Nuklearmedizin 1975; 14(03): 219-227
DOI: 10.1055/s-0038-1624901
Originalarbeiten — Original Articles
Schattauer GmbH

Comparison of Various Treatment Schedules for Accelerating the Elimination of Radioiodine from the Thyroid and the Human Body

Vergleich verschiedener Behandlungsschemata zur beschleunigten Ausscheidung von Radiojod aus der Schilddrüse und dem Körper
D. P. Livadas
1   Athens University Department of Clinical Therapeutics and Thyroid Section, “Alexandra” Hospital, Athens
,
D. A. Koutras
1   Athens University Department of Clinical Therapeutics and Thyroid Section, “Alexandra” Hospital, Athens
,
J. Sfontouris
1   Athens University Department of Clinical Therapeutics and Thyroid Section, “Alexandra” Hospital, Athens
,
A. D. Pharmakiotis
1   Athens University Department of Clinical Therapeutics and Thyroid Section, “Alexandra” Hospital, Athens
,
B. Malamos
1   Athens University Department of Clinical Therapeutics and Thyroid Section, “Alexandra” Hospital, Athens
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received:03. März 1975

Publikationsdatum:
11. Januar 2018 (online)

Summary

In 68 euthyroid patients undergoing 131I thyroid function tests the thyroidal, urinary and plasma protein-bound radioactivity has been serially measured for 14 days. The patients were subdivided in controls and 9 groups treated with potassium iodide, Carbimazole, potassium Perchlorate and TSH, singly or in combination. The aim was to devise a treatment scheme for accelerating the release of iodine from the thyroid and the elimination from the body in cases of accidental radioiodine poisoning if the patient is seen after the radioiodine has already been taken up by the gland. All treatment schedules were effective, but TSH injections gave the best results, especially if combined with Carbimazole and potassium Perchlorate. This combination is the treatment of choice under these circumstances.

Bei 68 euthyreoten Patienten wurde nach Verabfolgung von 131J die Radioaktivität in der Schilddrüse, im Harn und in den Plasmaproteinen bestimmt. Die Patienten waren in 9 Gruppen, die eine Behandlung mit Kaliumjodid, Carbimazol, Kaliumperchlorat und Thyreotropin (TSH) einfach oder kombiniert erhielten und in die Kontrollgruppe geteilt. Unser Ziel war es, ein Behandlungs-schema zu finden das eine Beschleunigung der Ausscheidung von Jod aus der Schilddrüse und dem Körper im Falle einer Radiojodvergiftung hervorruft, wenn der Patient nach der Speicherung von Radiojod in der Schilddrüse zur Behandlung kommt. Alle Behandlungsschemata waren erfolgreich. Thyreotropin (TSH)-Injektionen geben die besten Ergebnisse, besonders wenn sie mit Carbimazol und Kaliumperchlorat kombiniert werden. Diese Kombination ist die Behandlung der Wahl unter diesen Bedingungen.

 
  • References

  • 1 Blum M, Eisenbud M. Reduction of thyroid irradiation from 131I by potassium iodide. J. Amer. med. Ass 1967; 200: 1036.
  • 2 Clark D. E. Association of irradiation with cancer of the thyroid in children and adolescents. J. Amer. med. Ass 1955; 159: 1007.
  • 3 Conard R. A, Rail E. J, Sutow W. W. Thyroid nodules as a late sequela of radioactive fallout in a Marshall island population exposed in 1954. New Engl. J. Med 1966; 274: 1391.
  • 4 Crooks J, Buchanan W. W, Wayne J. E, Macdonald E. Effect of pretreatment with methylthiouracil on results of I131 therapy. Brit. med. J 1960; 1: 151.
  • 5 Editorial Iodide to reduce risks of reactor accidents. Brit. med. J 1963; 1: 628.
  • 6 Editorial Fallout of the cold war. New Engl. J. Med 1966; 274: 1442.
  • 7 Greer A. M, Grimm Y, Inoue K. Fate of iodide derived from intrathyroidal hydrolysis of thyroglobulin. Endocrinology 1969; 85: 837.
  • 8 Greig W. R, Crooks J, Macgregor A. G. The radioprotective effect of methylthiouracil on the thyroid gland of the rat. Brit. J. Radiol 1965; 38: 72.
  • 9 Grosvenor C. E. Effect of propylthiouracil upon thyroidal I131 release in the methimazole-thyroxine treated rat. Endocrinology 1963; 73: 122.
  • 10 Halmi N. S, Pitt-Rivers R. The iodide pools of the rat thyroid. Endocrinology 1962; 70: 660.
  • 11 Koutras D. A, Livadas D. The minimum dose of potassium iodide which inhibits the thyroidal radioiodine uptake. Nucl. Med 1966; 5: 256.
  • 12 Lindsay S, Chaikoff I. L. The effect of irradiation of the thyroid gland with particular reference to the induction of thyroid neoplasms: a review. Cancer Res 1964; 24: 1099.
  • 13 Loutit J. F, Marley W. G, Russel R. S. The nuclear reactor accident in Windscale – October 1957: Environmental aspects. In M. R. C. Report The Hazards to Man of Nuclear and Allied Radiations, H.M.S.O. London: 1960: 129
  • 14 Pochin E. E, Barnaby C. E. The effect of pharmacological doses of non-radioactive iodine on the course of radioiodine uptake by the thyroid. Hlth. Phys 1963; 7: 125.
  • 15 Samson R. J, Key C. R, Buncher C. R, Lijma S. Thyroid carcinoma in Hiroshima and Nagasaki. I. Prevalence of thyroid carcinoma at autopsy. J. Amer. Med. Ass 1969; 209: 65.
  • 16 Saxena K. M, Chapman E. M, Pryles C. V. Minimal dosage of iodine required to suppress uptake of iodine131 by normal thyroid. Science 1962; 138: 430.
  • 17 Sheline G. E, Lindsay S, Bell H. G. Occurrence of thyroid nodules in children following therapy with radioiodine for hyperthyroidism. J. clin. Endoer 1959; 19: 127.
  • 18 Sheline G. E, Lindsay S, McCormack K. R, Galante M. Thyroid nodules occurring late after treatment of thyrotoxicosis with radioiodine. J. clin. Endoer 1962; 22: 8.
  • 19 Sligerland D. W. Effect of Perchlorate on iodide in the thyroids of rats receiving propylthiouracil. Endocrinology 1963; 73: 115.
  • 20 Socolow E. R, Hashizumi A, Neriishi S, Niitani R. Thyroid cancer in man after exposure to ionizing radiation; a summary of the findings in Hiroshima and Nagasaki. New Engl. J. Med 1963; 268: 406.
  • 21 Wayne E. J, Koutras D. A, Alexander W. D. Clinical Aspects of Iodine Metabolism. Blackwell Scientific Publications; Oxford, U. K.: 1964.
  • 22 Wolff J, Chaikoff I. L. Plasma inorganic iodide as a homeostatic regulator of thyroid function. J. biol. Chem 1948; 174: 555.