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Use of low-dose radioiodine ablation for Graves’ orbitopathy: results of a pilot, perspective study in a small series of patients

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Abstract

Objective

Elimination of thyroid antigens by total thyroid ablation (TTA), namely, thyroidectomy followed by radioiodine, may be beneficial for Graves' Orbitopathy (GO). TTA is usually performed with a 131I dose of 30 mCi. In Italy, this dose must be followed by a 24-h protected hospitalization, with increase in the waiting lists. In contrast, a 15 mCi dose can be given without hospitalization and with lower costs. Here, we investigated whether a lower dose of radioiodine can be used to ablate thyroid remnants in patients with GO, after thyroidectomy.

Methods

The study was performed in two small groups of consecutive thyroidectomized patients (six patients per group) with Graves’ hyperthyroidism and GO. Patients underwent ablation with either 15 or 30 mCi of 131I following treatment with recombinant human TSH (rhTSH). The primary outcome was rhTSH-stimulated serum thyroglobulin (Tg) at 6 months. The secondary outcome was baseline Tg at 6 months.

Results

Baseline Tg and rhTSH-stimulated Tg after at 6 months did not differ between two groups, suggesting a similar extent of ablation. rhTSH-stimulated Tg was reduced significantly compared with rhTSH-stimulated Tg at ablation in both groups. GO outcome following treatment with intravenous glucocorticoids did not differ between the two groups.

Conclusions

Our findings may provide a preliminary basis for the use of a 15 mCi dose of radioiodine upon rhTSH stimulation in thyroidectomized patients with Graves’ hyperthyroidism and GO.

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Author information

Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, Endocrinology Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    M. Leo, E. Sabini, I. Ionni, B. Mazzi, F. Menconi, E. Molinaro, F. Bianchi, F. Brozzi, P. Santini, R. Elisei, P. Vitti, C. Marcocci & M. Marinò

  2. Department of Surgical, Medical and Molecular Pathology, Ophthalmopathy Unit I, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    A. Sframeli & M. Nardi

Authors
  1. M. Leo
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  2. E. Sabini
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  3. I. Ionni
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  4. A. Sframeli
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  5. B. Mazzi
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  6. F. Menconi
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  7. E. Molinaro
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  8. F. Bianchi
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  9. F. Brozzi
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  10. P. Santini
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  11. R. Elisei
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  12. M. Nardi
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  13. P. Vitti
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  14. C. Marcocci
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  15. M. Marinò
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Corresponding author

Correspondence to M. Marinò.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was registered at ClinicalTrials.gov (registration number: NCT03110835) and performed in accordance with Institutional guidelines. Being an observational study, approval by the local Review Board was not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Leo, M., Sabini, E., Ionni, I. et al. Use of low-dose radioiodine ablation for Graves’ orbitopathy: results of a pilot, perspective study in a small series of patients. J Endocrinol Invest 41, 357–361 (2018). https://doi.org/10.1007/s40618-017-0754-3

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  • DOI: https://doi.org/10.1007/s40618-017-0754-3

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