A 36-Year Retrospective Analysis of the Efficacy and Safety of Radioactive Iodine in Treating Young Graves’ Patients
Abstract
This report details the 26- and 36-yr outcomes of 116 patients under the age of 20 yr with Graves' disease who were treated with radioiodine between 1953 and 1973. Contacted by telephone and mail in 1991-1992, 107 of them supplied personal historical data, and their physicians furnished interval histories, physical examinations, and laboratory data. This was repeated in 2001-2002, with 98 of them being contacted. At the time of treatment, the patients' ages ranged between 3 yr, 7 months and 19 yr, 9 months. Six were less than 6 yr of age, 11 were between 6 and 11 yr, 45 were between 11 and 15 yr, and 45 were between 16 and 19 yr. The average length of follow-up in 1991-1992 was 26.1 yr; that in 2001-2002 was 36.2 yr. None of the patients developed cancer of the thyroid or leukemia. Early on, when the objective of treatment was euthyroidism, the dose of radioiodine was low, and retreatment was frequently needed. Later, the doses used were increased. Over time, all but two patients became hypothyroid. Pregnancies did not result in an unusual number of congenital anomalies or spontaneous abortions. Treating young people with Graves' disease with radioiodine is safe and effective over the long term.
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Once a patient of either sex is euthyroid after RAI, there is no evidence of reduced fertility, and offspring of treated patients show no congenital anomalies compared to the population at large.
“However, once the patient (either sex) is euthyroid, there is no evidence of reduced fertility, and offspring of treated patients show no congenital anomalies compared to the population at large (100).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [100]
No patient developed thyroid cancer or leukemia.
“No patient developed thyroid cancer or leukemia.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [100]
The pediatric study with the longest follow-up reported 36-year outcomes of 116 patients treated with RAI between 1953 and 1973.
“The pediatric study with the longest follow-up reported 36year outcomes of 116 patients, treated with RAI between 1953 and1973 (100).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [100]
The patients ranged in age at treatment from 3 to 19 years.
“The patients ranged in age at treatment from 3 to 19 years.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [100]
There was no increase in the rate of spontaneous abortion or in the number of congenital anomalies in offspring.
“There was no increase in the rate of spontaneous abortion or in the number of congenital anomalies in offspring.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [100]
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References 25 · Cited by 204
- Authors
- Read, C. H., Tansey, M. J., & Menda, Y.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Read, Charles H.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-09
- Volume
- 89
- Issue
- 9
- Pages
- 4229-4233
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2109975681
- Cited by
- 204
- References
- 25
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 11 · 2020: 4 · 2019: 6 · 2018: 10 · 2017: 7 · 2016: 14 · 2015: 9 · 2014: 10 · 2013: 12 · 2012: 17
- FWCI
- 7.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (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
- Graves' disease, radioiodine therapy, pediatric thyroid disease, long-term outcomes, hypothyroidism, radioiodine dose, thyroid cancer, leukemia, pregnancy outcomes, congenital malformations, miscarriage, treatment safety
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Female, Follow-Up Studies, Graves Disease, Humans, Iodine Radioisotopes, Male, Pregnancy, Radiotherapy Dosage, Recurrence, Retrospective Studies
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