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Successful Treatment of Solitary Toxic Thyroid Nodules with Relatively Low-Dose Iodine-131, with Low Prevalence of Hypothyroidism

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Grant support: by grants AM 07118 and AM 16791 from the National Institutes of Health.

▸Requests for reprints should be addressed to Douglas S. Ross, M.D.; Thyroid Unit, Massachusetts General Hospital; Boston, MA 02114.

Boston, Massachusetts

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;101(4):488-490. doi:10.7326/0003-4819-101-4-488
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Forty-five patients with solitary toxic thyroid adenomas received 131I (mean dose, 10.3 mCi) for treatment of hyperthyroidism and were followed for 4.9 ± 3.2 years (range, 0.5 to 13.5). Seventy-seven percent were euthyroid by 2 months, 91% by 6 months, and 93% by 1 year. Only 3 patients did not respond to a single dose of 131I, but all responded to multiple doses. Late recurrent hyperthyroidism occurred in 3 patients at 4.5, 6, and 10 years after treatment with a single dose of 131I. No patient developed clinical hypothyroidism, and none had a low serum thyroxine level associated with an elevated serum thyrotrophin level. Three patients developed minimal elevations in serum thyrotrophin levels: 1, 4, and 7. 5 years after 131I treatment, their thyrotrophin levels were 8.4, 6.2, and 9.6 µU/mL, respectively. All 3 had normal serum thyroxine levels and were clinically euthyroid. Mean serum thyroxine concentrations of all patients were unchanged between 1 and more than 9 years of follow-up. These data suggest that solitary toxic adenomas may be treated with relatively low doses of 131I (5 to 15 mCi), and that post-treatment hypothyroidism is very unusual.





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