Radioiodine therapy and Graves’ disease – Myths and reality

English version

Autoři: Maria Teresa Plazinska ^aff001; Nadia Sawicka-Gutaj ^aff002; Agata Czarnywojtek ^aff002; Kosma Wolinski ^aff002; Małgorzata Kobylecka ^aff001; Maria Karlińska ^aff004; Karolina Prasek ^aff001; Małgorzata Zgorzalewicz-Stachowiak ^aff005; Magdalena Borowska ^aff003; Paweł Gut ^aff002; Marek Ruchala ^aff002; Leszek Krolicki ^aff001
Působiště autorů: Department of Nuclear Medicine, Warsaw Medical University, Warsaw, Poland ^aff001; Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland ^aff002; Department of Pharmacology, Poznan University of Medical Sciences, Poznan, Poland ^aff003; Department of Medical Informatics and Telemedicine, Warsaw Medical University, Warsaw, Poland ^aff004; Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Poznan University of Medical Sciences, Poznan, Poland ^aff005
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226495

Souhrn

Introduction

Autoimmune reactions in Graves’ disease (GD) occur not only in the thyroid gland, but also in the orbital connective tissue, eyelids, extraocular muscles. The occurrence of orbitopathy in the course of GD is influenced by environmental factors, e.g. cigarette smoking.

Objectives

The aim of the study was to analyze the effect of cigarette smoking on the efficacy of activity of radioiodine(131I) therapy in patients with GD. We also studied the influence of cigarette smoking and the efficacy of prednisone prophylaxis on the risk of thyroid-associated ophthalmopathy (TAO) development after radioiodine therapy (RIT) during two years of follow-up.

Patients and methods

Medical records of hyperthyroid patients treated with radioiodine had been included. Patients were scheduled to visit outpatient clinics at baseline and 1, 3, 6, 9, 12, 18, and 24 months after RIT.

Results

The studied group consisted of 336 patients (274 women, 62 men) diagnosed with GD and treated with RIT; 130 patients received second therapeutic dose of ¹³¹I due to recurrent hyperthyroidism. Among all studied patients, 220 (65.5%) were smokers and 116 (34.5%) non-smokers. In the group of smokers 115 (52.2%) of patients received single RIT, 105 (47.8%) received second dose of RAI due to recurrent hyperthyroidism. In non-smokers 91 (78.6%) received single activity of RAI, while 25 (21.4%) patients required second RIT due to recurrent hyperthyroidism. The ophthalmic symptoms in the group of smokers after RIT were less frequent, if the patient received preventative treatment in the form of oral prednisone (P = 0.0088).

Conclusions

The results of our study suggest that cigarette smoking reduces the efficacy of treatment with ¹³¹I in patients with GD. The study also confirmed the effectiveness of steroid prophylaxis against TAO development or exacerbation after RIT.

Klíčová slova:

Outpatient clinics – Prophylaxis – Smoking habits – Steroids – Thyroid – Thyroid hormones – Thyroid-stimulating hormone – Graves' disease

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Radioiodine therapy and Graves’ disease – Myths and reality

Souhrn

Introduction

Objectives

Patients and methods

Results

Conclusions

Klíčová slova:

Zdroje

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