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| UDK 617.7:616.441-008.61-085(497.11)"1969/2014";615.849.5:546.15 |
ISSN 035-2899, 39(2014) br.4 p.193-197 |
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Original paper Postprocedural hypothyroidism after a single therapeutic dose of radioiodine during a 5-year follow up in Graves-Basedow disease patients treated in the department of nuclear medicine Zaječar (Postproceduralni hipotireoidizam nakon jedne terapijske doze radiojoda tokom pet godina praćenja kod pacijenata sa Grejvs-Bazedovljevom bolešću lečenih u službi za nuklearnu medicinu u Zaječaru) Mirjana Milićević (1), Željka Aleksić (1), Aleksandar Aleksić (2) (1) Služba za nuklearnu medicinu, Zaječar (2) Internistička služba, Zaječar |
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| Download in pdf format | Extended summary:
Autoimmune hyperthyreoidism known as Graves-Basedow disease (GD) is
a thyrotoxic condition due to the excessive production of thyroid
hormone, caused by pathological thyroid stimulation by TSH receptor
antibodies. Radioiodine therapy (RIT=J-131=RI) is the treatment of
choice in patients with GB who do not achieve remission during the
tirosupressive drug therapy (MTT), who have frequent recurrences of
disease or poor compliance to the MTT. Post-procedural
hypothyroidism (PPH) occurs as a long-term effect of RIT and
requires lifelong replacement with levothyroxine. The aim of this
study was to retrospectively assess the incidence of PPH in our GD
patients treated with RIT. We analyzed data from patients' Registery
book for endocrine disorders of the Department of Nuclear Medicine,
Health Centre Zaječar, treated in the period 2002-2007 and followed
until 2012. During this period 91 patients were treated. 62 patients
were treated with a single dose and their data were included in the
analysis. There were 8 men and 54 women, mean age 55.3 ± 11.7 years
(range 33-83). The average dose of RIT was 6.6±1.7mCi (range
4.5-15mCi) - medium-to-moderate fixed dose. Median MTT duration
until RI treatment was 55.5 months, range (1-384 months). During the
entire follow-up period, nearly half (47%) patients developed PPH,
the largest number being in the year after receiving the therapeutic
dose, 39% of them. By means of a life-table analysis, we
demonstrated the likelihood of PPH in the first posttherapy year of
41%, and 7-9% new cases in the following years. The structure of
patients with PHH and those who remained euthyroid, according to
gender and goiter size before applying the RI, as well as the
average age, average MTT duration, average dose of applied RI were
shown. The data indicate the need for lifelong monitoring of the
function of the thyroid status of patients treated with radioiodine
for Graves-Basedow disease. Medium to moderate fixed doses give no
higher incidence of postprocedural hypothyroidism with respect to
the incidence of hypothyroidism using calculated RI doses, reported
in literature. Keywords: hyperthyroidism, Graves-Basedow disease, radioiodine therapy, postprocedural hypothyroidism Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
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Corresponding Address: Mirjana Milićević Služba za nuklearnu medicinu, Zdravstven Centar Zaječar, Rasadnička bb, 19 000 Zaječar, Srbija; E-mail: mmilicevic@ptt.rs |
Paper received: 17.8.2014 Paper accepted: 8.10.2014 Paper Internet issues: 17.11.2014 |
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