A clinical guide to the management of Graves' disease with radioactive iodine.
More than 50 years have passed since radioactive iodine (RAI) was initially demonstrated as a therapeutic modality for the treatment of Graves' Disease. Today, more than a million patients have been treated with RAI. RAI is considered safe and highly effective. Its side-effect profile, ease of administration, and relative cost make RAI the treatment of choice for Graves' Disease of thyroidologists in this country. Questions continue to be raised as to which patients will benefit most from RAI therapy. Marked differences still exist between the practice preferences of thyroidologists as to whom, when, and how to treat with RAI. Factors that influence patient selection for RAI include age, the presence of pre-existing ophthalmopathy, lifestyle, history of previous treatment failure, and goiter size. Treatment goals, dosimetry, use of thionamides prior to therapy, safety recommendations following therapy, and prophylactic therapy with glucocorticoids for patients with ophthalmopathy highlight are some of the controversial issues facing the endocrinologist treating Graves' Disease with RAI. This symposium article reviews the current management of Graves' Disease with RAI.
Levetan
C
C
Department of Medicine, Washington Hospital Center, Washington, DC 20010-2975, USA.
Wartofsky
L
L