High-Dose Iodine 131 Treatment of Hyperthyroidism: Experience at King Faisal Specialist Hospital and Research Centre

Abstract

We have treated 186 Saudi patients (110 females, 76 males) with hyperthyroidism in the last 10 years. Case records of 100 patients were randomly selected for review. The female:male ratio was 1.4:1. The thyroid gland was diffusely enlarged in 46%, small, nodular, or gritty in 46%, and impalpable in 8%. Thyroid scanning revealed diffuse isotope uptake in 40% and patchy uptake in 60%. Ablative doses of 10 or 15 mCi of iodine 131 were given to 78 patients. The patients who became hypothyroid have been followed for a median of 18 months. Of these, 37% were hypothyroid at 3 months, 58% at 6 months, 63% at 9 months, and 68% at 12 months. The clinical presentation of hyperthyroidism appears to differ in Saudi Arabia compared with Western countries. The female:male ratio is significantly lower (P < 0.001), and classical Graves' disease less frequent. In large countries where follow-up may be difficult, ablative radioiodine treatment and subsequent thyroxine replacement have advantages over other treatments.

Thyrotoxicosis: Experience from the King Khalid University Hospital, Riyadh

“…5,6 The finding of a marginal female preponderance in this study is striking and probably the lowest quoted in the world literature. [7][8][9] This confirms the observation noted by Johansen et al 10 Of the causes of thyrotoxicosis, Graves' disease was found to be the commonest. The incidence of ophthalmopathy was lower than in other series.…”

Clinical Presentation of Spontaneous Primary Hypothyroidism in Adults

“…1 The severity ranges from subclinical to the clinically overt 2 and the estimated prevalence of spontaneous overt hypothyroidism in community-based studies is 2 to 4/1000 total population worldwide. 3 There has been a paucity of data on primary hypothyroidism in Saudi Arabia [4][5][6] and its prevalence in the Kingdom is not known. This study was undertaken to provide information about its prevalence and clinical features with emphasis on clinical presentation at the time of diagnosis.…”

Comparison Between the Treatment Modalities for Graves' Disease at King Abdulaziz Medical City, Jeddah

“…Thirty-seven percent developed hypothyroidism post RAI [8]. At King Faisal Specialist Hospital and Research Center in Riyadh, 78% were treated with RAI ablation, 73% became hypothyroid during the observation period of three months to eight years (median, 1.5 years) [10].…”