Study of factors that influence the outcome of 131 I treatment in hyperthyroidism secondary to nodular goitre

• Published in: Revista espanola de medicina nuclear e imagen molecular Vol. 36; no. 6; p. 356
• Main Authors: Tabuenca-Dopico, O, Boente-Varela, R, Lamas-Ferreiro, J L
• Format: Journal Article
• Language: English
• Published: Spain 01.11.2017
• Subjects: Adult; Aged; Aged, 80 and over; Female; Goiter, Nodular - complications; Humans; Hyperthyroidism - etiology; Hyperthyroidism - radiotherapy; Hypothyroidism - etiology; Iodine Radioisotopes - adverse effects; Iodine Radioisotopes - therapeutic use; Male; Middle Aged; Retrospective Studies; Hipertiroidismo; Hyperthyroidism; Bocio nodular; Treatment failure; Tratamiento I; Hipotiroidismo; Fracaso de tratamiento; Hypothyroidism; Nodular goitre; I treatment
• ISSN: 2253-8070

To assess the outcome after I treatment in patients with multinodular (MNG) and nodular toxic goitre (NTG) according to the administered dose and other factors related to the patient, pathology, or previous treatments. A retrospective study was conducted on 108 patients (67 MNG and 41 NTG) treated in our department, with a follow-up period of at least 2 years. Development of hypothyroidism and treatment failure were evaluated along with their relationship with the administered dose and other factors such as age, sex, grade of hyperthyroidism, type of goitre, presence of autoimmunity, or previous antithyroid medication. More than one-third (36.9%) of MNG patients, and even higher proportion of NTG patients (51.2%) developed non-transient hypothyroidism, particularly in those receiving 740MBq (66.7%). No relationship was found with any other variable. The development of early hypothyroidism (before one year) was also not related to any variable. Treatment failure was not related to the dose, but in MNG there was a relationship with male gender, presence of autoimmunity, or previous antithyroid drugs use. The high rate of hypothyroidism obtained with high doses of I in hyperthyroidism secondary to nodular goitre treatment suggests that lower doses might be sufficient to control the disease without an increase in treatment failures. Only patients with positive autoimmunity, in previous anti-thyroid medication, and perhaps male gender in MNG might be given higher doses, as the failure rate increases, but further studies are required.