The efficacy of low-dose radioactive iodine without a thionamide in the treatment of thyrotoxicosis.
Between 1999 and June 2001, 55 unselected thyrotoxic patients were prescribed 200 MBq radioactive iodine (131I). None of these patients received a thionamide such as carbimazole or propylthiouracil within two weeks of treatment or subsequently. Symptom relief was achieved using beta blockers alone. Remission at one year was achieved in 84% of these patients and of these 62% were hypothyroid and taking thyroxine. Within this time, re-treatment of those who remained thyrotoxic achieved an overall success rate at one year of 95%. The outcome of 164 similar patients prescribed 250-400 MBq 131I between 1996 and 2001 gave comparable results. The failure rate after a single 200 MBq 131I dose was significantly lower than that previously published where 185 MBq 131I and thionamides had been used. Our low-dose strategy has the potential for halving the radiation exposure to the patient and the environment, when compared with the ablative strategies in common use.
Aitken
Mark
M
Department of Endocrinology, Colchester General Hospital, Essex. mark.aitken@essexrivers.nhs.uk
George
Ajith
A
Bodmer
Charles
C
Cameron
John
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011829:Radiation Dosage; D018570:Risk Assessment; D012720:Severity of Illness Index; D013960:Thyroid Function Tests; D013971:Thyrotoxicosis / Q000175:diagnosis / Q000532:radiotherapy*; D016896:Treatment Outcome
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes