Effects of thyroidectomy alone or followed by radioiodine ablation of thyroid remnants on the outcome of graves' ophthalmopathy.
Fifty-five patients with Graves' disease (GD) and mild to moderate Graves' ophthalmopathy (GO) underwent near-total thyroidectomy (Tx). In 16 patients this was followed by a standard ablative dose of (131)I because of the hystologic evidence of differentiated thyroid carcinoma. We retrospectively evaluated whether or not GO activity could be affected by thyroid surgery alone or followed by complete ablation of thyroid tissue. Accordingly, on the basis of clinical activity score (CAS) values prior to thyroidectomy, we identified two groups: group A with active GO (CAS > or = 3; n = 31) and group B with inactive GO (CAS < or = 2; n = 24). CAS values were then recorded at 6, 12, and 24 months after surgery/(131)I ablation. Over the course of the follow-up period, GO became inactive in approximately 70% of group A patients (CAS 4.2 +/- 0.8 at baseline, 2.1 +/- 2.0 at 24 months, p < 0.0001) and became active in 37.5% patients from group B. When we examined GO activity according to the type of treatment used (Tx or Tx and (131)I), the prevalence of inactive GO both short- and long-term, was significantly higher in the group of patients who underwent Tx and (131)I ablation. Therefore, this seems to be a more effective means of inducing and maintaining inactive GO.
Moleti
Mariacarla
M
Dipartimento Clinico-Sperimentale di Medicina e Farmacologia, Sezione di Endocrinologia, University of Messina, Messina, Italy.
Mattina
Filiberto
F
Salamone
Ignazio
I
Violi
Maria Antonia
MA
Nucera
Carmelo
C
Baldari
Sergio
S
Lo Schiavo
Maria Grazia
MG
Regalbuto
Concetto
C
Trimarchi
Francesco
F
Vermiglio
Francesco
F
D000328:Adult; D000368:Aged; D005260:Female; D006111:Graves Disease / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000528:radiation effects* / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome
D007457:Iodine Radioisotopes