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The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development

The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 ((131)I) activities in the treatment of Graves’ disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis...

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Autor principal: Husseni, Maha Abd El-Kareem El-Sayed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729012/
https://www.ncbi.nlm.nih.gov/pubmed/26912976
http://dx.doi.org/10.4103/1450-1147.167582
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author Husseni, Maha Abd El-Kareem El-Sayed
author_facet Husseni, Maha Abd El-Kareem El-Sayed
author_sort Husseni, Maha Abd El-Kareem El-Sayed
collection PubMed
description The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 ((131)I) activities in the treatment of Graves’ disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis was performed on 272 patients with GD who were treated with (131)I, among whom 125 received 370 MBq and 147 received 555 MBq. The outcome was categorized as hypothyroidism, euthyroidism, and persistent hyperthyroidism. Multiple logistic regression analysis was performed to identify significant risk factors that affect the development of hypothyroidism. The incidence of hypothyroidism following the first low activity was 24.8% with a high treatment failure rate of 58.4%, compared with 48.3% and 32% following high activity. The overall cumulative incidence of hypothyroidism following repeated activities was 50.7%, out of which 73.9% occurred after the first activity and 20.3% after the second activity. The higher (131)I activity (P < 0.001) and average and mild enlargement of the thyroid gland (P = 0.004) were identified as significant independent factors that increase the rate of incidence of hypothyroidism (Odds ratios were 2.95 and 2.59). No correlation was found between the development of hypothyroidism and the factors such as age, gender, presence of exophthalmos, previous antithyroid medications, and the durations, and Technetium-99m (Tc-99m) pertechnetate thyroid uptake. In view of the high treatment failure rate after first low activity and lower post high activity hypothyroid incidence, high activity is recommended for GD patients, reserving the use of 370MBq for patients with average sized and mildly enlarged goiter; this increases patient convenience by avoiding multiple activities to achieve cure and long-term follow-up.
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spelling pubmed-47290122016-02-24 The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development Husseni, Maha Abd El-Kareem El-Sayed World J Nucl Med Original Article The purpose of this study is to evaluate and compare the incidence of hypothyroidism following different fixed radioactive iodine-131 ((131)I) activities in the treatment of Graves’ disease (GD) and to investigate the predictive factors that may influence its occurrence. This retrospective analysis was performed on 272 patients with GD who were treated with (131)I, among whom 125 received 370 MBq and 147 received 555 MBq. The outcome was categorized as hypothyroidism, euthyroidism, and persistent hyperthyroidism. Multiple logistic regression analysis was performed to identify significant risk factors that affect the development of hypothyroidism. The incidence of hypothyroidism following the first low activity was 24.8% with a high treatment failure rate of 58.4%, compared with 48.3% and 32% following high activity. The overall cumulative incidence of hypothyroidism following repeated activities was 50.7%, out of which 73.9% occurred after the first activity and 20.3% after the second activity. The higher (131)I activity (P < 0.001) and average and mild enlargement of the thyroid gland (P = 0.004) were identified as significant independent factors that increase the rate of incidence of hypothyroidism (Odds ratios were 2.95 and 2.59). No correlation was found between the development of hypothyroidism and the factors such as age, gender, presence of exophthalmos, previous antithyroid medications, and the durations, and Technetium-99m (Tc-99m) pertechnetate thyroid uptake. In view of the high treatment failure rate after first low activity and lower post high activity hypothyroid incidence, high activity is recommended for GD patients, reserving the use of 370MBq for patients with average sized and mildly enlarged goiter; this increases patient convenience by avoiding multiple activities to achieve cure and long-term follow-up. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4729012/ /pubmed/26912976 http://dx.doi.org/10.4103/1450-1147.167582 Text en Copyright: © World Journal of Nuclear Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Husseni, Maha Abd El-Kareem El-Sayed
The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title_full The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title_fullStr The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title_full_unstemmed The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title_short The Incidence of Hypothyroidism Following the Radioactive Iodine Treatment of Graves’ Disease and the Predictive Factors Influencing its Development
title_sort incidence of hypothyroidism following the radioactive iodine treatment of graves’ disease and the predictive factors influencing its development
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729012/
https://www.ncbi.nlm.nih.gov/pubmed/26912976
http://dx.doi.org/10.4103/1450-1147.167582
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