Treatment of thyrotoxicosis
Division of Nuclear Medicine and Molecular Imaging Program at Stanford, Department of Radiology, Stanford University Medical Center, Stanford, California, USA. Journal of Nuclear Medicine
(Impact Factor: 6.16).
In this review, the causes of thyrotoxicosis and the treatment of syndromes with increased trapping of iodine are discussed. The benefits and the potential side effects of 3 frequently used therapies--antithyroid medications, thyroidectomy, and (131)I treatment--are presented. The different approaches to application of (131)I treatment are described. Treatment with (131)I has been found to be cost-effective, safe, and reliable.
Available from: Mustafa Ali Akin
- "Radioiodine (I131) is a convenient, inexpensive, safe and effective treatment for hyperthyroidism and thyroid malignancy in children and adults (1,2). The use of I131 is absolutely contraindicated during pregnancy principally because of the risk of damaging the fetal thyroid gland and thus leading to hypothyroidism or cretinism (1,2,3,4,5,6). Neonatal hyperthyrotropinemia is observed if the applieddose is below 10 mCi (7). "
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ABSTRACT: Radioactive iodine (RAI) is used effectively in the treatment of hyperthyroidism and thyroid cancer, but it is contraindicated during pregnancy. RAI treatment during pregnancy can lead to fetal hypothyroidism, mental retardation and increased malignancy risk in the infant. Pregnancy tests must be performed before treatment in all women of reproductive age. However, at times, RAI is being used before ruling out pregnancy.
We herein present a male newborn infant with congenital hypothyroidism whose mother was given a three-week course of methimazole therapy for her multiple hyperactive nodules and subsequently received 20 mCi RAI during the 12th week of her pregnancy. The patient was referred to our neonatology unit at age two weeks when his thyrotropin (TSH) level was reported to be high in the neonatal screening test. Physical examination was normal. Laboratory investigations revealed hypothyroidism (free triiodothyronine 1.55 pg/mL, free thyroxine 2.9 pg/mL, TSH 452 mU/L, thyroglobulin 20.1 ng/mL). The thyroid gland could not be visualized by ultrasonography. L-thyroxine treatment was initiated.
Conflict of interest:None declared.
Available from: PubMed Central
- "Radioactive iodine thyroid ablation has been shown to be an inexpensive, safe, and effective treatment for hyperthyroidism . It is the most commonly used method for treating adult patients with Graves' disease . "
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ABSTRACT: Graves' disease is a thyroid-specific autoimmune disorder in which the body makes antibodies to the thyroid-stimulating hormone receptor leading to hyperthyroidism. Therapeutic options for the treatment of Graves' disease include medication, radioactive iodine ablation, and surgery. Radioactive iodine is absolutely contraindicated in pregnancy as exposure to I-131 to the fetal thyroid can result in fetal hypothyroidism and cretinism. Here we describe a case of a female patient with recurrent Graves' disease, who inadvertently received I-131 therapy when she was estimated to be eight days pregnant. This was despite the obtaining of a negative history of pregnancy and a negative urine pregnancy test less than 24 hours prior to ablation. At birth, the infant was found to have neonatal Graves' disease. The neonatal Graves' disease resolved spontaneously. It was suspected that the fetal thyroid did not trap any I-131 as it does not concentrate iodine until 10 weeks of gestation.
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