Nonimmunogenic hyperthyroidism: cumulative hypothyroidism incidence after radioiodine and surgical treatment.
During 1977, 246 hyperthyroid patients were seen in our departments, 140 (57%) with nonimmunogenic hyperthyroidism (NIH)--101 with a toxic adenoma (TA) and 39 with multifocal functional autonomy (MFA). All patients but one could be followed over 9 yr, 101 after 131I treatment (RIT), another 29 after surgery (S). Ten patients were left untreated. Thirty-four treated (24%) patients died, none as a result of thyroid or post-treatment complications. There was no hyperthyroidism later than 9 mo after therapy. Only 1% (RIT) and 24% (S) were hypothyroid 1 yr after treatment. But 19% of all treated NIH patients were hypothyroid after 9 yr or at the time of their death, 12% after RIT and 41% after S. The cumulative hypothyroidism incidences 1.4%/yr for RIT and 2.2%/yr for S, were not significantly different. Out of the five survivers without RIT or S, two TA patients were hypothyroid. The effect of RIT on goiter related loco-regional complications was not worse than after S. We conclude that RIT is the treatment for NIH, leaving surgery for exceptional cases.
Kinser
J A
JA
Department of Nuclear Medicine, University of Berne, Switzerland.
Roesler
H
H
Furrer
T
T
Grütter
D
D
Zimmermann
H
H
D000236:Adenoma / Q000532:radiotherapy / Q000601:surgery; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D006980:Hyperthyroidism / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D007037:Hypothyroidism / Q000209:etiology*; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy
D007457:Iodine Radioisotopes