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Nuklearmedizin 2002; 41(04): 178-183
DOI: 10.1055/s-0038-1623893
Original Article
Schattauer GmbH

Early change of thyroid hormone concentration after 131I treatment in patients with solitary toxic adenoma

Frühe Veränderungen der Schilddrüsenhormonkonzentration nach Radioiodtherapie von Patienten mit solitärem toxischen Adenom
E. Pirnat
1   University Medical Centre Ljubljana, Department of Nuclear Medicine (Head: Sergej Hojker), Slovenia
,
V. Fidler
1   University Medical Centre Ljubljana, Department of Nuclear Medicine (Head: Sergej Hojker), Slovenia
,
K. Zaletel
1   University Medical Centre Ljubljana, Department of Nuclear Medicine (Head: Sergej Hojker), Slovenia
,
S. Gaberšček
1   University Medical Centre Ljubljana, Department of Nuclear Medicine (Head: Sergej Hojker), Slovenia
,
S. Hojker
1   University Medical Centre Ljubljana, Department of Nuclear Medicine (Head: Sergej Hojker), Slovenia
› Author Affiliations
Further Information

Publication History

Received: 18 February 2002

15 May 2002

Publication Date:
11 January 2018 (online)

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Summary

Aim: In spite of extensive use of 131I for treatment of hyperthyroidism, the results of early outcome are variable. In our prospective clinical study we tested whether 131I induced necrosis causing clinical aggravation of hyperthyroidism and increasing the free thyroid hormone concentration in the serum of patients with solitary toxic adenoma not pretreated with antithyroid drugs. Patients and methods: 30 consecutive patients were treated with 925 MBq 131I. Serum concentration of thyrotropin (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (Tg), and interleukin-6 (IL-6) were measured before and after application of 131I. Results: After application of 131I no clinical worsening was observed. FT4 and fT3 concentration did not change significantly within the first five days, whereas both of them significantly decreased after 12 days (p <0.0001). Slight and clinically irrelevant increase in the level of the two thyroid hormones was observed in 9 patients. Furthermore, we observed a prolonged increase in Tg concentration and a transient increase in IL-6 concentration. Conclusion: Neither evidence of any clinical aggravation of hyperthyroidism nor any significant increase in thyroid hormone concentration by 131I induced necrosis of thyroid cells was found. Therefore, the application of 131I may be considered as a safe and effective treatment for patients with hyperthyroidism due to toxic adenoma.

Zusammenfassung

Ziel: Trotz der häufigen Anwendung von Radioiod zur Behandlung der Hyperthyreose, variieren die Ergebnisse in der frühen Phase. In unserer prospektiven klinischen Studie testeten wir, ob 131I bei nicht mit Thyreostatika vorbehandelten Patienten mit solitärem toxischen Adenom Nekrosen induziert, zur klinischen Verschlimmerung der Hyperthyreose führt und zu erhöhter Konzentration an freien Schilddrüsenhormonen. Patienten und Methoden: 30 konsekutive Patienten wurden mit 925 MBq 131I therapiert. Die Serumkonzentrationen von TSH, freiem Thyroxin (fT4), freiem Triiodthyronin (fT3), Thyreoglobulin (Tg) und Interleukin-6 (IL-6) wurden vor und nach der Radioiodapplikation bestimmt. Ergebnisse: Nach Radioiodgabe wurden keine klinische Verschlimmerung beobachtet. Die fT3- und fT3-Konzentrationen veränderten sich in den ersten fünf Tagen nicht signifikant. Doch beide verringerten sich nach 12 Tagen signifikant (p <0,0001). Ein leichter, klinisch unbedeutender Anstieg der beiden Schilddrüsenhormone wurde bei 9 Patienten beobachtet. Außerdem wurde ein lang dauernder Anstieg der Tg-Konzentration und ein zeitlich begrenzter Anstieg der IL-6-Konzentration festgestellt. Schlussfolgerung: Da weder ein Hinweis auf die Induktion von Schilddrüsenzellnekrose durch 131I einschl. Verschlimmerung der Hyperthyreose noch eine signifikant erhöhte Schilddrüsenhormonkonzentration gefunden wurden, darf die Radioiodtherapie als sichere und effektive Behandlung der Hyperthyreose infolge eines toxischen Adenoms gelten.

Keywords

Toxic adenoma - hyperthyroidism - 131I treatment - necrosis

Schlüsselwörter

Toxisches Adenom - Hyperthyreose - Radioiodtherapie - Nekrose
 

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