Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres.

摘要: In routine use for more than 50 years, radioiodine ( 131 I) is generally considered safe and devoid of major side effects. Therefore, it surprising that relatively many aspects therapy are controversial, as illustrated by recent international questionnaire studies. Our review aims at highlighting three these areas - namely, the influence I on course Graves' ophthalmopathy, possible radioprotective effects antithyroid drugs, in large goitres. carries a small (but definite) risk causing progression ophthalmopathy. Identification factors (thyroid dysfunction, high level thyroid-stimulating hormone (TSH) receptor antibodies, cigarette smoking) allows identification patients institution concomitant glucocorticoid treatment, thereby hindering eye disease. On basis, largely, retrospective data appears carbimazole (or methimazole), if stopped 3-5 days before does not outcome therapy. Simultaneous thyrostatic medication most probably reduces efficacy I, restarting within 7 days. Propylthiouracil seems to have prolonged effect carbimazole. Surgery treatment first choice with goitre. However, case patient ineligibility or preference, may be an option. The has favourable tracheal compression inspiratory capacity, but reduction thyroid volume only 30-40%. Inpatient necessitated doses, makes cumbersome. Controversy related mainly based lack adequate prospective randomised studies comparing efficacy, effects, cost satisfaction.