Standardized radioiodine therapy in Graves' disease: the persistent effect of thyroid weight and radioiodine uptake on outcome
| Autor: | C. D. L. Croon, T.W.A. de Bruin, J. W. Van Isselt, J. M. H. De Klerk |
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| Rok vydání: | 1994 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty endocrine system diseases Graves' disease medicine.medical_treatment Thyroid Gland Gastroenterology Iodine Radioisotopes Internal medicine Immunopathology Internal Medicine medicine Humans Prospective Studies Prospective cohort study Chemotherapy business.industry Incidence (epidemiology) Thyroid Organ Size Middle Aged medicine.disease Graves Disease Confidence interval Treatment Outcome medicine.anatomical_structure Female business Complication Nuclear medicine Follow-Up Studies |
| Zdroj: | Journal of Internal Medicine. 236:507-513 |
| ISSN: | 1365-2796 0954-6820 |
| DOI: | 10.1111/j.1365-2796.1994.tb00837.x |
| Popis: | Objective. To assess the incidence of hypothyroidism, euthyroidism, and recurrent hyperthyroidism following a standard dose of Na131I (3.7 MBq or 100 μCi) per g thyroid tissue, adjusted for radioiodine tracer uptake. Design. A single-centre prospective follow-up study from January 1990 to December 1992. Setting. Academic Hospital in Utrecht, the Netherlands. Subjects. Newly diagnosed patients with Graves' disease (n = 148). Interventions. Radioiodine treatment at a standard dose of 3.7 MBq or 100 μCi per g thyroid tissue. Main outcome measures. Confidence interval testing of resulting thyroid status, defined by biochemical criteria. Results. The overall cure rate was 70% (103 of 148 subjects), confidence interval (CI) 62–77%. A 90% incidence of hypothyroidism was found in patients with a small thyroid (less than 20 g). Recurrent hyperthyroidism was found significantly more often in subjects with a thyroid weight exceeding 60 g compared to those who had a thyroid of 9–59 g. More recurrences were found in subjects in the highest tertile of a 24-h radioiodine uptake test (> 80% uptake) compared to those in the lowest tertile (< 60% uptake). Conclusions. No uniform treatment results expressed per thyroid weight category were obtained, in spite of standardizing the treatment Na131I dose (3.7 MBq per g thyroid). Graves' patients with a thyroid smaller than 20 g and those with less than 60% 24-h radioiodine uptake have a 50–90% chance of hypothyroidism at the 12-month follow-up. |
| Databáze: | OpenAIRE |
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