The development of transient hypothyroidism after iodine-131 treatment in hyperthyroid patients with Graves' disease: prevalence, mechanism and prognosis
| Autor: | Noriyo Sayama, Nobuko Kaise, Keishi Abe, Yoshihiko Aizawa, Katsumi Yoshida, Hiroshi Fukazawa, Hironobu Hori, Yoshinori Kiso |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male Thyroid Hormones endocrine system medicine.medical_specialty Time Factors endocrine system diseases Endocrinology Diabetes and Metabolism medicine.medical_treatment Graves' disease Thyroid Gland Iodine Radioisotopes Endocrinology Hypothyroidism Internal medicine Immunopathology Prevalence medicine Humans Aged Autoantibodies Retrospective Studies Autoimmune disease Chemotherapy business.industry Thyroid Radiotherapy Dosage Receptors Thyrotropin Retrospective cohort study Middle Aged Prognosis medicine.disease Graves Disease Pathophysiology medicine.anatomical_structure Female Thyroid function business hormones hormone substitutes and hormone antagonists Immunoglobulins Thyroid-Stimulating |
| Zdroj: | Clinical Endocrinology. 46:1-5 |
| ISSN: | 0300-0664 |
| Popis: | Objective Recovery of thyroid function in patients following hypothyroidism induced by 131I therapy for Graves' disease has been described, but only a few detailed clinical and biochemical studies of this phenomenon (transient hypothyroidism) have been published. The prevalence, mechanism, and final outcome of transient hypothyroidism in 260 patients with Graves' disease treated with 131I was studied. Design A retrospective study. Patients Two hundred sixty patients with Graves' disease, treated with 131I between 1 and 15 years previously, were categorized into 4 groups according to their thyroid function during and 1 year after therapy (Group 1: permanent hypothyroidism, 28 patients; Group 2: transient hypothyroidism, 39 patients; Group 3: euthyroidism without transient hypothyroidism, 83 patients; Group 4: hyperthyroidism, 110 patients). Measurements We compared total T4, total T3, TSH, anti-thyroglobulin (TGHA) and anti-microsomal (MCHA) antibodies, the TSH-binding inhibitory immunoglobulin (TBII) index, thyroid weight, dose of 131I, and 24-hour 131I uptake as pretreatment variables. The mean time for permanent hypothyroidism to develop was estimated by the Kaplan-Meier product limit method. The TBII index and thyroid stimulating antibody (TSAb) activity were measured in seven patients from Group 1 and in nine patients from Group 2 at the time that they became hypothyroid. Results Hypothyroidism developing within 12 months of therapy was transient in 58% (39/67) of patients. No pretreatment variables were found to differ between patients with and without transient hypothyroidism. The mean estimated time between therapy and the development of permanent hypothyroidism was 96 months in Group 2; this time interval was significantly shorter than 126 months in Group 3 and 129 months in Group 4 (P 500% In 78% (7/9) of patients from Group 2, which was significantly higher than that found (14%, 1/7) in Group 1. Conclusions These results indicate that (1) more than half the patients who developed hypothyroidism within 6 months after 131I treatment for Graves' disease recovered spontaneously, (2) TSAb activity might play some role in the recovery of transient hypothyroidism, and (3) the development of transient hypothyroidism may influence long-term thyroid function. |
| Databáze: | OpenAIRE |
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