Thyroid Storm in a Child following Radioactive Iodine (RAI) Therapy: A Consequence of RAI Versus Withdrawal of Antithyroid Medication
Abstract
A 7.5-yr-old boy with Graves’ disease, difficult to control with antithyroid medication and radioactive iodine (RAI) therapy, developed thyroid storm encephalopathy on day 13 after withdrawal of methimazole therapy, 4 days after iodione-131 treatment. We attributed his thyroid storm to withdrawal of antithyroid medication as opposed to RAI therapy. We interpret this case as indicating that there may be a need to reevaluate the duration of antithyroid medication withdrawal before RAI therapy for hyperthyroid children at increased risk for thyroid storm.
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There are rare reports of pediatric patients with severe hyperthyroidism who have developed thyroid storm after receiving RAI.
“Although the frequency of short-term worsening of hyperthyroidism following pretreatment with ATD therapy is not known, there are rare reports of pediatric patients with severe hyperthyroidism who have developed thyroid storm after receiving RAI (347,348).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [347]
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- Authors
- Kadmon, P. M., Noto, R. B., Boney, C. M., Goodwin, G., & Gruppuso, P. A.
- Affiliations
- Departments of Pediatrics (P.M.K., C.M.B., G.G., P.A.G.), Providence, Rhode Island 02903
- Brown University (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2001-05-01
- Volume
- 86
- Issue
- 5
- Pages
- 1865-1867
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2056419639
- Cited by
- 58
- References
- 14
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 2 · 2018: 1 · 2017: 2 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 2 · 2012: 3
- FWCI
- 2.07
- 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 › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- thyroid storm, Graves' disease, radioiodine therapy, methimazole, hyperthyroidism in children, iodine-131
- MeSH terms
- Child, Graves Disease, Humans, Iodine Radioisotopes, Male, Substance Withdrawal Syndrome, Antithyroid Agents, Thyroid Crisis
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