| ¹³¹I treatment of toxic nodular goiter under combined thyrostatic-thyromimetic medication is at low risk of late hypothyroidism. | |
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MedLine Citation:
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PMID: 20639819 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Treatment of toxic nodular goiter with ¹³¹I is a first-line therapy for hyperthyroidism. To avoid a thyrotoxic storm, ¹³¹I 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 ¹³¹I-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 ¹³¹I uptake and gland weight. Methymazole was discontinued 6 days before treatment and T3 was maintained until administration of ¹³¹I-therapy. Euthyroidism 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 ¹³¹I-therapy were found during the 6.8+/-4.2 year follow-up period. CONCLUSION: Treatment of toxic nodular goiter with ¹³¹I-therapy, under combined thyrostatic-thyromimetic treatment is a simple, safe, well-tolerated, and effective procedure. |
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Authors:
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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:
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Type: Journal Article Date: 2009-01-01 |
Journal Detail:
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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 Radiopharmaceutical Chemistry and Biology Volume: 54 ISSN: 1824-4785 ISO Abbreviation: Q J Nucl Med Mol Imaging Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-19 Completed Date: 2010-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101213861 Medline TA: Q J Nucl Med Mol Imaging Country: Italy |
Other Details:
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Languages: eng Pagination: 341-7 Citation Subset: IM |
Affiliation:
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Unit of Nuclear Medicine, Civilian Hospitals of Brescia, Brescia, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Antithyroid Agents / therapeutic use Combined Modality Therapy Female Goiter, Nodular / drug therapy*, radiotherapy* Humans Hypothyroidism / prevention & control Iodine Radioisotopes / therapeutic use Male Methimazole / therapeutic use Middle Aged Thyrotoxicosis / drug therapy*, radiotherapy* Time Factors Triiodothyronine / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Antithyroid Agents; 0/Iodine Radioisotopes; 60-56-0/Methimazole; 6893-02-3/Triiodothyronine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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