[Follow-up and long-term results of radioiodine therapy in immune hyperthyroidism].
Follow-up and long-term results of 131-I treatment in Graves' disease are mainly influenced by the initial therapy. In Austria 131I-dose is estimated mostly as a result of thyroid uptake and volume, with the aim to restore euthyroidism. Methimazole or Propanolol pretreatment is performed in more than half of the patients. In Salzburg fixed dosis of 185 MBq 131-I are delivered until euthyroidism is achieved. Follow-up is done in 3 to 6 monthly intervals, later on once a year. Long-term results of 131-I-therapy are rare, because of the difficulty in discriminating Graves' disease from hyperthyroidism due to thyroid autonomy in the years before antibodies could be evaluated. Results are also quite uncertain, when obtained before the age of TSH- and TRH-test, because mild hyperthyroidism and hypothyroidism might have been overlooked. Early hyperthyroidism after 131-I-treatment can occur in 7% to 40% within the first year, raising with 2% to 5% each year. Hypothyroidism seems to depend on the dose, but may be caused even by low doses. This difficulty in finding the "ideal" dose might be due to stimulating, blocking and destroying antibodies with differences in the sensitivity of the thyroid tissue. The goal should be, to attain euthyroidism by radioiodine therapy, but hyperthyroidism should not be prolonged over a long period by delivering too small doses in order to avoid hypothyroidism.
Galvun
G
G
Institut für Nuklearmedizin und Endokrinologie, Landeskrankenanstalten Salzburg.
D001323:Autoantibodies / Q000032:analysis; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006111:Graves Disease / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000276:immunology
D001323:Autoantibodies; D007457:Iodine Radioisotopes
Verlaufskontrolle und Langzeitergebnisse der Radiojodtherapie bei Immunhyperthyreose.