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Effect of Lugol’s solution on 131I therapy efficacy in Graves’ disease

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Abstract

Purpose

Lugol’s solution could control thyroid function and suppress 131I uptake in hyperthyroidism. This study aimed to investigate the appropriate time to withdraw Lugol’s solution before 131I therapy (RIT) in Graves’ disease (GD) patients, and how this should influence 131I uptake and RIT outcome.

Methods

Two groups (125 cases and 1805 cases) of GD patients received RIT, who were pre-treated with and without Lugol’s solution (RI-CI group and RI group). The RI-CI group was further divided into the following sub-groups depending on the duration span between Lugol’s solution withdrawal and RIT: sub-group A, 4–7 d (n = 49); sub-group B, 8–14 d (n = 41); and sub-group C, 15–30 d (n = 35). The highest radioactive iodine uptake rate (RAIUmax), effective half-life (Teff), TRAb, and free triiodothyronine (FT3) and free thyroxine (FT4) levels were compared, and therapeutic outcome was evaluated.

Results

There were no significant differences in RAIUmax, TRAb, and Teff among the four sub-groups (P > 0.05). Both FT3 and FT4 levels in sub-groups A and B were lower than those in group RI and sub-group C (P < 0.05). The outcome of non-hyperthyroidism (euthyroidism + hypothyroidism) in groups RI-CI and RI was significantly different at post-RIT month 1 and 3 (P < 0.05). However, intergroup differences at 6 and 12 months were not significant (P > 0.05).

Conclusions

Withdrawal of Lugol’s solution 4–7 or 8–14 d before RIT does not influence 131I uptake and RIT efficacy in GD. Moreover, in order to avoid a rapid increase in thyroid hormone levels at the same time, Lugol’s solution should be withdrawn 4–7 d before RIT.

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Availability of data and materials

The data of this study are available on request from the corresponding author. The data are not publicly available due to privacy restrictions.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, People’s Republic of China

    Jinyan Chai, Ruiguo Zhang, Wei Zheng, Guizhi Zhang, Qiang Jia, Jian Tan & Zhaowei Meng

  2. Department of Nuclear Medicine, Tongji University Tenth People’s Hospital, Shanghai, 200000, People’s Republic of China

    Renfei Wang

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  1. Jinyan Chai
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Contributions

MZ and WR conceived and designed the study. CJ performed the experiments and wrote the paper. ZR, ZW, ZG, TJ and JQ reviewed and edited the manuscript. All authors read and approved the manuscript.

Corresponding authors

Correspondence to Zhaowei Meng or Renfei Wang.

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Ethics approval and consent to participate

The ethical, methodological and protocol aspects of this study were reviewed and approved by the institutional review board and ethic committee of Tianjin Medical University General Hospital. Written informed consents were provided by the participants. Every patient participated in our study voluntarily and comprehended all aspects about the research.

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All authors consent to the publication of this work.

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The authors have no conflicts of interest.

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Chai, J., Zhang, R., Zheng, W. et al. Effect of Lugol’s solution on 131I therapy efficacy in Graves’ disease. Clin Exp Med 23, 825–831 (2023). https://doi.org/10.1007/s10238-022-00859-4

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  • DOI: https://doi.org/10.1007/s10238-022-00859-4

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