Journal of Regional Section of Serbian Medical Association in Zajecar

Year 2014     Vol 39     No 4
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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

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


  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
      Corresponding Address:
Mirjana Milićević
Služba za nuklearnu medicinu, Zdravstven Centar Zaječar, Rasadnička bb, 19 000 Zaječar, Srbija;
Paper received: 17.8.2014
Paper accepted: 8.10.2014
Paper Internet issues: 17.11.2014
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Timočki medicinski glasnik, Zdravstveni centar Zaječar
Journal of Regional section of Serbian medical association in Zajecar
Rasadnička bb, 19000 Zaječar, Srbija

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