Document Detail


(131)I treatment of toxic nodular goiter under combined thyrostatic-thyromimetic medication is at low risk of late hypothyroidism.
MedLine Citation:
PMID:  19333217     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: Treatment of toxic nodular goiter with (131)I is a first-line therapy for hyperthyroidism. To avoid a thyrotoxic storm, (131)I is usually administered after pretreatment with antithyroid drugs, with thyroid-stimulating hormone (TSH) increase and functional recruitment of inhibited normal tissue. Therefore, both autonomous nodule(s) and normal tissue are irradiated. This may be a reason for late hypothyroidism occurring in 15-25% of patients. This study aimed at assessing different pretreatment modalities with combined methymazole and triiodothyronine, achieving euthyroidism with suppressed TSH. METHODS: After diagnosis of autonomously functioning toxic nodule, patients were subjected to thyrostatic medication. Two months later, TSH was checked; if >0.5 mU/L triiodothyronine treatment was associated. After 2 more months, if the TSH level was suppressed, patients received (131)I-therapy. A total of 149 patients were consecutively enrolled, 41 of whom with uninodular and 108 with multinodular goiter. They were evaluated at diagnosis, pretreatment, 3 and 6 months after therapy and at late follow-up (6.8+/-4.2 years; range: 1-22 years). RESULTS: Administered activity was calculated according to (131)I uptake and gland weight. Methymazole was discontinued 6 days before treatment and T3 was maintained until administration of (131)I-therapy. Euthyroi-dism was achieved in 88% of patients. At late follow-up, subclinical hypothyroidism was observed in 10 patients (6.7%) and overt hypothyroidism in 5 patients (3.3%). No pathological consequences or side effects of (131)I-therapy were found during the 6.8+/-4.2 year follow-up period. CONCLUSIONS: Treatment of toxic nodular goiter with (131)I-therapy, under combined thyrostatic-thyromimetic treatment is a simple, safe, well-tolerated, and effective procedure.
Authors:
B Paghera; M B Panarotto; G Maira; G C Magri; F Bertagna; G Bosio; P Rossini; A De Agostini; G Savelli; S Lucchini; R Giubbini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-3-31
Journal Detail:
Title:  The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of...     Volume:  -     ISSN:  1824-4785     ISO Abbreviation:  -     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-3-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213861     Medline TA:  Q J Nucl Med Mol Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Unit of Nuclear Medicine, Civilian Hospitals of Brescia, Brescia, Italy giubbini@spedalicivili.brescia.it.
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