Influence of Iodine-131 Dose on the Outcome of Hyperthyroidism in Children
Abstract
Objectives. Iodine-131 is an effective treatment for Graves’ hyperthyroidism in children and adults. Yet the responses to treatment as related to iodine-131 dose in children are not well-defined. The objective of this study was to examine the relationship between the dose of iodine-131 in children with hyperthyroidism and thyroid status 1 year after treatment. Methods. We examined the outcome of iodine-131 treatment in children and adolescents with Graves’ disease, as related to dose. Three iodine-131 doses were compared: 72 to 108 Gy (80–120 μCi/g), 180 to 225 Gy (200–250 μCi/g), and 270 to 364 Gy (300–405 μCi/g) in 31 patients ranging in age from 7 to 18 years old. Thyroid status was assessed >1 year after therapy. Results. We found that doses of 100 Gy (110 μCi/g), 200 Gy (220 μCi/g), and 300 Gy (330 μCi/g) resulted in hypothyroidism in 50%, 70%, and 95% of treated individuals, respectively. These data show that to insure ablation of thyroid tissue doses, >270 Gy (300 μCi/g) is needed, especially when the thyroid is large.
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When RAI activities >150 μCi/g (>5.55 MBq/g) are administered, hypothyroidism rates are about 95%.
“When RAI activities >150 lCi/g (>5.55 MBq/g) are administered, hypothyroidism rates are about 95% (88,339,349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [349]
With large glands (50-80 g), RAI activities of 131I 200-300 μCi/g (7.4-11.1 MBq/g) may be needed.
“With large glands (50-80 g), RAI activities of 131 I 200-300 lCi/g (7.4-11.1 MBq/g) may be needed (349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [349]
Physicians at some centers administer a fixed dose of about 15 mCi RAI to all children, whereas others calculate the activity from estimation or direct measurement of gland size and 123I uptake.
“Physicians at some centers administer a fixed dose of about 15 mCi RAI to all children (350), whereas others calculate the activity from estimation or direct measurement of gland size and 123 I uptake (349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [349]
Hypothyroidism typically develops by 2-3 months posttreatment.
“Hypothyroidism typically develops by 2-3 months posttreatment (333,349,350), at which time levothyroxine should be prescribed.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [349]
Fewer than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24-48 hours.
“Fewer than 10% of children complain of mild tenderness over the thyroid in the first week after therapy; it can be treated effectively with acetaminophen or nonsteroidal anti-inflammatory agents for 24-48 hours (310,349).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [349]
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References 35 · Cited by 88
- Authors
- Rivkees, S. A., & Cornelius, E. A.
- Affiliations
- Yale University (US)
- ORCID
- Rivkees, Scott A.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2003-04-01
- Volume
- 111
- Issue
- 4
- Pages
- 745-749
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2035898842
- Cited by
- 88
- References
- 35
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 5 · 2012: 7
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (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 › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- iodine-131, Graves' disease, pediatric hyperthyroidism, radioiodine dose, dose-response relationship, hypothyroidism, thyroid ablation, thyroid size, treatment outcomes
- MeSH terms
- Adolescent, Adult, Child, Dose-Response Relationship, Radiation, Female, Follow-Up Studies, Graves Disease, Humans, Hyperthyroidism, Hypothyroidism, Iodine Radioisotopes, Male, Radiotherapy Dosage, Thyroid Gland, Treatment Outcome
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