Uticaj tretmana litijum karbonatom na ishod terapije radioaktivnim jodom kod grejsovog hipertiroidizma
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Crucial influence on the outcome of radioiodine therapy (RIT) in Graves’ hyperthyroidism (GH) has the effective half-life of 131I in the gland. The short-term treatment with Lithium carbonate (LiCO3) enhances the 131I half-life and increase the thyroid radiation dose. The aim of this study was to assess the efficacy of RIT combined with LiCO3 in patients with GH. This prospective study included 30 patients treated with 131I-NaI in combination with LiCO3 (RI-Li group), and 30 patients treated only with 131I-NaI (RI group). Treatment with LiCO3 (daily dose of 900 mg) was started one day before RIT and continued six days after. Results: In RI-Li group the serum level of Li was 0.571±0.156 μmol/l at RIT. Despite of significantly increased serum TT4 and FT4 levels, and decreased TSH level in RI group, there were no considerable changes in hormone levels in RI-Li group 7 days after treatment. The successful therapy outcome (euthyroidism or hypothyroidism) was registered in 73.3% of patients ...from RI and in 90.0% of patients from RI-Li group (p<0.01). Lithium treated patients were cured faster (27 of 30 patients were cured after one month) than those treated only with 131I (12 patients were cured after one and 22 patients after 12 months). The presence of euthyroidism gradually decreased while the presence of hypothyroidism increased in lithium-treated patients, and contrary to RI group not all cured patients were hypothyroid at the end of the study. There were no toxic effects of LiCO3 during 7 days treatment. Conclusions: Presented results showed beneficial influence of short-term treatment of LiCO3 on RIT outcome. Lithium-treated cured patients slowly achieved hypothyroidism in comparison to patients treated with 131I alone, and not all of them were hypothyroid after one year. Also, lithium prevented a significant increase of TT4 and FT4 in serum seven days after RIT.