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ISSN 0188-9796 (Print)

2011, Number 2

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Rev Endocrinol Nutr 2011; 19 (2)

Treatment of the principal forms of thyrotoxicosis. Radioactive iodine (Second of two parts)

Navarro-Hermosillo L, Rangel-Sánchez G, Bolaños-Gil de Montes F

Language: Spanish
References: 27
Page: 74-82
PDF size: 89.37 Kb.


ABSTRACT

Therapy with radioactive iodine is an effective treatment for patients with hyperthyroidism due to autoimmune hyperthyroidism, toxic multinodular goiter and toxic adenoma. This therapy has been used since 1946. Adverse effects are uncommon and absolute contraindications are pregnancy and lactation. Patients who receive more than 7 mCi of 131 I must be instructed to avoid close contact with other people, and patients who receive more than 30 mCi must be hospitalized. There are different approaches to dose selection, and we prefer the use of fixed doses, being higher in the case of patients with toxic multinodular goiter and toxic adenoma. The target of 131I treatment is the achievement of euthyroidism, although this is rarely accomplished because of the high incidence of hypothyroidism, from 20-40% at one year to 50-80% at 10 years. Hypothyroidism is also considered a good outcome, since it can be controlled with thyroid hormone substitution easily. Hyperthyroidism recurrences can be treated with another 131I dose.


REFERENCES

  1. Cooper DS. Radioiodine for hyperthyroidism. Where do we stand after 50 years? Editorials. JAMA 1998; 280: 375-376.

  2. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, Segal RL, Garber JR, Hamilton Jr CR, Handelsman Y, Hellman R, Kukora JS, Levy P, Palumbo PJ, Petak SM, Rettinger HI, Rodbard HW, Service FJ, Shankar TP, Stoffer SS, Tourtelot JB. AACE Thyroid Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract 2002; 8: 457-469.

  3. Hegedüs L. Treatment of Graves’ hyperthyroidism: Evidence-based and emerging modalities. Endocrinol Metab Clin North Am 2009; 38: 355-371.

  4. Kaplan MM, Meier DA, Dworkin HJ. Treatment of hyperthyroidism with radioactive iodine. Endocrinol Metab Clin North Am 1998; 27: 205-223.

  5. Hertz BE, Schuller KE, Saul Hertz, MD (1905-1945). A pioneer in the use of radioactive iodine. Endocr Pract 2010; 16: 713-715.

  6. Woeber KA. Update on the management of hyperthyroidism and hypothyroidism. Arch Intern Med 2000; 160: 1067-1071.

  7. Nayak B, Hodak SP. Hyperthyroidism. Endocrinol Metab Clin North Am 2007; 36: 617-656.

  8. Ron E, Doody MM, Becker DV, Brill AB, Curtis RE, Goldman MB, Harris BSH, Hoffman DA, McConahey WM, Maxon HR, Preston Martin-S, Wasrshauer ME, Wong FL, Boice JD. Cancer mortality following treatment for adult hyperthyroidism. JAMA 1998; 280: 347-355.

  9. Holm LE, Hall P, Wiklund K, Lundell G, Berg G, Bjelkengren G, Cederquist E, Ericsson UB, Hallquist A, Larsson LG, Lidberg M, Lindberg S, Tennvall J, Wicklund H, Boice JD Jr. Cancer risk after iodine 131 therapy for hyperthyroidism. J Natl Cancer Inst 1991; 83: 1072-1077.

  10. Franklyn JA, Maisonnevue P, Sheppard M, Betteridge J, Boyle P. Cancer incidence and mortality after radioactive iodine treatment for hyperthyroidism: a population based cohort study. Lancet 1999; 353: 2111-2115.

  11. Metso S, Auvinen A, Huhtala H, Salmi J, Oksala H, Jaatianen P. Increased cancer incidence after radioiodine treatment of hyperthyroidism. Cancer 2007; 109: 1972-1979.

  12. Sisson JC, Freitas J, McDougall IR, Dauer LT, Hurley JR, Brierley JD, Edinboro CH, Rosenthal D, Thomas MJ, Wexler JA, Asamoath E, Avram AM, Milas M, Greenlee C. Radiation safety in the treatment of patients with thyroid diseases by radioiodine 131 I: practice recommendations of the American Thyroid Association. Thyroid 2011; 21: 335-346.

  13. Bahn RS, Burch HB, Cooper DS, Garber JR, Greenle MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN. Hyperthyroidism and other causes of thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid 2011; 21: 593-646.

  14. Rivkees SA, Cornelius EA. Influence of iodine-I131 dose on the outcome of hyperthyroidism in children. Pediatrics 2003; 111: 745-749.

  15. Rivkees SA, Dinauer C. An optimal treatment for pediatric Graves disease is radioiodine. J Clin Endocrinol Metab 2007; 92: 797-800.

  16. Iagaru A, Mc Dougall R. Treatment of thyrotoxicosis. J Nucl Med 2007; 48: 379-389.

  17. Lee JA, Grumbach MM. The optimal treatment for pediatric Graves disease is surgery. J Clin Endocrinol Metab 2007; 92: 801-803.

  18. Rivkees SA, Sklar C, Freemark M. Clinical review: The management of Graves´ disease in children, with special emphasis on radioiodine treatment. J Clin Endocrinol Metab 1998; 83: 3767-3776.

  19. Read Jr CH, Tansey MJ, Menda Y. A thirty six year retrospective analysis of the efficacy and safety of radioactive iodine in treating young Graves´patients. J Clin Endocinol Metab 2004; 89: 4229-4233.

  20. Boice Jr JD. Thyroid disease 60 years after Hiroshima and 20 years after Chernobyl. JAMA 2006; 295: 1060-1062.

  21. Hernández-Salazar E, Torres-Ambriz P, Normandía-Almeida MA, Galindo-Rujana ME, Amador-Licona N, González-Bárcena D. Tratamiento del bocio tóxico difuso con dosis única de yodo radiactivo 131 calculada por el tamaño del bocio y las concentraciones séricas de triyodotironina (T3). Rev Endocrinol Nutr 2003; 11: 157-161.

  22. Ross DS. Radioiodine therapy for hyperthyroidism. N Engl J Med 2011; 364: 542-550.

  23. Bogazzi F, Giovannetti C, Fessehatsion R, Tanda ML, Campomori A, Compri E, Rossi G, Ceccarelli C, Vitti P, Pinchera A, Bartalena L, Martino E. Impact of lithium on efficacy of radioactive iodine therapy for Graves disease: a cohort study on cure rate, time to cure, and frequency of increased serum thyroxine after antithyroid drug witdrawal. J Clin Endocrinol Metab 2010; 95: 201-208.

  24. Bartalena L. The dilemma of how to manage Graves´ hyperthyroidism in patients with associated orbitopathy. J Clin Endocrinol Metab 2011; 96: 592-599.

  25. Bartalena L, Baldeschi L, Dickinson AJ, Eckstein A, Kendall-Taylor P, Marcocci C, Mourits MP, Perros P, Boboridis K, Boschi A, Curró N, Daumerie C, Kahaly GJ, Krassas G, Lane CM, Lazarus JH, Marinó M, Nardi M, Neoh C, Orgiazzi J, Pearce S, Pinchera A, Pitz S, Salvi M, Sivelli P, Stahl M, von Arx G, Wiersinga WM. Consensus statement of the European Group on Graves orbitopathy (EUGOGO) on management of GO. Thyroid 2008; 18: 333-346.

  26. Vannuchi G, Campi I, Covelli D. Graves orbitopathy activation after radioactive iodine therapy with and without steroid prophylaxis. J Clin Endocrinol Metab 2009; 94: 3381-3386.

  27. Consolidated guidance about materials licenses. NUREG-1556 2008; 9: 1-500.




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