TREATMENT OF TOXIC NODULAR AND DIFFUSE GOITRE WITH RADIOACTIVE IODINE

Abstract

ABSTRACT The results of treatment of hyperthyroidism with radioiodine were evaluated in a series of 387 patients treated between 1959 and 1963. The observation time was 8 years. The 1st year incidence of hypothyroidism was 14.5%. There was a distinct difference between patients with toxic nodular and toxic diffuse goitre: 11.8% in the former and 25.6% in the latter. Among all patients 77% had nodular goitre. After the first year the yearly increment of hypothyroidism was 1-2%. 14% of the patients were pretreated with antithyroid agents. In those not so treated, severe post-treatment reactions occurred in 4% of the cases: a few patients developed an impending crisis and one patient succumbed in a thyroid crisis. The importance of this type of pre-treatment in severely ill patients or in patients with complicating conditions is stressed. In the pretreated group of patients, the incidence of hypothyroidism was smaller than in patients not treated in this way and the patients more commonly required more than one treatment dose. The percentage of severe reactions was much smaller in the 1959-1963 series of patients than in our first series, probably because of this pre-treatment. The administration of antithyroid drugs for only a few weeks after the radioiodine dose did not influence the results.