Juvenile Hypothyroidism among Two Populations Exposed to Radioiodine

Goldsmith, John R.; Grossman, Charles M.; Morton, William E.; Nussbaum, Rudi H.; Kordysh, Ella; Quastel, Michael R.; Sobel, Richard; Nussbaum, Fred D.

doi:10.2307/3434598

Cited by 6 publications

(6 citation statements)

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“…Contrasting with the evident correlation between childhood radiation exposure and an increase in thyroid cancer incidence, the effects of radiation on thyroid status are less clear. Belarusian and Ukrainian cohort studies suggested that an increase in serum TSH levels was related to childhood exposure to 131 I [8,9], while other studies did not suggest any relationship [10,11]. In rodent models, an early study demonstrated that whole body or cervical X-irradiation could change serum thyroid hormone levels in adult rats [12].…”

Section: Discussionmentioning

confidence: 99%

Morphological and functional changes in neonatally X-irradiated thyroid gland in rats

2020

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Exposure to ionized radiation in childhood has been recognized as a risk factor for the development of thyroid cancer and possibly for other thyroid disorders. However, the effects of neonatal radiation exposure on thyroid morphology and functions have never been explored despite its potential importance. One-week-old male Wistar rats were subjected to cervical X-irradiation at 6 and 12 Gy. Animals were examined at the ages of 2, 8 and 18 weeks old. For comparison, 8-weekold rats were cervically X-irradiated at the same doses. Thyroid histology was examined by computer-assisted microscopy to measure areas of colloid and epithelium of thyroid follicles as well as epithelial heights. In rats that received cervical Xirradiation at 1 week old, the colloid size of thyroid follicles decreased at the age of 8 weeks old in a radiation-dose dependent manner. This morphological change was persistently found at 18 weeks old. There were no significant differences in serum total T3 or T4 levels among the groups. Serum TSH levels increased significantly in 8-week-old rats neonatally X-irradiated. Thyroglobulin (Tg) mRNA and protein expressions were significantly decreased in the neonatally-irradiated group while thyroid peroxidase mRNA express increased at 18 weeks old. None of these changes were observed in the rats X-irradiated at 8 weeks old. In conclusion, our results clearly demonstrated that neonatal rat thyroid was sensitive to ionized radiation, developing specific morphological changes characterized by smaller thyroid follicles along with changes in serum TSH levels and Tg expressions in the thyroid tissue. AN ASSOCIATION between childhood radiation and an increased risk of thyroid cancer has been well established. Early investigations of neoplasms in those who were treated with X-rays in infancy suggested that radiation exposure in childhood increases the risk of thyroid cancer [1]. A study in rats exposed to cervical Xirradiation showed that neonatal rats were more susceptible to developing thyroid cancer than adult animals [2]. Moreover, the rapid increase in childhood thyroid cancer after the Chernobyl nuclear plant accident clearly demonstrated the risk of radiation exposure in childhood and adolescence [3,4]. A cohort study of Japanese atomic bomb survivors also showed an excess thyroid cancer risk associated with childhood radiation exposure [5]. It has been suggested that a high mitotic rate of thyroid fol-

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Section: Discussionmentioning

confidence: 99%

Morphological and functional changes in neonatally X-irradiated thyroid gland in rats

2020

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“…Although hypothyroidism is inevitable after total thyroidectomy for malignancy or Graves' disease, hypothyroidism can also occur after lobectomy or a Sistrunk procedure for benign thyroid nodules or thyroglossal duct remnant [27,28]. External beam radiotherapy for head and neck malignancy, radioactive iodine therapy for thyrotoxicosis, environmental radioiodine exposure, and experimental use of radioiodinated immunoglobulins for cancer treatment all have hypothyroidism as a complication [16,[29][30][31]. Exposure to other toxins, including rescorcinol and polybrominated and polychlorinated biphenyls, has also been reported to cause hypothyroidism.…”

Section: Acquired Primary Hypothyroidismmentioning

confidence: 99%

Hypothyroidism After a Cancer Diagnosis: Etiology, Diagnosis, Complications, and Management

2013

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Hypothyroidism is a common disease that is easily treated in the majority of cases, when readily diagnosed; however, presentation of an aggregate of its symptoms is often clinically overlooked or attributed to another disease and can potentially be lethal. Already prevalent in older women, its occurrence in younger patients is rising as a result of radiation therapy, radioactive iodine therapy, and newer antineoplastic agents used to manage various malignancies. The presence of nonspecific constitutional symptoms and neuropsychiatric complaints in cancer patients can be attributed to a myriad of other diagnoses and therapies. Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer's clinical picture, particularly in the pediatric population. Underdiagnosis can have important consequences for the management of both hypothyroidism and the malignancy. At minimum, quality of life is adversely affected. Untreated hypothyroidism can lead to heart failure, psychosis, and coma and can reduce the effectiveness of potentially life-saving cancer therapies, whereas iatrogenic causes can provoke atrial fibrillation and osteoporosis. Consequently, the diagnosis and treatment of hypothyroidism in cancer patients are pertinent. We summarize the history, epidemiology, pathophysiology, clinical diagnosis, and management of hypothyroidism in cancer patients. The Oncologist 2014;19:34-43Implications for Practice: Clinicians should be aware of the role that hypothyroidism can play in the diagnosis, treatment, and recovery of cancer. Because the myriad of symptoms associated with hypothyroidism can easily be attributed to the initial malignancy, to chemotherapy or radiation therapy, or to cancer recurrence, it is easy to miss the diagnosis of hypothyroidism. Timely diagnosis and treatment is necessary to minimize the complications of hypothyroidism, to optimize cancer therapy, and to minimize recurrence.We highlight newer therapies associated with hypothyroidism and the negative impact that hypothyroidism can have in patients with a malignancy.

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“…In contrast, 131 I is a volatile short-lived isotope with a t 1/2 of $8.02 days, which needs to be captured immediately aer being released, as it tends to accumulate and become concentrated in the thyroid gland, which seriously affects human metabolic processes. [9][10][11][12][13][14][15] In addition, radioactive iodine is likely to form organic compounds such as methyl iodide (CH 3 I) with hydrocarbons and other volatile organic compounds present in the gas stream. Therefore, there is a strong interest in the nuclear energy community to develop alternative and effective means of capturing and storing these radionuclides.…”

Section: Introductionmentioning

confidence: 99%