The incidence of hypothyroidism following the radioactive iodine treatment of graves' disease and the predictive factors influencing its development
| Autor: | Maha Abd El-Kareem El-Sayed Husseni |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty endocrine system Goiter Pertechnetate Exophthalmos endocrine system diseases Graves' disease lcsh:R895-920 Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Cumulative incidence 030212 general & internal medicine business.industry Incidence (epidemiology) Thyroid Odds ratio medicine.disease radioactive iodine therapy Surgery medicine.anatomical_structure chemistry Original Article hypothyroidism medicine.symptom business Graves’ disease |
| Zdroj: | World Journal of Nuclear Medicine, Vol 15, Iss 1, Pp 30-37 (2016) World Journal of Nuclear Medicine |
| ISSN: | 1450-1147 |
| Popis: | The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 (131I) activities in the treatment of Graves' disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis was performed on 272 patients with GD who were treated with 131I, among whom 125 received 370 MBq and 147 received 555 MBq. The outcome was categorized as hypothyroidism, euthyroidism, and persistent hyperthyroidism. Multiple logistic regression analysis was performed to identify significant risk factors that affect the development of hypothyroidism. The incidence of hypothyroidism following the first low activity was 24.8% with a high treatment failure rate of 58.4%, compared with 48.3% and 32% following high activity. The overall cumulative incidence of hypothyroidism following repeated activities was 50.7%, out of which 73.9% occurred after the first activity and 20.3% after the second activity. The higher 131I activity (P < 0.001) and average and mild enlargement of the thyroid gland (P = 0.004) were identified as significant independent factors that increase the rate of incidence of hypothyroidism (Odds ratios were 2.95 and 2.59). No correlation was found between the development of hypothyroidism and the factors such as age, gender, presence of exophthalmos, previous antithyroid medications, and the durations, and Technetium-99m (Tc-99m) pertechnetate thyroid uptake. In view of the high treatment failure rate after first low activity and lower post high activity hypothyroid incidence, high activity is recommended for GD patients, reserving the use of 370MBq for patients with average sized and mildly enlarged goiter; this increases patient convenience by avoiding multiple activities to achieve cure and long-term follow-up. |
| Databáze: | OpenAIRE |
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