The effect of radioiodine treatment on the characteristics of TRAb in Graves’ disease

Fang, Yun; Wen, Du; Zhang, Cao-Xu; Zhao, Shuang‐Xia; Song, Hwangjun; Gao, Guan-Qi; Dong, Mei

doi:10.1186/s12902-021-00905-4

Cited by 7 publications

(5 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, we found that the TRAb levels increased 3 months after RIT, and slightly decreased (but not statistically significant) at 6 months, and significantly decreased at 12 months follow-up. The time course changes in TRAb in our study was largely consistent with that of Fang, which showed an increase of TRAb after 6 months and a decline after 12 months’ RAI [ 36 ].…”

Section: Discussionsupporting

confidence: 88%

Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves’ disease

Shao

Feng

et al. 2022

BMC Endocr Disord

View full text Add to dashboard Cite

Liver dysfunction is a common complication of Graves’ disease (GD) that may be caused by excessive thyroid hormone (TH) or anti-thyroid drugs (ATDs). Radioactive iodine (RAI) therapy is one of the first-line treatments for GD, but it is unclear whether it is safe and effective in patients with liver dysfunction. 510 consecutive patients with GD receiving first RAI were enrolled in the study, and followed up at 3-, 6- and 12-month. Liver dysfunction was recorded in 222 (43.5%) patients. GD patients with liver dysfunction had higher serum levels of free triiodothyronine (FT3) (median 27.6 vs. 20.6 pmol/L, p < 0.001) and free thyroxine (FT4) (median 65.4 vs. 53.5 pmol/L, p < 0.001) levels than those with normal liver function. Binary logistic regression analysis showed that duration of disease (OR = 0.951, 95% CI: 0.992–0.980, p = 0.001) and male gender (OR = 1.106, 95% CI: 1.116–2.384; p = 0.011) were significant differential factors for liver dysfunction. Serum TSH levels were higher in patients with liver dysfunction at all 3 follow-up time points (p = 0.014, 0.008, and 0.025 respectively). FT3 level was lower in patients with liver dysfunction at 3-month follow-up (p = 0.047), but the difference disappeared at 6 and 12 months (p = 0.351 and 0.264 respectively). The rate of euthyroidism or hypothyroidism was higher in patients with liver dysfunction than in those with normal liver function at 3 months (74.5% vs 62.5%; p = 0.005) and 6 months (82.1% vs 69.1%; p = 0.002) after RAI treatment, but the difference did not persist at 12-month follow-up (89.6% vs 83.2%, p = 0.081).There were no statistically significant differences in treatment efficacy (94.48% vs 90.31%, p = 0.142), incidence of early-onset hypothyroidism (87.73% vs 83.67%, p = 0.277), and recurrence rate (4.91% vs 7.14%, p = 0.379) between the 2 groups at 12-month follow-up. In conclusion, the efficacy of RAI was comparable in GD patients with liver dysfunction and those with normal liver function.

show abstract

Section: Discussionsupporting

confidence: 88%

Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves’ disease

Shao

Feng

et al. 2022

BMC Endocr Disord

View full text Add to dashboard Cite

show abstract

“…In patients with Graves’ hyperthyroidism, TPO Ab status is neither routinely evaluated during the diagnostic workup nor measured to guide management. Treatment with RAI is known to elicit an increase in thyroid antibodies for approximately 1 year, including TPO Ab, considered an immune response secondary to the release of thyroid antigens ( 12 , 13 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

Verdickt¹,

Nes²,

Moyson³

et al. 2022

European Thyroid Journal

View full text Add to dashboard Cite

Objective We investigated if a positive thyroid peroxidase antibody (TPO Ab) status before radioactive iodine (RAI) therapy in patients with Graves’ hyperthyroidism is a predictive factor for developing hypothyroidism post RAI. Methods We performed a retrospective study of patients with Graves’ hyperthyroidism with known TPO Ab status, receiving a first administration of RAI. Patients from 4 thyroid outpatient centres in Belgium receiving a first RAI therapy between the years 2011 and 2019 were studied. Clinical, laboratory, imaging, and treatment data were recorded from medical charts. Hypothyroidism and cure (defined as combined hypo- and euthyroidism) were evaluated in period 1 (≥2 and ≤9 months, closest to 6 months post RAI) and period 2 (>9 months and ≤ 24 months post RAI, closest to 12 months post RAI). Results One hundred fifty-two patients were included of which 105 (69%) were TPO Ab positive. Compared to TPO Ab negative patients, TPO Ab positive patients were younger, had a larger thyroid gland, and had more previous episodes of hyperthyroidism. In period 1, 89% of the TPO Ab positive group developed hypothyroidism versus 72% in the TPO Ab negative group (p=0.007). In period 2, the observation was similar: 88% vs. 72% (p=0.019). In the multivariate logistic regression analysis, a positive TPO Ab status was associated with hypothyroidism in period 2 (adjusted OR 4.78 (95% CI 1.27-20.18;p=0.024). In period 1, the aOR was 4.16 (95% CI 1.0-18.83; p=0.052). Conclusion A positive TPO Ab status in patients with Graves’ hyperthyroidism receiving a first administration of RAI is associated with a higher risk of early hypothyroidism.

show abstract

“…In relation to this matter, it is important to consider that levels of AbTg may increase or return to positive values within six months after receiving RAI treatment. This phenomenon is predominantly caused by the release of antigens from any remaining thyroid tissue and should not be automatically interpreted as a recurrence of cancer [54][55][56].…”

Section: Discussionmentioning

confidence: 99%

Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response

Donnici,

Mirabelli,

Giuliano

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Introduction: Differentiated thyroid carcinoma (DTC) is frequently found in conjunction with autoimmune thyroid disorders, particularly Hashimoto’s thyroiditis (HT). This study investigates the impact of coexisting HT on the persistence of an indeterminate response to therapy due to positive anti-thyroglobulin antibodies (AbTg), measured via competitive immunoassay, in a consecutive patient series from Calabria, Southern Italy. Methods: This retrospective longitudinal study analyzed 259 consecutive DTC patients managed at the Endocrinology Unit of Renato Dulbecco Hospital (Catanzaro, Italy) up to 2023. Patients with medullary and undifferentiated thyroid carcinoma, partial thyroidectomy, less than six months of post-operative monitoring, or missing clinical data were excluded. Demographic information, histological findings, initial tumor stage, and ATA risk category were collected. The response to therapy was assessed based on ATA guidelines. Results: Among the 259 patients, 29% had coexisting HT. Patients with HT exhibited distinct characteristics: a higher proportion of females (87.0% vs. 74.7%), a shorter post-operative monitoring duration (median 3 vs. 5 years), and a higher prevalence of papillary thyroid carcinoma (PTC) (97.4% vs. 86.3%). The tumor size, lymph node involvement, and distant metastasis were similar between the groups, with patients without HT having a higher incidence of extrathyroidal tumor extension. However, the initial TNM stage and ATA risk category did not differ significantly. At the six-month follow-up, HT patients showed a higher rate of indeterminate responses, primarily due to positive AbTg. After 12 months, the response categories aligned, with decreasing AbTg levels in the HT group. After 24 months, most patients with long-term follow-up demonstrated an excellent response to DTC therapy, irrespective of HT coexistence. Conclusions: While HT does not worsen DTC prognosis, it may result in indeterminate responses. AbTg measurements in the peri-operative period should be encouraged to facilitate post-operative monitoring, emphasizing the importance of using standardized assays. Further research in larger populations with extended follow-up is needed to comprehensively understand the HT-DTC relationship.

show abstract

The effect of radioiodine treatment on the characteristics of TRAb in Graves’ disease

Cited by 7 publications

References 38 publications

Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves’ disease

Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves’ disease

TPO antibody status prior to first radioactive iodine therapy as a predictive parameter for hypothyroidism in Graves’ disease

Coexistence of Hashimoto’s Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response

Contact Info

Product

Resources

About