Analysis of iodine-131-induced early thyroid hormone variations in Graves' disease

作者：Xu, Feng; Gu, Aichun; Pan, Yifan; Yang, Liwen; Ma, Yubo^*

来源：Nuclear Medicine Communications, 2016, 37(11): 1154-1159.

DOI：10.1097/MNM.0000000000000570

• Graves' disease
• iodine-131
• radioiodine therapy
• thyroid hormone

ObjectiveThis prospective study aimed to assess iodine-131 (I-131)-induced early thyroid hormone variations in Graves' disease (GD) and determine the associated factors.Materials and methodsOne hundred and seventy-one GD patients treated with I-131 were evaluated (47 men, 124 women). I-131 was administered at 9.04.9mCi on average. Serum free triiodothyronine and free thyroxin were measured within 24h before treatment and 8 (3-14) days after treatment. Patients were divided into increase, no change, and decrease groups, respectively, on the basis of hormone variations after treatment. (2)-Test, analysis of variance, and the Kruskal-Wallis test were used to compare groups in terms of sex, age, course of disease, thyroid stimulating hormone receptor antibodies, antithyroid drug (ATD) pretreatment time, time of ATD discontinuation before I-131 treatment, 24h thyroid I-131 uptake, thyroid weight, I-131 activity, and I-131 activity/thyroid weight (Ci/g). The Spearman method was used for correlation analyses.ResultsTwenty-seven, 20, and 124 cases were assigned to increase, no change, and decrease groups, respectively. Significant differences were found among groups in the time of ATD discontinuation before I-131 treatment [the median duration for methimazole was 11 (5-26), 16 (10-30), and 21 (1-30) days, P=0.000, the median duration for propylthiouracil was 12.5 (5-24), 22 (11-26), and 26 (21-30) days, P=0.000], thyroid weight (93.5 +/- 33.6, 90.3 +/- 48.8, and 74.1 +/- 26.0g, P=0.003), andCi/g (84.8 +/- 11.8, 100.4 +/- 24.9, and 121.1 +/- 44.0Ci/g, P=0.000). Interestingly, Ci/g was negatively and positively correlated to the possibility of hormone increase and decrease, respectively. No significant differences were found in the other parameters assessed.ConclusionAt the early stage of I-131 treatment for GD, few patients showed increased thyroid hormone levels. Key factors may include time of ATD discontinuation before I-131 treatment and Ci/g. High Ci/g might decrease thyroid hormone levels in early treatment, making it safe.

• 出版日期2016-11
• 单位上海交通大学