Radioiodine therapy may induce thyrotropin
receptor antibodies in patients with toxic nodular goiter
(July 2002)
The background of
the study. Radioiodine is an effective therapy for patients
with hyperthyroidism caused by a nodular goiter, but it can result
in the production of thyroid antibodies. In this study several antithyroid
antibodies were measured before and after radioiodine therapy in
patients with hyperthyroidism caused by a nodular goiter.
How the study was done. The study
subjects were 41 patients with hyperthyroidism caused by thyroid
nodular disease who were treated with radioiodine. Twenty patients
had a solitary thyroid adenoma, and 21 patients had a multinodular
goiter (the pattern of uptake was patchy or uneven in 11 patients
and localized in multiple discrete nodules in 10 patients). Serum
antithyroid peroxidase antibodies, antithyroglobulin antibodies,
and thyrotropin (TSH)-receptor antibodies were measured before and
3 to 11 months after radioiodine therapy.
The results of the study. Before
therapy, none of the patients had any TSH receptor antibodies. After
therapy, 4 patients, all in the group of 11 patients with a patchy
multinodular goiter, had a high serum concentration of these antibodies.
Several patients had high serum antithyroid peroxidase and antithyroglobulin
antibody concentrations before therapy, and they and one other patient
had high concentrations after therapy.
Among the 10 patients with multiple discrete nodules and the 20
patients with a solitary thyroid adenoma, only 2 in each group had
a high serum concentration of thyroid antibodies before or after
therapy.
The conclusions of the study. Patients
with hyperthyroidism caused by a patchy nodular goiter may have
increase in serum TSH receptor antibody concentrations after radioiodine
therapy, suggesting that they have preexisting Graves' disease.
The original article. Wallaschofski
H, Muller D, Georgi P, Paschke R. Induction of TSH-receptor antibodies
in patients with toxic multinodular goitre by radioiodine treatment.
Horm Metab Res 2002;34:36-9.
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