Endocrine Abstracts

Used for the first time in 1941 in the United States by Hertz and Roberts for the treatment of hyperthyroidism in Grave’s Disease, radioactive active therapy (RAI) has been able to gain its place within the already existing therapeutic arsenal by being efficient, easy to use and minimally invasive. Our work is a retrospective study of 46 patients collected at the Department of Endocrinology, over a period of 7 years and half from January 1, 2011 to June 30, 2018. The purpose of this study is to determine the place of radioiodine therapy in the treatment of Graves’ disease in our context, and to evaluate its results. We defined 2 groups of patients: An ‘A’ group corresponding to all 46 patients followed for Graves’ disease (the average age was 43 years and the sex ratio (F/M) was 0.84), including a subgroup ‘B’ corresponding to the 17 patients treated with RAI (the average age is 41 years and the sex ratio (F/M) was 1.12). All patients in group ‘A’ received first-line medical treatment, 37% of whom resorted to RAI because of either resistance to treatment in 70.6% of cases, relapse in 23.5% of cases, or serious side effects (severe leukoneutropenia and cholestatic hepatitis) caused by antithyroid drugs (ATD) which required an immediate interruption of the treatment in 5.9% of cases. Thirteen patients in group ‘B’ received a single dose of radioiodine (76.5%), 3 patients received 2 doses (17.6%) and only 1 patient received 3 doses of treatment (5.9%). The administered activities were between 8 and 15 mCi. The average activity administered in the first dose of treatment was 9.7 mCi (41.2% received 8 mCi, 52.9% received an activity between 10 and 12 mCi and 5.9% received an activity > 12 mCi). The average activity of the 2nd dose of treatment was 9.2 mCi. The additional doses were justified by either resistance to ATDs or persistence of hyperthyroidism. The administration of iodine was very well tolerated. Only one case of xerophthalmia and ocular pain was noted in the short term.

The long-term results were as follows:

− 29.4% benefited from a return to euthyroidism.

− 47.1% went into hypothyroidism.

− 23.5% are still hyperthyroid.

Overall, the treatment was successful in 76.5% of cases and failed in 23.5% of cases. Despite the limited number of patients and the short period we had in order to evaluate this therapy, the results seem encouraging.