Radioiodine therapy and Graves’ disease – Myths and reality


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: 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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