open access

Vol 65, No 1 (2014)
Original papers
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19
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Radioactive iodine (RAI) treatment of hyperthyroidism is safe in patients with Graves’ orbitopathy — a prospective study

Aleksandra Król, Aleksandra Koehler, Mariusz Nowak, Ewa Paliczka-Cieślik, Jolanta Krajewska, Michał Kalemba, Beata Jurecka-Lubieniecka, Kornelia Hasse-Lazar, Barbara Michalik, Sylwia Szpak-Ulczok, Łukasz Zarudzki, Józef Roskosz, Barbara Jarząb
DOI: 10.5603/EP.2014.0006
·
Endokrynologia Polska 2014;65(1):40-45.

open access

Vol 65, No 1 (2014)
Original papers
Published online: 2014-02-19
Submitted: 2014-02-19
Accepted: 2014-02-19

Abstract

Introduction: Radioactive iodine (RAI) therapy may induce or worsen orbitopathy (GO) in Graves’ disease (GD). The aim of this study was a prospective assessment of the risk of GO exacerbation in a GD patients cohort submitted to RAI therapy for hyperthyroidism.

Material and methods: 208 consecutive GD patients treated with 131I in 2007 were enrolled. The analysis was performed on 156 patients strictly monitored for one year. Glucocorticosteroid (GCS) prophylaxis was administered if GO symptoms or GO history were present, and in cases of tobacco smokers even without GO symptoms. Clinical and biochemical evaluation at one, three, six, and 12 months after therapy was performed in the whole group, then at 24 months in 138 patients.

Results: There was no severe GO progression in patients without GO symptoms at the time of RAI treatment. The risk of severe GO worsening for preexisting GO patients (demanding systemic GCS administration) during the 12-month follow-up after RAI therapy was 10%. 12 and 24 months after 131I administration, stable improvement compared to the initial GO status had been achieved in most (98–96%) patients.

Conclusions:

1. In patients with mild GO, the risk of severe GO worsening after RAI therapy is acceptable, as long as RAI therapy is applied with GCS cover.

2. In patients without GO symptoms at the time of RAI therapy but with a history of GO and with subclinical GO diagnosed by MRI only, the risk of severe progression is minimal.

3. Distant outcomes of RAI treatment confirmed its safety in GO patients. (Endokrynol Pol 2014; 65 (1): 40–45)

Abstract

Introduction: Radioactive iodine (RAI) therapy may induce or worsen orbitopathy (GO) in Graves’ disease (GD). The aim of this study was a prospective assessment of the risk of GO exacerbation in a GD patients cohort submitted to RAI therapy for hyperthyroidism.

Material and methods: 208 consecutive GD patients treated with 131I in 2007 were enrolled. The analysis was performed on 156 patients strictly monitored for one year. Glucocorticosteroid (GCS) prophylaxis was administered if GO symptoms or GO history were present, and in cases of tobacco smokers even without GO symptoms. Clinical and biochemical evaluation at one, three, six, and 12 months after therapy was performed in the whole group, then at 24 months in 138 patients.

Results: There was no severe GO progression in patients without GO symptoms at the time of RAI treatment. The risk of severe GO worsening for preexisting GO patients (demanding systemic GCS administration) during the 12-month follow-up after RAI therapy was 10%. 12 and 24 months after 131I administration, stable improvement compared to the initial GO status had been achieved in most (98–96%) patients.

Conclusions:

1. In patients with mild GO, the risk of severe GO worsening after RAI therapy is acceptable, as long as RAI therapy is applied with GCS cover.

2. In patients without GO symptoms at the time of RAI therapy but with a history of GO and with subclinical GO diagnosed by MRI only, the risk of severe progression is minimal.

3. Distant outcomes of RAI treatment confirmed its safety in GO patients. (Endokrynol Pol 2014; 65 (1): 40–45)

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Keywords

Graves’ orbitopathy; 131I therapy; glucocorticosteroid prophylaxis

About this article
Title

Radioactive iodine (RAI) treatment of hyperthyroidism is safe in patients with Graves’ orbitopathy — a prospective study

Journal

Endokrynologia Polska

Issue

Vol 65, No 1 (2014)

Pages

40-45

Published online

2014-02-19

DOI

10.5603/EP.2014.0006

Bibliographic record

Endokrynologia Polska 2014;65(1):40-45.

Keywords

Graves’ orbitopathy
131I therapy
glucocorticosteroid prophylaxis

Authors

Aleksandra Król
Aleksandra Koehler
Mariusz Nowak
Ewa Paliczka-Cieślik
Jolanta Krajewska
Michał Kalemba
Beata Jurecka-Lubieniecka
Kornelia Hasse-Lazar
Barbara Michalik
Sylwia Szpak-Ulczok
Łukasz Zarudzki
Józef Roskosz
Barbara Jarząb

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