Open AccessRadioiodine therapy and Graves’ disease – Myths and reality
Author(s) -
Maria Teresa Płazińska,
Nadia SawickaGutaj,
Agata Czarnywojtek,
Kosma Woliński,
Małgorzata Kobylecka,
Maria Karlińska,
Karolina Prasek,
Małgorzata Zgorzalewicz-Stachowiak,
Magdalena Borowska,
Paweł Gut,
Marek Ruchała,
Leszek Królicki
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0226495
Subject(s) - medicine , prednisone , graves' disease , thyroid , medical record , outpatient clinic , radioiodine therapy , retrospective cohort study , graves' ophthalmopathy , pediatrics , disease , gastroenterology , thyroid cancer
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 131 I 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 131 I in patients with GD. The study also confirmed the effectiveness of steroid prophylaxis against TAO development or exacerbation after RIT.