Endocrine Abstracts

Aim : We compared the Hospital practice in the management of hyperthyroidism using radioiodine with the guidelines recommended by the working group of Royal College of Physicians and Society for Endocrinology. We also assessed the outcome of the treatment.

Methods: All 51 consecutive patients (female - 47, male - 4) who had radioiodine treatment from Jan 1997 till Dec 1998 were included, among which 5 patients had two doses of radioiodine. All of them received fixed dose (400 MBq) of radioiodine and their follow-up was reviewed from the case notes retrospectively for 2 years.

Results: Signed consent was documented from 98% of patients. Although the isotope department gives a warning card to all patients there was no documentation of this for any patients. Antithyroid medication was withdrawn appropriately i.e., 4 days prior to radioiodine and restarted no sooner than 3 days in 92% of the patients. During the follow-up thyroid function test was assessed in all patients (100%) at 4-8 weeks and at 6 months. However, thyroid function was tested in 48 patients (94%) in 1 year and 47 patients (92%) in 2 years. Treatment outcome were as follows - At 6 months 27% had no treatment, 38% were on thyroxine, 31% were on antithyroid medication, 2% lost follow-up, 2% discharged. At 1 year - 31% had no treatment, 38% were on thyroxine, 25% were on antithyroid medication, 4% lost follow-up, 2% discharged. At 2 years - significant number of patients 39% required thyroxine, 25% had no treatment, 16% were on antithyroid medication, 12% lost follow-up, 2% moved away, 6% discharged. Significant weight gain (more than 3 Kg) was noted in 35% of patients at 1 year.

Conclusion: We found our practice to be satisfactory compared to working group recommendations. More reliable follow-up through electronic patients register and better documentation is planned. Possibly more use of second dose radioiodine would be appropriate.