Endocrine Abstracts

The RCP clinical guideline on Radioiodine in the management of benign thyroid disease was published in 2007. An audit was undertaken in patients receiving this treatment between April 2006 and April 2007. The audit was performed to assess compliance with the guidelines and provide patients receiving radioiodine data regarding the efficacy of the treatment and its complications.

Sixty-two patients received radioiodine and 59 patients entered into the audit (notes unavailable in 3 patients). The median age was 56 years (range 20–82) and 45 patients were female. Thirty patients were diagnosed with Graves disease, 16 toxic multinodular goitre, 1 solitary adenoma and 12 with either ‘thyrotoxicosis’ or ‘hyperthyroidism’. Thyroid eye disease was noted in 10 patients.

All patients received 400 MBq of I-131 as their first dose. Forty-seven patients were cured following a single dose (80%) and of the 12 patients in whom thyrotoxicosis recurred 6 patients received a second dose (10%) and 1 patient received a third dose (2%). Of the 7 patients who received more than 1 dose 3 had Graves disease, 3 had toxic multinodular goitre and 1 had a toxic adenoma. The one patient who received 3 doses had toxic multinodular goitre.

Thirty-one patients became hypothyroid (53%) following radioiodine therapy (follow-up 6–18 months). The median duration from radioiodine to hypothyroid state was 4 months (range 2–8 months). Twenty-one of the 31 patients who became hypothyroid had Graves disease, 1 had toxic multinodular goitre, 1 had toxic adenoma and 8 had either ‘thyrotoxicosis’ or ‘hyperthyroidism’. The mean duration between radioiodine and the first thyroid function test was 1.8 months, in accordance with the 6 weeks recommended by the Guideline.

In conclusion, this audit shows good compliance with the published Guidelines, a cure rate of 80% after 1 dose of radioiodine and a hypothyroid rate of 50% by 18 months.