[Radioiodine treatment of benign thyroid diseases]. 2006

András Konrády
Jávorszky Odön Kórház, Belgyógyászati Osztály és Izotóprészleg Vác.

Radioiodine treatment of benign thyroid disease has a 60 year history. Among the radioactive isotopes (131)-I can be used successfully. This method has been spread at different rate over the world. Radioiodine is used in Hungary since 1959, however, incidence of this type of therapy does not reach an optimal proportion. The aim of therapy is to decrease the function and/or the volume of thyroid gland. This study considers the reasons of radioiodine treatment in Graves' disease and in different forms of autonomously functioning nodular thyroid disorders, moreover, in cases of compressive euthyroid multinodular goiter when the thyroid volume is to be diminished. There are controversies in terms of indications of radioiodine treatment, however, contraindications are generally well accepted. Sometimes radioiodine therapy could exert an unfavourable effect on ophthalmopathy but this can be prevented with steroids. In cases of suitable administration of thyrostatic treatment before (131)-I therapy the outcome of which does not change significantly though propylthiouracil has really some radioprotection effect. Excellent cure rate can be reached in Graves' disease with radioiodine but hypothyroidism after the treatment may be frequent. In cases of autonomously functioning nodular thyroid disorders (i.e., toxic uninodular or multinodular goiter) cure rate is as high as in Graves' disease but the incidence of thyroid hypofunction is much lower. Thyrotoxic crisis after the treatment is extremely rare. In some cases thyroiditis can be observed after (131)-I therapy but this condition can be easily managed. Thyroid radioiodine uptake and the effectiveness of (131)-I can be increased with the administration of recombinant human thyrotropin in cases of euthyroid multinodular goiter. Recently radioiodine is recommended to young patients having Graves' disease (over 15 years) in special cases. The risk of malignancy after isotope therapy is not significant. Radioiodine treatment of benign thyroid disorders is a simple, safe and cost-effective method, the propagation of which can be suggested.

UI MeSH Term Description Entries
D006980 Hyperthyroidism Hypersecretion of THYROID HORMONES from the THYROID GLAND. Elevated levels of thyroid hormones increase BASAL METABOLIC RATE. Hyperthyroid,Primary Hyperthyroidism,Hyperthyroidism, Primary,Hyperthyroids
D007457 Iodine Radioisotopes Unstable isotopes of iodine that decay or disintegrate emitting radiation. I atoms with atomic weights 117-139, except I 127, are radioactive iodine isotopes. Radioisotopes, Iodine
D006044 Goiter, Nodular An enlarged THYROID GLAND containing multiple nodules (THYROID NODULE), usually resulting from recurrent thyroid HYPERPLASIA and involution over many years to produce the irregular enlargement. Multinodular goiters may be nontoxic or may induce THYROTOXICOSIS. Nodular Goiter,Goiters, Nodular,Nodular Goiters
D006111 Graves Disease A common form of hyperthyroidism with a diffuse hyperplastic GOITER. It is an autoimmune disorder that produces antibodies against the THYROID STIMULATING HORMONE RECEPTOR. These autoantibodies activate the TSH receptor, thereby stimulating the THYROID GLAND and hypersecretion of THYROID HORMONES. These autoantibodies can also affect the eyes (GRAVES OPHTHALMOPATHY) and the skin (Graves dermopathy). Basedow's Disease,Exophthalmic Goiter,Goiter, Exophthalmic,Graves' Disease,Basedow Disease,Hyperthyroidism, Autoimmune,Basedows Disease,Disease, Basedow,Disease, Basedow's,Disease, Graves,Disease, Graves',Exophthalmic Goiters,Goiters, Exophthalmic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075202 Contraindications A condition or factor associated with a recipient that makes the use of a drug, procedure, or physical agent improper or inadvisable. Contraindications may be absolute (life threatening) or relative (higher risk of complications in which benefits may outweigh risks). Contraindications, Physical Agent,Medical Contraindications,Agent Contraindication, Physical,Agent Contraindications, Physical,Contraindication,Contraindication, Medical,Contraindication, Physical Agent,Contraindications, Medical,Medical Contraindication,Physical Agent Contraindication,Physical Agent Contraindications
D013959 Thyroid Diseases Pathological processes involving the THYROID GLAND. Disease, Thyroid,Diseases, Thyroid,Thyroid Disease
D013964 Thyroid Neoplasms Tumors or cancer of the THYROID GLAND. Cancer of Thyroid,Thyroid Cancer,Cancer of the Thyroid,Neoplasms, Thyroid,Thyroid Adenoma,Thyroid Carcinoma,Adenoma, Thyroid,Adenomas, Thyroid,Cancer, Thyroid,Cancers, Thyroid,Carcinoma, Thyroid,Carcinomas, Thyroid,Neoplasm, Thyroid,Thyroid Adenomas,Thyroid Cancers,Thyroid Carcinomas,Thyroid Neoplasm
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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