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Time course of Graves ’ orbitopathy after total thyroidectomy and radioiodine therapy for thyroid cancer

View Article: PubMed Central - PubMed

ABSTRACT

The risk of cancer is relatively higher in Graves’ patients presenting simultaneously with thyroid nodules. Radioiodine (RAI) therapy recommended in high-risk differentiated thyroid carcinoma may be associated with worsening of a pre-existing Graves’ orbitopathy (GO) or developing a new onset. The impact of RAI therapy in patients with differentiated thyroid cancer on the course of a pre-exisiting GO has not been specifically investigated.

The aim of this study is to assess the influence of RAI treatment administered for differentiated thyroid cancer on the course of a pre-existing GO.

This is a retrospective multicenter study including 35 patients from the University Hospital of Clermont-Ferrand (7 patients) and Lyon-Est (6 patients) in France and from a literature review published as case reports or studies (22 patients).

Seven patients exhibited a worsened pre-existing GO after total thyroidectomy followed by RAI treatment for thyroid cancer. Older men, those who initially presented with a lower clinical score of GO before RAI therapy, received higher doses of 131I especially when prepared with recombinant thyroid-stimulating hormone, and/or not prepared with glucocorticoids during RAI are at a higher risk to worsen their GO.

This study is the first and complete study collection. We describe worsening of GO in 20% of patients after RAI treatment for thyroid cancer and determine a pool of predictive factors.

No MeSH data available.


Flowchart of searched articles and case reports.
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Figure 1: Flowchart of searched articles and case reports.

Mentions: Seven patients with GO, treated both by thyroidectomy and RAI for incidental thyroid carcinoma, were included from the University Hospital of Clermont-Ferrand. Six cases came from the University Hospital of Lyon-Est. The number of cases with previously published data that met the inclusion criteria for this study was 22. They are from a case report series with 3 patients,[19] a clinical trial with 17 cases published by De Bellis et al,[20] and from 2 case reports.[21,22] Finally, 35 patients were included for analysis (Fig. 1).


Time course of Graves ’ orbitopathy after total thyroidectomy and radioiodine therapy for thyroid cancer
Flowchart of searched articles and case reports.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134772&req=5

Figure 1: Flowchart of searched articles and case reports.
Mentions: Seven patients with GO, treated both by thyroidectomy and RAI for incidental thyroid carcinoma, were included from the University Hospital of Clermont-Ferrand. Six cases came from the University Hospital of Lyon-Est. The number of cases with previously published data that met the inclusion criteria for this study was 22. They are from a case report series with 3 patients,[19] a clinical trial with 17 cases published by De Bellis et al,[20] and from 2 case reports.[21,22] Finally, 35 patients were included for analysis (Fig. 1).

View Article: PubMed Central - PubMed

ABSTRACT

The risk of cancer is relatively higher in Graves’ patients presenting simultaneously with thyroid nodules. Radioiodine (RAI) therapy recommended in high-risk differentiated thyroid carcinoma may be associated with worsening of a pre-existing Graves’ orbitopathy (GO) or developing a new onset. The impact of RAI therapy in patients with differentiated thyroid cancer on the course of a pre-exisiting GO has not been specifically investigated.

The aim of this study is to assess the influence of RAI treatment administered for differentiated thyroid cancer on the course of a pre-existing GO.

This is a retrospective multicenter study including 35 patients from the University Hospital of Clermont-Ferrand (7 patients) and Lyon-Est (6 patients) in France and from a literature review published as case reports or studies (22 patients).

Seven patients exhibited a worsened pre-existing GO after total thyroidectomy followed by RAI treatment for thyroid cancer. Older men, those who initially presented with a lower clinical score of GO before RAI therapy, received higher doses of 131I especially when prepared with recombinant thyroid-stimulating hormone, and/or not prepared with glucocorticoids during RAI are at a higher risk to worsen their GO.

This study is the first and complete study collection. We describe worsening of GO in 20% of patients after RAI treatment for thyroid cancer and determine a pool of predictive factors.

No MeSH data available.