Acute radiation thyroiditis

Nishiyama, Kinji; Kozuka, Takenori; Higashihara, Tokurou; Miyauchi, Keisuke; Okagawa, Kazuhiro

doi:10.1016/s0360-3016(96)00480-4

Cited by 61 publications

(34 citation statements)

References 8 publications

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“…Several studies have addressed alterations in biochemical markers after external irradiation of the thyroid [15][16][17][18]. Nishiyama et al [15] reported that serum Tg and thyroid hormone levels were elevated due to cellular damage after incidental external irradiation to the thyroid.…”

Section: Discussionmentioning

confidence: 99%

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Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Jeong

Song

Park

et al. 2016

Nucl Med Mol Imaging

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Purpose Serum thyroglobulin (Tg) level is frequently elevated shortly after radioactive iodine (RAI) ablation therapy. The authors studied the relationship between the elevation of serum Tg after RAI therapy and iodine uptake pattern on postablation whole body scans (RxWBSs) in patients with papillary thyroid carcinoma (PTC). Materials and MethodsThe study subjects were patients with PTC that had undergone first RAI therapy with thyroid hormone withdrawal after total thyroidectomy. Patients with a high level of serum anti-Tg antibody (TgAb, ≥ 60 U/mL), possible regional or distant metastasis as determined by preablation or post-ablation studies, and negative iodine uptake of the anterior neck on RxWBS were excluded. Serum Tg was checked twice, that is, 7 days after (post-ablation Tg) and on the day of RAI therapy (pre-ablation Tg). Ratio of pre-ablation Tg to post-ablation Tg (Tg ratio) was used to assess changes in serum Tg levels after RAI therapy. Patients were classified into two groups according to the presence of midline uptake above the thyroidectomy bed on RxWBS (negative (group 1) or positive (group 2) midline uptake). Variables were subjected to analysis to identify differences between the two groups. Results Two hundred and fifty patients were enrolled in this study; 101 in group 1 and 149 in group 2. Based on univariate analysis, post-ablation Tg (8.12 ± 11.05 vs. 34.12 ± 54.31; P < 0.001) and Tg ratio (7.81 ± 8.98 vs. 20.01 ± 19.84; P < 0.001) were significantly higher in group 2. On the other hand, gender, tumor (T) stage, lymph node (N) stage, size, multiplicity or bilaterality of primary tumor, dose of 131 I, serum TgAb and thyroid-stimulating hormone (TSH) level (before or after RAI therapy) were not significantly different in the two groups. Variables with P values of < 0.25 by univariate analysis were subjected to multivariate analysis, which showed post-ablation Tg (OR 1.060, 95 % CI = 1.028-1.092; P < 0.001) and Tg ratio (OR 1.059, 95 % CI = 1.028-1.092; P = 0.001) were significantly higher in group 2. Conclusion Serum Tg level after RAI therapy was significantly higher in patients with midline uptake on RxWBS, compared with patients without midline uptake on RxWBS. Further investigations are needed to reveal the correlation between serum Tg elevation and clinical outcome according to the presence of midline uptake.

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Section: Discussionmentioning

confidence: 99%

“…Nishiyama et al [15] reported that serum Tg and thyroid hormone levels were elevated due to cellular damage after incidental external irradiation to the thyroid. Increased cellular membrane permeability and apoptosis after radiation exposure have been suggested to be the most important mechanisms responsible for those phenomena [16,17].…”

Section: Discussionmentioning

confidence: 99%

Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Jeong

Song

Park

et al. 2016

Nucl Med Mol Imaging

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“…This was in accordance with the study of Chicarelli et al (2007) who pointed out that irradiation affected the beginning of bone formation as well as acceleration of bone resorption in rats exposed to γ-radiation. However, several factors may be involved in the pathogenicity of osteoporosis after exposure to fractionated doses of γ-irradiation; as thyrotoxicosis (Nishiyama et al, 1996) which could be linked to osteoporosis (Lakatos, 2003). Additionally, Girinsky et al (1994) demonstrated that total body irradiation with a dose of 10 Gy induced a massive increase in levels of bone resorbing cytokines in blood accompanied by a dramatic increase in levels of adrenocorticotrophic hormone (ACTH) inducing an increase in serum cortisol that has adverse effects on bone metabolism.…”

Section: Discussionmentioning

confidence: 99%

Possible Role of Garlic Oil and Parsley Extract in Ameliorating Radiation-Induced Bone Loss in Female Rats

2011

Egypt. J. Rad.Sci.

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“…External-beam radiotherapy has been known to induce various thyroid disorders, such as primary hypothyroidism (3%-92%), Graves' disease (0.1%-2%), silent thyroiditis (0.6%-3%), Hashimoto's thyroiditis (0.7%-48%), Graves' ophthalmopathy (0.2%-1.3%), benign adenoma (0.6%-3%), and thyroid cancer (0.35%) [13][14][15][16]. External-beam radiation is known to promote the release of excessive thyroid hormones during treatment, thereby suppressing TSH via negative feedback ( Fig.…”

Section: Discussionmentioning

confidence: 99%

“…External-beam radiation is known to promote the release of excessive thyroid hormones during treatment, thereby suppressing TSH via negative feedback ( Fig. 2A) [16]. The etiology of radiationinduced acute injury to the thyroid includes autoimmune reactions, parenchymal cell damage, and vascular damage [13].…”

Section: Discussionmentioning

confidence: 99%

Thyroid Storm After Intensity-Modulated Radiation Therapy: A Case Report and Discussion

et al. 2009

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A 43-year-old man with locally advanced squamous cell carcinoma of the base of tongue was treated with induction chemotherapy followed by intensity-modulated radiation therapy (IMRT). Within 20 days posttreatment, the patient developed clinical symptoms highly suggestive of hyperthyroidism. Two and one half months after completion of therapy, the patient developed severe thyrotoxicosis, which, in retrospect, appears to have met the criteria for thyroid storm. This case history illustrates a previously unreported, lifethreatening complication of external-beam radiation that should be considered in patients receiving IMRT therapy involving the thyroid. Diagnosis of the patient's hyperthyroidism and probable thyroid storm was difficult to recognize because of the significant overlap between the signs and symptoms of severe thyrotoxicosis and the expected toxicities of his cancer therapy. The Oncologist 2009;14:233-239 CASE STUDYA 43-year-old nonsmoker with unremarkable past medical and family histories presented with an enlarging mass in his left neck. For one month he had noted fatigue and left otalgia, and had expectorated bright red blood when waking up. He had no weight loss, fevers, chills, dysphagia, or night sweats. Examination demonstrated a bilateral base of tongue mass extending onto the left tonsil; a biopsy revealed poorly differentiated squamous cell carcinoma. A positron emission tomography/computed tomography (CT) scan confirmed a left base of tongue and tonsil tumor, crossing midline toward the right measuring 2.4 ϫ 4.2 ϫ 3.6 cm, extending to the base of the epiglottis and pre-epiglottic space, and causing deviation of the airway toward the right.

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Acute radiation thyroiditis

Cited by 61 publications

References 8 publications

Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Iodine Uptake Patterns on Post-ablation Whole Body Scans are Related to Elevated Serum Thyroglobulin Levels After Radioactive Iodine Therapy in Patients with Papillary Thyroid Carcinoma

Possible Role of Garlic Oil and Parsley Extract in Ameliorating Radiation-Induced Bone Loss in Female Rats

Thyroid Storm After Intensity-Modulated Radiation Therapy: A Case Report and Discussion

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