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Horm Metab Res 2024; 56(02): 134-141
DOI: 10.1055/a-2205-2052
Original Article: Endocrine Care

The Presence of Anti-TPO Antibodies Increase the Likelihood of Post-I131 Hypothyroidism

Felix Quataert 
1   Dermatology, UZ Brussel, Brussel, Belgium
,
Bert Bravenboer
2   Endocrinology, UZ Brussel, Brussel, Belgium
,
Marleen Keyaerts
3   Nuclear Medicine, UZ Brussel, Brussel, Belgium
,
Corina Emilia Andreescu
2   Endocrinology, UZ Brussel, Brussel, Belgium
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Abstract

The use of radioactive iodine in the treatment of hyperthyroidism is common practice. However, a standardized treatment protocol with regard to radioactive iodine treatment (RAI) remains subject to discussion. We retrospectively analyzed 100 patient records. Patient diagnosis, age, gender, body mass index (BMI), dose of radioactive iodine, thyroid size, the 24 h radioiodine uptake (24 h RAIU) and protein bound iodine (PBI) were deducted, as well as the use of antithyroid drugs prior to RAI. Biochemical parameters were obtained, such as TSH, fT4, fT3, Anti-TPO, Anti-TG antibodies and thyroid stimulating antibodies. After 5 years of follow-up, 46% of the patients proved to be hypothyroid, whereas 8% of the patients were not cured after one dose of RAI. One year after RAI, a larger proportion of patients with a toxic nodule developed hypothyroidism compared to patients with a multinodular goiter (MNG) (44.2% vs. 21.2%). Radioactive iodine dose, PBI, RAIU, BMI, size of the thyroid gland, diagnosis, age and TPO-antibodies showed statistically significant differences in the development of hypothyroidism. Furthermore, thiamazole pretherapy was shown to be a predictor of hypothyroidism, as well as a high PBI value, exhibiting a positive predictive value of 85.2% when the PBI exceeded 0.16. We suggest a standardized measurement of TPO-Ab’s to further determine their role in the development of hypothyroidism after RAI. The empirical dosing regimen was very effective, illustrating a 92% cure rate after 1 dose.

Key words

radioactive iodine - hypothyroidism - protein bound iodine - TPO-antibodies


Publication History

Received: 02 April 2022

Accepted after revision: 06 November 2023

Accepted Manuscript online:
06 November 2023

Article published online:
19 December 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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