Effect of (131)I with and without artificial liver support system in patients with Graves’ disease and severe liver dysfunction: A retrospective study

OBJECTIVE: Treatment decision-making in Graves’ disease (GD) with severe liver dysfunction (LD) is a clinical challenge. This research was carried out to evaluate the effect of radioiodine ((131)I) with or without an artificial liver support system (ALSS) in GD patients with severe LD. METHODS: In total, 45 patients diagnosed with GD and severe LD were enrolled and allocated to two groups: patients treated with (131)I alone (n=30) (Group A)and patients by a combination of (131)I and ALSS (n=15)(Group B). Liver function, thyroid hormone concentrations, therapeutic efficacy, and the cost of treatment were compared between the two groups. RESULTS: Thyroid hormone concentrations were lower 2 weeks after (131)I treatment, but no deterioration in liver function was identified. There was no statistically significant difference in the treatment efficacy between the two groups. The hospital stay, total cost, and daily cost were lower in patients treated with (131)I alone than in those treated with (131)I and an ALSS (p<0.05). CONCLUSION: The key point of treating GD patients with severe LD is to control the GD.(131)I is recommended as an effective and safe and should be applied as soon as possible once the diagnosis is clarified; however, when used in combination with an ALSS, there was no substantial improvement in therapeutic efficacy.