Abstract
BackgroundRadioactive iodine (I131) is a common definitive treatment for Graves’ Disease. Potential complications include worsening, or new development of Graves’ eye disease and development of a radiation thyroiditis. The purpose of the present study was to assess outcomes of patients treated with I131 in an Australian tertiary centre over 10 years.MethodsData from 101 consecutive patients treated with I131 for a diagnosis of Graves’ disease between 2005 to 2015 was collected and reviewed retrospectively. Baseline TSH receptor antibody titre, pre-treatment free thyroxine (FT4), technetium scan uptake, initial treatment, duration of treatment, reason for definitive therapy, complications, and time to remission (defined as euthyroidism or hypothyroidism after 12 months) were recorded.ResultsOf the 92 patients with adequate outcome data, 73 (79.3%) patients achieved remission with a single dose of I131. Of the remaining 19 patients, 12 had a second dose and became hypothyroid. TSH receptor antibody titre at diagnosis was significantly lower in the group that achieved remission with the first dose compared with those who did not (P = 0.0071). There was no difference in technetium uptake, I131 dose, duration of therapy or pre-treatment free thyroxine (FT4). I131 was complicated by development of eye disease in 3 patients and 1 (of 11 with pre-existing eye disease) had worsening eye disease. A clinically apparent flare of hyperthyroidism following I131 was evident in 8 patients (8.6%).ConclusionRadioiodine is an effective therapy for Graves’ Disease with few complications. The majority of patients achieve remission with a single dose. Those who require a second dose are more likely to have higher TSH receptor antibody titres at diagnosis. To the best of our knowledge, this is the first study to report outcomes from radioiodine treatment for Graves’ disease in an Australian population.
Highlights
Radioactive iodine (I131) is a common definitive treatment for Graves’ Disease
There was no difference in technetium uptake, I131 administered activity, duration of medical therapy, pre-treatment Free thyroxine (FT4) or duration of disease (Table 3)
We found that 79% of patients achieved remission with a single dose of I131
Summary
Radioactive iodine (I131) is a common definitive treatment for Graves’ Disease. Graves’ disease is the most common cause of adult hyperthyroidism in the developed world. [1, 2] It is an autoimmune condition caused by stimulating antibodies acting as an agonist on the thyrotropin (TSH) receptor on thyroid follicular cells [3]. Though it can occur at any age it is most commonly diagnosed in women aged 40–60 years [2]. Treatment options include antithyroid drugs, radioiodine therapy (I131) and surgery. Radioiodine is a safe and effective definitive treatment for Graves’ disease. In Australia, it is generally used as second line therapy for relapsed or persistent disease
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