Radioiodine therapy of Graves' disease

被引:12
作者
Piccardo, Arnoldo [1 ]
Ugolini, Martina [1 ]
Altrinetti, Vania [1 ]
Righi, Sergio [2 ]
Fiz, Francesco [3 ]
Foppiani, Luca [4 ]
Giovanella, Luca [5 ]
机构
[1] EO Osped Galliera, Dept Nucl Med, Mura Cappuccine 14, I-16128 Genoa, Italy
[2] EO Osped Galliera, Dept Med Phys, Genoa, Italy
[3] Humanitas Clin & Res Ctr, Milan, Italy
[4] EO Osped Galliera, Dept Internal Med, Genoa, Italy
[5] Imaging Inst Southern Switzerland, Clin Nucl Med & Mol Imaging, Bellinzona, Switzerland
关键词
Iodohippuric acid; Hyperthymidism; Therapeutics; Review; RADIOACTIVE IODINE THERAPY; I-131; THERAPY; HYPOTHYROIDISM; MANAGEMENT; LONG; PROPYLTHIOURACIL; OPHTHALMOPATHY; ORBITOPATHY; GUIDELINES; LITHIUM;
D O I
10.23736/S1824-4785.21.03337-9
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Graves' disease (GD), the most common cause of hyperthyroidism, is an autoimmune disease directly caused by circulating autoantibodies that bind and activate the TSH receptor, inducing metabolic activation of the thyroid gland; this may be associated with important cardiac (atrial fibrillation) and ocular (ophthalmopathy) complications. Treating GD with real curative intent implies the full elimination of the functioning thyroid parenchyma using surgery or radioactive iodine therapy (RAI). RAI has been used in humans with hyperthyroidism since 1941, thanks to the pioneering work of a physician (Dr. Saul Hertz) and a physicist (Dr. Arthur Roberts). The rationale of RAI is based on the effect of radiation of I-131 on target cells leading to DNA damage, both directly, through breakage of molecular bonds, and indirectly through the formation of free radicals. In particular, irradiation causes a broad spectrum of cellular damage due to the production of reactive oxygen species and lipid peroxidation of the plasma membrane. Thus, RAI-related cellular death takes place through both apoptosis and necrosis. The aim of this review was to summarize indications, efficacy, safety profile, and dosimetric aspects of RAI treatment in patients affected by GD.
引用
收藏
页码:132 / 137
页数:6
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