title: Short term treatment with lithium carbonate as adjunct to radioiodine treatment for long-lasting Graves' hyperthyroidism.
abstract: OBJECTIVE
  Lithium carbonate is primarily used for the treatment of patients with bipolar affective disorders. Initial treatment of Graves' hyperthyroidism (GHT) with antithyroid drugs (ATD) has limitations at over 50% of treated patients because of significant side effects and relatively high relapses of the disease after drugs withdrawal. Till now, the influence of LiCO₃on RIT outcome was mainly studied in patients with recent onset of GHT, and results were contradicted. Meta-analysis of case-control studies showed higher rated hypothyroidism in patients with mood disorders treated with LiCO₃(121/869) than in controls (10/578). Although in a small number of patients (n=28) with long-lasting GHT, preliminary results of ours showed that ¹³¹I treatment with LiCO₃for 7 days significantly improved the efficacy of RIT versus the non-LiCO₃treated patients (P<0.001). Lithium treated patients were cured faster (12 of 13 patients were cured after one month) than those treated only with ¹³¹I (8 patients were cured after one and 11/15 patients after 12 months). Fewer patients treated with ¹³¹I and LiCO₃had persistent hyperthyroidism than those treated with ¹³¹I alone. There were no toxic effects of LiCO₃during 7 days treatment.
  
  
  CONCLUSIONS
  These observations indicate of that short-term treatment with LiCO₃in GHT patients as adjunct to ¹³¹I-NaI improves the efficacy of RIT, prevents transient exacerbation of hyperthyroidism, early induction of hypothyroidism and does not worsen ophthalmopathy.
authors.affiliation: Center of Nuclear Medicine, Clinical Center of Niš, bul. Dr Zoran Đinđić 48, 18000, Niš, Serbia. vladansekulic@live.com, vsek_vlada@yahoo.com.
authors.forename: Vladan
authors.initials: V
authors.lastname: Sekulić
authors.forename: Milena P
authors.initials: MP
authors.lastname: Rajić
authors.forename: Marina Ž
authors.initials: MŽ
authors.lastname: Vlajković
authors.forename: Slobodan S
authors.initials: SS
authors.lastname: Ilić
authors.forename: Miloš Lj
authors.initials: MLj
authors.lastname: Stević
authors.forename: Marko M
authors.initials: MM
authors.lastname: Kojić
mesh_terms: D013956:Antithyroid Agents / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000379:methods*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002908:Chronic Disease; D004334:Drug Administration Schedule; D006111:Graves Disease / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D016651:Lithium Carbonate / Q000008:administration & dosage*; D008137:Longitudinal Studies; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D016651:Lithium Carbonate