thyroid sarcoidosis. This diagnosis needs biopsy for confirmation, which our patient didn't consent for.

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“…Worsening thyrotoxicosis and even thyroid storm have been reported. 20 As a result, many patients, including most patients in this audit, are rendered euthyroid prior to radioiodine therapy. Pre-treatment of patients with propylthiouracil has been reported to be associated with relative radio-resistance and hence the possible need for a larger activity of radioiodine.…”

Section: Discussionmentioning

confidence: 99%

Comparison of two fixed activities of radioiodine therapy (370 vs. 555 MBq) in patients with Graves? disease

Collier¹,

Ghosh²,

Hair³

et al. 2009

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OBJECTIVE: Radioiodine therapy is the most commonly used therapy for patients with Graves' disease (GD) in the United Kingdom. It is considered safe, effective and relatively inexpensive. The aim of our study was to examine the outcome of 131Iodine therapy in patients with GD when two different activities of 131Iodine were used. DESIGN: A retrospective audit was undertaken to compare the efficacy of 370 (10 millicuries) versus 555MBq (15 millicuries) radioiodine therapy in patients with Graves' disease over a period of ten years. RESULTS: Overall, 90% of the patients had a successful outcome from treatment with no significant difference in the success rate between the lower and higher activities or between genders. CONCLUSIONS: 555 MBq of radioiodine was no more effective than 370 MBq in managing patients with Graves' disease. We therefore recommend that the higher activity should not be routinely used in these patients.

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Radioiodine-induced thyroid storm

Cited by 127 publications

References 26 publications

Autoimmune Thyroid Disease with Fluctuating Thyroid Function

Autoimmune Thyroid Disease with Fluctuating Thyroid Function

Resistant thyrotoxicosis: A case of sarcoidosis of thyroid

Comparison of two fixed activities of radioiodine therapy (370 vs. 555 MBq) in patients with Graves? disease

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