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CC BY-NC-ND 4.0 · Ibnosina Journal of Medicine and Biomedical Sciences 2019; 11(01): 16-19
DOI: 10.4103/ijmbs.ijmbs_1_19
Original Article

Efficacy of radioiodine in the treatment of primary hyperthyroidism

Khaled Aldahmani
1   The Endocrine and Diabetes Center, Tawam Hospital
2   Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain
,
Bachar Afandi
1   The Endocrine and Diabetes Center, Tawam Hospital
2   Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain
,
Manal Ali
1   The Endocrine and Diabetes Center, Tawam Hospital
,
Jayadevan Sreedharan
3   Department of Community Medicine, College of Medicine, Gulf Medical University, Ajman
,
Rizwan Syed
4   Department of Radiology, Tawam Hospital, Al Ain
,
Juma Alkaabi
1   The Endocrine and Diabetes Center, Tawam Hospital
2   Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain
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Background: Radioiodine (RI) is a commonly used treatment modality for primary hyperthyroidism. A single dose of RI has been reported to cure hyperthyroidism in the range of 50%–90% of the treated cases. The efficacy of RI treatment has not yet been investigated in the local population. Objectives: To assess the efficacy of RI therapy in patients with primary hyperthyroidism treated at Tawam Hospital, Al Ain, UAE. Patients and Methods: The electronic medical records of hyperthyroid patients who received RI treatment at Tawam Hospital between January 2009 and March 2017 were reviewed. The diagnosis was verified by reviewing clinical, laboratory, and imaging data. Following RI therapy, a cure was defined as the development of hypothyroidism or euthyroid status without the aid of antithyroid drugs (ATDs) within 6 months post-RI therapy. Multivariate analysis was used to assess predictors of RI response. Results: A total of 125 patients (68.8% women) met the study criteria. The mean age ± standard deviation (SD) at RI therapy was 40 ± 15.1 years. The etiology of hyperthyroidism was available for 121 patients; Graves' disease (GD) (n = 83, 68.6%), toxic multinodular goiter (TMNG) (n = 31, 25.6%), and toxic adenoma (TA) (n = 7, 5.8%). The majority of patients (109, 87.2%) were pretreated with ATDs; 70.3% of those were treated for a period exceeding 18 months. Almost quarter of the patients were referred to RI due to other compelling medical reasons including ATDs intolerance, neutropenia, and hepatotoxicity. The mean ± SD administered RI activity was 14.6 ± 3.7 mCi (range: 8–25). Treatment response evaluation was possible in 97 cases. Post a single dose of RI treatment, 91.8% of patients achieved either euthyroid or hypothyroid status. Patients with GD developed hypothyroidism more frequently than TMNG or TA (80.6% vs. 65.2% vs. 33.3%, respectively). The time to cure was within 3 months in 21% and 3–6 months in 79% of the patients. The given dosage of I131 was the only predictor of cure rate. No major adverse effects were reported. Conclusion: We found that there is a delay in referring potential patients with hyperthyroidism for RI treatment and the cure rate of a single dose of I131 is 91.8% within 6 months of posttreatment; patients with TA may require higher doses of I131 therapy. Further studies are needed to explore the patient–physician barriers in utilizing RI as a timely mode of treatment for appropriately selected patients.

Key-words:

Efficacy - Graves' disease - hyperthyroidism - primary hyperthyroidism - radioactive iodine - toxic multinodular goiter - treatment

Financial support and sponsorship

Nil.




Publication History

Received: 06 January 2019

Accepted: 13 January 2019

Article published online:
07 July 2022

© 2019. The Libyan Authority of Scientific Research and Technologyand the Libyan Biotechnology Research Center. All rights reserved. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License,permitting copying and reproductionso long as the original work is given appropriate credit. Contents may not be used for commercial purposes, oradapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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