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Article
| Exp Clin Endocrinol Diabetes 2006; 114: 235-239
DOI: 10.1055/s-2006-924239 |
J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York |
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Incidence of Radioiodine Induced Graves' Disease in Patients with Multinodular Toxic Goiter |
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| J. Meller1, U. Siefker1, A. Hamann1, M. Hüfner2 |
1 Department of Nuclear Medicine, University of Göttingen, Göttingen, Germany
2 Department of Internal Medicine, University of Göttingen, Göttingen, Germany |
Abstract
In this study, we assessed the incidence of Graves' disease (GD) following radioiodine therapy (RIT) in a large cohort of well characterized patients with autonomy in comparison to the clinical course of control patients with thyroidal autonomy not definitively treated with 131I or surgery. 622 consecutive patients were treated with 131I for autonomy (unifocal: n = 321; multifocal: n = 199; disseminated: n = 102) and followed up for at least 6 months post RIT. 108 consecutive patients with autonomy not definitively treated (unifocal: n = 49; multifocal: n = 42; disseminated: n = 11) followed up for at least 6 months served as controls. Initial evaluation and follow-up included determination of FT3, FT4, TSH, autoantibodies against the thyroid peroxidase (anti-TPO) and TSH-receptor antibodies (TRAb) by highly sensitive radio receptor-assay, quantitative thyroid scintigraphy and sonography. After 6 months, GD was newly diagnosed in 1/321 patients with unifocal autonomy, in 1/199 patients with multifocal autonomy and in 0/108 control patients. In patients with disseminated autonomy (group C), GD was diagnosed significantly more often compared to the other groups (5/102 patients; 4,1 %; p < 0.05). In conclusion, RIT may induce Graves' disease in a few cases with toxic multinodular goiter. The incidence in this population is small. Compared with patients suffering from uni- or multifocal autonomy, subjects with disseminated autonomy have a more than tenfold higher risk for the development of GD.
Key words
Radioiodine therapy (RIT) - toxic multinodular goiter - autoimmunity - disseminated autonomy - Graves' disease - TSH-receptor antibodies
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