title: Sialadenitis after radioiodine therapy. Analysis of factors that influence the response to medical treatment.
abstract: OBJECTIVE
  To assess the incidence of 131I-induced sialadenitis (SD) in patients with differentiated thyroid cancer (DTC), to analyze clinical and other factors related to metabolic radiotherapy that may predict the lack of response to conventional medical therapy (CMT), and to determine the effectiveness of intraductal steroid instillation in patients failing CMT.
  
  
  METHODS
  Fifty-two patients with DTC, 45 females (86.5%) and 7 males (13.5%) with a mean age of 44.21±13.3 years (r=17-74) who received ablation therapy with 131I after total thyroidectomy. Patients with diseases and/or medication causing xerostomia were excluded. Patients underwent salivary gland scintigraphy with 99Tc (10mCi).
  
  
  RESULTS
  Eighteen patients (34.62%) had SD and received antibiotics, antispasmodics, and oral steroids for 15 days. They were divided into two groups: responders to medical therapy (n=12, age 44.3±14.4 years, 2 men [17%], 10 women [83%], cumulative dose 225±167.1 mCi) and non-responders to medical treatment, who underwent steroid instillation into the Stensen's duct (n=6 [33%], 2 men [33%], 4 women [67%], age 50±13.8 years, cumulative dose 138.3±61.7 mCi). Scintigraphy showed damage to the parotid and submaxillary glands.
  
  
  CONCLUSIONS
  Incidence of 131I-induced sialadenitis was similar to that reported by other authors. Age, mean cumulative dose of 131I, and involvement of parotid and submaxillary glands did not condition response to CMT; however, male sex was a conditioning factor. Symptom persistence for more than 15 days makes instillation into the Stensen's duct advisable. This is an effective and safe method to avoid surgical excision of salivary glands.
authors.affiliation: Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina. Electronic address: drageres@hotmail.com.
authors.forename: Alejandra E
authors.initials: AE
authors.lastname: Geres
authors.affiliation: Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors.forename: Paula Szafryk
authors.initials: PS
authors.lastname: Mereshian
authors.affiliation: Postgraduate Department of Endocrinology, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fernández
authors.affiliation: Department of Ear, Nose and Throat, Chutro Clinic.
authors.forename: Daniel Gonzalo
authors.initials: DG
authors.lastname: Rey Caro
authors.affiliation: Department of Nuclear Medicine, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Castro
authors.affiliation: Department of Nuclear Medicine, Hospital Nacional de Clínicas, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Podio
authors.affiliation: Probability and Statistics Department, Faculty of Mathematics, Astronomy and Physics, Universidad Nacional de Córdoba, Córdoba, Argentina.
authors.forename: Silvia
authors.initials: S
authors.lastname: Ojeda
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007322:Instillation, Drug; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000627:therapeutic use*; D010306:Parotid Gland / Q000473:pathology / Q000528:radiation effects; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D018987:Salivary Ducts; D012793:Sialadenitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D013363:Submandibular Gland / Q000473:pathology / Q000528:radiation effects; D013964:Thyroid Neoplasms / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007457:Iodine Radioisotopes; D010276:Parasympatholytics
keywords: Cáncer diferenciado de tiroides; Differentiated thyroid cancer; Instilación intraductal; Intraductal instillation; Radioiodine induced sialadenitis; Sialadenitis; Sialoadenitis; Sialoadenitis inducida por radioyodo