title: Time course of Graves' orbitopathy after total thyroidectomy and radioiodine therapy for thyroid cancer.
abstract: The risk of cancer is relatively higher in Graves' patients presenting simultaneously with thyroid nodules. Radioiodine (RAI) therapy recommended in high-risk differentiated thyroid carcinoma may be associated with worsening of a pre-existing Graves' orbitopathy (GO) or developing a new onset. The impact of RAI therapy in patients with differentiated thyroid cancer on the course of a pre-exisiting GO has not been specifically investigated.The aim of this study is to assess the influence of RAI treatment administered for differentiated thyroid cancer on the course of a pre-existing GO.This is a retrospective multicenter study including 35 patients from the University Hospital of Clermont-Ferrand (7 patients) and Lyon-Est (6 patients) in France and from a literature review published as case reports or studies (22 patients).Seven patients exhibited a worsened pre-existing GO after total thyroidectomy followed by RAI treatment for thyroid cancer. Older men, those who initially presented with a lower clinical score of GO before RAI therapy, received higher doses of I especially when prepared with recombinant thyroid-stimulating hormone, and/or not prepared with glucocorticoids during RAI are at a higher risk to worsen their GO.This study is the first and complete study collection. We describe worsening of GO in 20% of patients after RAI treatment for thyroid cancer and determine a pool of predictive factors.
authors.affiliation: CHU Clermont-Ferrand, Endocrinology Department, Clermont-Ferrand, France Department of Clinical and Experimental Medicine and Surgery "F. Magrassi, A. Lanzara," Second University of Naples, Naples, Italy CHU Clermont-Ferrand, Biostatistics Unit (Clinical Research and Innovation Direction), Clermont-Ferrand Department of nuclear medicine, Hospices civils de Lyon, Groupement hospitalier Est, Bron, France Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand UMR CNRS 6293, INSERM U1103, Génétique Reproduction et Développement, Université Clermont-Auvergne, Aubiere Department of Endocrinology, Hospices Civils de Lyon, Bron, Université Lyon I Lyon 1 University, CRCL, INSERM U1052, Lyon, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Louvet
authors.forename: Annamaria
authors.initials: A
authors.lastname: De Bellis
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.forename: Claire
authors.initials: C
authors.lastname: Bournaud
authors.forename: Antony
authors.initials: A
authors.lastname: Kelly
authors.forename: Salwan
authors.initials: S
authors.lastname: Maqdasy
authors.forename: Beatrice
authors.initials: B
authors.lastname: Roche
authors.forename: Francoise
authors.initials: F
authors.lastname: Desbiez
authors.forename: Francoise
authors.initials: F
authors.lastname: Borson-Chazot
authors.forename: Igor
authors.initials: I
authors.lastname: Tauveron
authors.forename: Marie
authors.initials: M
authors.lastname: Batisse-Lignier
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005602:France; D049970:Graves Ophthalmopathy / Q000150:complications*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D013965:Thyroidectomy
chemical_list: D007457:Iodine Radioisotopes