Radioiodine therapy and Graves' disease - Myths and reality.
Adult
Aged
Anti-Inflammatory Agents
/ therapeutic use
Cigarette Smoking
Female
Graves Disease
/ drug therapy
Graves Ophthalmopathy
/ diagnosis
Humans
Hyperthyroidism
/ diagnosis
Iodine Radioisotopes
/ chemistry
Male
Middle Aged
Prednisone
/ therapeutic use
Radiopharmaceuticals
/ chemistry
Recurrence
Retrospective Studies
Thyrotropin
/ blood
Thyroxine
/ blood
Triiodothyronine
/ blood
Young Adult
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
28
05
2019
accepted:
07
11
2019
entrez:
14
1
2020
pubmed:
14
1
2020
medline:
9
4
2020
Statut:
epublish
Résumé
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. 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. 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. 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). 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.
Identifiants
pubmed: 31929534
doi: 10.1371/journal.pone.0226495
pii: PONE-D-19-12954
pmc: PMC6957158
doi:
Substances chimiques
Anti-Inflammatory Agents
0
Iodine Radioisotopes
0
Iodine-131
0
Radiopharmaceuticals
0
Triiodothyronine
06LU7C9H1V
Thyrotropin
9002-71-5
Thyroxine
Q51BO43MG4
Prednisone
VB0R961HZT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0226495Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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