Induction of Myxedema by Iodide in Patients Euthyroid after Radioiodine or Surgical Treatment of Diffuse Toxic Goiter
Abstract
In all 10 patients with diffuse toxic goiter of Graves disease rendered euthyroid by radioiodine six months to six years earlier, myxedema (as evidenced by typical signs and symptoms, rises in serum TSH and cholesterol concentrations and decrease in serum thyroxine into the hypothyroid range) developed after small, pharmacologic doses of iodide. Of seven similar patients who had been treated surgically, frank hypothyroidism developed in two, one remained entirely unchanged, and the remaining four displayed slight abnormalities in serum thyroxine or TSH concentrations without overt hypothyroidism. The thyroid gland in Graves disease appears to be inherently susceptible to the induction of iodide myxedema, and such susceptibility may be enhanced or its demonstration facilitated by radioiodine treatment.
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The inhibitory effects of iodine are greater in patients with a prior history of RAI exposure, suggesting a role for KI in patients who remain hyperthyroid after one dose of RAI and prefer to avoid a second dose.
“The inhibitory effects of iodine are greater in patients with a prior history of RAI exposure (245) suggesting a role for KI in patients who remain hyperthyroid after one dose of RAI and prefer to avoid a second dose.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [245]
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“The inhibitory effects of iodine are greater in patients with a prior history of RAI exposure (245) suggesting a role for KI in patients who remain hyperthyroid after one dose of RAI and prefer to avoid a second dose.”
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- Authors
- Braverman, L. E., Woeber, K. A., & Ingbar, S. H.
- ORCID
- Braverman, Lewis E.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1969-10-09
- Volume
- 281
- Issue
- 15
- Pages
- 816-821
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2323639046
- Cited by
- 126
- References
- 23
- Citations by year
- 2024: 1 · 2022: 2 · 2021: 2 · 2020: 1 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 6.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- iodide, Graves' disease, radioiodine therapy, thyroidectomy, hypothyroidism, serum thyroxine, thyroid-stimulating hormone, serum cholesterol
- MeSH terms
- Cholesterol, Female, Graves Disease, Humans, Hypothyroidism, Iodides, Iodine Isotopes, Male, Myxedema, Potassium Iodide, Thyroid Gland, Thyroid Hormones, Thyrotropin, Thyroxine, Thyroxine-Binding Proteins
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