Radioactive Iodine Therapy Without Recent Antithyroid Drug Pretreatment For Hyperthyroidism Complicated By Severe Hyperbilirubinemia Due To Hepatic Dysfunction: Experience Of A Chinese Medical Center
| Autor: | Xiaobo. Peng, Jia-liu Xing, Zewu. Qiu, Yong Ding, Pei. Deng, Yong Wang, You-ren Zhang, Ya-hong Long, Yi Fang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male China medicine.medical_specialty Digoxin Endocrinology Diabetes and Metabolism medicine.medical_treatment Jaundice 030209 endocrinology & metabolism Hyperthyroidism Severity of Illness Index Gastroenterology Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine Endocrinology Antithyroid Agents Refractory Internal medicine Severity of illness medicine Humans Hyperbilirubinemia Retrospective Studies Methimazole business.industry Liver Diseases Antithyroid agent Furosemide Retrospective cohort study General Medicine Middle Aged Surgery Propylthiouracil 030220 oncology & carcinogenesis Female Chemical and Drug Induced Liver Injury medicine.symptom business medicine.drug |
| Zdroj: | Endocrine Practice. 22:173-179 |
| ISSN: | 1530-891X |
| DOI: | 10.4158/ep15736.or |
| Popis: | The objective of this work is to report our experience with (131)I therapy without recent antithyroid drug (ATD) pretreatment for refractory severe hyperthyroidism complicated by hyperbilirubinemia due to hepatic dysfunction.Five patients with refractory severe hyperthyroidism were treated with (131)I at 90 to 120 μCi/g-thyroid (total activity, 6.2 to 10.1 mCi). The patients previously had received ATD treatment from 2 months to 12 years and discontinued ATDs from 2 months to 4 years before (131)I treatment due to treatment failure or severe jaundice. Prior to (131)I therapy, the patients were asked to take a low-iodine diet and were treated with bisoprolol fumarate, digoxin, furosemide, S-adenosylmethionine, polyene phosphatidylcholine, and plasma exchange as supportive treatment for related clinical conditions. Four of the patients also received lithium carbonate in conjunction with their (131)I treatment. The patients were followed for 4 to 9 years after (131)I therapy.After (131)I treatment, jaundice disappeared completely within 3 to 4 months in all patients, and liver function tests returned to normal. Concurrent atrial fibrillation and heart failure, leukopenia and thrombocytopenia, or thrombocytopenia and left cardiac enlargement improved remarkably in 3 patients during the follow-up period. Three to 45 months after (131)I treatment, hypothyroidism was noted in the patients and they were treated with L-thyroxine replacement therapy.(131)I therapy without recent ATD pretreatment for refractory severe hyperthyroidism complicated by serious jaundice appears to be safe and effective, with good long-term results. It may be the preferred therapy for such patients and should be used as early as possible. |
| Databáze: | OpenAIRE |
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