ECE2020 ePoster Presentations Thyroid (122 abstracts)
Risk factors in graves’ disease recurrence after treatment with radioactive iodine
Joana Reis Guiomar 1 , Luís Lemos 2 , Carolina Moreno 1 , Diana Catarino 1 , Lúcia Fadiga 1 , Diana Silva 1 , Inês Vieira 1 , Mariana Lavrador 1 , Gracinda Costa 2 & Isabel Paiva 1
1Coimbra Hospital and University Center, EPE., Endocrinology, Diabetes and Metabolism Department, Coimbra, Portugal; 2Coimbra Hospital and University Center, EPE., Nuclear Medicine Department
Introduction: Radioactive iodine (131I) therapy is a safe and cost-effective choice in Graves’ disease (GD). Usually only one treatment with 131I is sufficient, however, individual characteristics of the disease can lead to its recurrence. The aim of this study is to determinate the risk factors that influence the recurrence of GD after 131I.
Materials and methods: Retrospective cohort study in 528 patients with GD who did 131I therapy between January/2003 and May/2019. From this sample, 78 relapsed after the first therapy with 131I (cases). 78 patients with therapeutic success (-euthyroidism/hypothyroidism 36 months after 131I) were randomly selected, adjusted for age and sex (controls). Statistical analysis in SPSSv.23, with the variables: disease progression, family history of thyroid disease, thyroid function tests, antithyroid antibodies, previous therapy with antithyroid treatment, 131I uptake at 24 h (RAIU-24 h), functioning parenchyma mass and administered activity.
Results: A total of 528 patients were enrolled, out of which 82% (n = 433) were female and 9% (n = 95) were males, with an average age of 44 ± 12 years. The recurrence rate was 14.8%(n = 78), on average 11 ± 9 months after the first treatment. With regards to previous therapy, propylthiouracil (PTU) compared to thiamazole, was used more often in patients with recurrence (31.4% vs 6.5%; P < 0.01), with an odds ratio of 6.67 (95% CI: 2.14–20.41). Recurrent patients had significantly higher T3l (14.9 ± 10.5 vs 8.9 ± 6.3; P = 0.001), TPO Ab (1107 ± 1505 vs 549 ± 666; P = 0.04), RAIU-24 h (65 ± 11 vs 61 ± 12; P = 0.02) and functioning parenchyma mass (75 ± 30 vs 48 ± 19; P < 0.01). There was a tendency to prolonged illness in recurrent patients (months) (32 ± 10 vs 24 ± 8; P = 0.064), but without statistical significance. There were no difference between: family history of thyroid disease, TRABs and administered activity.
Conclusion: In this study, the recurrence rate of GD submitted to therapy with 131I was 14.8%, on average one year after the first treatment. The recurrence is significantly associated with higher: T3l, TPO Ab, functioning parenchyma mass and RAIU-24h. Previous therapy with PTU was associated with a significant increased risk of recurrence. The longer the duration of the disease, the greater the tendency for recurring disease.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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