We treated 187 patients who had Graves' disease with low-dose radioactive iodide (131I), using a protocol that included a compensation for thyroid size. The incidence of early hypothyroidism (12 per cent) was acceptably low in the first year after 131I treatment, but we found a cumulative high incidence (up to 76 per cent) at the end of the 11th year. In contrast, the incidence of permanent hypothyroidism was relatively stable in 166 surgically treated patients, increasing from 19 to 27 per cent at the end of 11 years. Among 122 medically treated patients, only 40 per cent entered remission, and hypothyroidism developed in 2 per cent during the same period of follow-up. The long-term incidence of hypothyroidism in our patients treated with low-dose 131I therapy was much higher than that found in earlier studies using a comparable dose. Our study suggests that it will be difficult to modify therapy with 131I alone to produce both early control of thyrotoxicosis and a low incidence of hypothyroidism.
This article has been cited by other articles:
Azizi, F, Ataie, L, Hedayati, M, Mehrabi, Y, Sheikholeslami, F
(2005). Effect of long-term continuous methimazole treatment of hyperthyroidism: comparison with radioiodine. Eur J Endocrinol
152: 695-701
[Abstract][Full Text]
Ginsberg, J.
(2003). Diagnosis and management of Graves' disease. CMAJ
168: 575-585
[Abstract][Full Text]
Bogazzi, F., Bartalena, L., Campomori, A., Brogioni, S., Traino, C., De Martino, F., Rossi, G., Lippi, F., Pinchera, A., Martino, E.
(2002). Treatment with Lithium Prevents Serum Thyroid Hormone Increase after Thionamide Withdrawal and Radioiodine Therapy in Patients with Graves' Disease. J. Clin. Endocrinol. Metab.
87: 4490-4495
[Abstract][Full Text]
Alexander, E. K., Larsen, P. R.
(2002). American Board of Internal Medicine. 2002 Certification Examination in Endocrinology, Diabetes, and Metabolism. J. Clin. Endocrinol. Metab.
87: 1073-1077
[Abstract][Full Text]
Andrade, V. A., Gross, J. L., Maia, A. L.
(2001). The Effect of Methimazole Pretreatment on the Efficacy of Radioactive Iodine Therapy in Graves' Hyperthyroidism: One-Year Follow-Up of a Prospective, Randomized Study. J. Clin. Endocrinol. Metab.
86: 3488-3493
[Abstract][Full Text]
Allahabadia, A., Daykin, J., Sheppard, M. C., Gough, S. C. L., Franklyn, J. A.
(2001). Radioiodine Treatment of Hyperthyroidism--Prognostic Factors for Outcome. J. Clin. Endocrinol. Metab.
86: 3611-3617
[Abstract][Full Text]
Nygaard, B., Hegedus, L., Ulriksen, P., Nielsen, K. G., Hansen, J. M.
(1999). Radioiodine Therapy for Multinodular Toxic Goiter. Arch Intern Med
159: 1364-1368
[Abstract][Full Text]
Sabri, O., Zimny, M., Schulz, G., Schreckenberger, M., Reinartz, P., Willmes, K., Buell, U.
(1999). Success Rate of Radioiodine Therapy in Graves' Disease: The Influence of Thyrostatic Medication. J. Clin. Endocrinol. Metab.
84: 1229-1233
[Abstract][Full Text]
Rivkees, S. A., Sklar, C., Freemark, M.
(1998). The Management of Graves' Disease in Children, with Special Emphasis on Radioiodine Treatment. J. Clin. Endocrinol. Metab.
83: 3767-3776
[Full Text]
Chiovato, L., Fiore, E., Vitti, P., Rocchi, R., Rago, T., Dokic, D., Latrofa, F., Mammoli, C., Lippi, F., Ceccarelli, C., Pinchera, A.
(1998). Outcome of Thyroid Function in Graves' Patients Treated with Radioiodine: Role of Thyroid-Stimulating and Thyrotropin-Blocking Antibodies and of Radioiodine-Induced Thyroid Damage. J. Clin. Endocrinol. Metab.
83: 40-46
[Abstract][Full Text]
Petrone, L. R.
(1996). A Primary Care Approach to the Adult Patient With Nodular Thyroid Disease. Arch Fam Med
5: 92-100
[Abstract]
Franklyn, J. A.
(1994). The Management of Hyperthyroidism. NEJM
330: 1731-1738
[Full Text]
Previous
