Endocrine Abstracts

Radioactive iodine therapy (RAI) is a treatment method used to in cases of Graves’ disease(GD), toxic multinodular guatr and solitary toxic nodüle and residual tissue after thyroidectomy or in the treatment of metastases capable of capturing iodine. The biological basis of the treatment is the inhibition of follicle cell functions. Side effects such as thyroid swelling, radiation thyroiditis and sialadenitis are rare. Radiation thyroiditis tends to occur within two weeks after RAI administration and is generally asymptomatic in most patients. Approximately % 1-5 of patients with GD develop radiation thyroiditis after RAI treatment. Radiation causes ınflammation that develops as a result of exposure of a large residual tissue to a high radiation dose may cause tenderness in the thyroid tissue or neck, erythema and edema, pain when swallowing, rarely airway obstruction, and in some patients, a thyrotoxic state. Symptoms generally begin 1-10 days after treatment. Pain and tenderness in the thyroid and neck area are mild and disappear within 3-7 days. There may be a temporary hyperthyroidism attack at this time. Mild symptoms are usually relieved with non-steroidal anti-inflammatory drugs. In more severe cases, corticosteroid treatment (30 mg/day prednisone) provides rapid relief of symptoms. In case of thyroid storm, symptoms can be controlled with corticosteroids, if severe adrenergic symptoms are accompanied by beta blockers and if necessary antithyroid drugs. Here we will present a case of radiation tyroditis developing after Graves Diseaes(GD). A 71-year-old patient with a diagnosis of Graves’ disease was treated with 20 mcı radioactive iodine due to elevated liver function tests under antithyroid drug therapy. 1 week after radioactive iodine treatment, she was admitted to our outpatient clinic with complaints of pain in the throat and difficulty swallowing. Thyrotoxicosis was detected in the tests. Oral cavity looked natural and sensivity was detected in the neck area. No respiratory distress was detected. Newyl developed tracheal stenosis was detected on the cervical graphy. Color doppler pattern 3 and edema in the thyroid gland was detected on the ultrasonography. The patient ‘s complaıns were primarily evaluated as thyroiditis secondary to radıoactive iodine treatment. The patient was started on oral methylprednisolone sodıum succinate, non-steroidal anti-inflamatory and betablocker treatment. The patient’s complaints regressed under treatment. In conclusion, radiation thyroiditis is a complication of RAI for the treatment of GD and may cause morbidity. Radiation thyroiditis should be suspected as the etiology of patients presenting with neck pain and difficulty swallowing immediately after RAI.