SUCCESSFUL REDUCTION IN THYROID AND NODULE VOLUMES WITH SERIAL 131IODINE THERAPY IN LARGE MULTINODULAR NON-TOXIC GOITERS

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 437-470-Non-neoplastic Thyroid Disorders
Basic/Clinical
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-465
April Melody de la Torre Abcede* and Leilani Basa Mercado-Asis
University of Santo Tomas Hospital, Manila City, Philippines
SUCCESSFUL REDUCTION IN THYROID AND NODULE VOLUMES WITH SERIAL 131IODINE THERAPY IN LARGE MULTINODULAR NON-TOXIC GOITERS

April Melody T. Abcede, MD*; Sjoberg A. Kho, MD**; Bien J. Matawaran, MD**; Leilani B. Mercado-Asis, MD, PhD MPH**

*Fellow, Section of Endocrinology and Metabolism, University of Santo Tomas Hospital, Manila, Philippines

**Consultant, Section of Endocrinology and Metabolism, University of Santo Tomas Hospital, Manila, Philippines

Background:  Among inoperable patients with enlarged non-toxic multinodular goiter and those with refusal to surgery, in comparison with levothyroxine suppressive therapy, 131I is both safe and effective in goiter size reduction and offers improvement in compressive symptoms (dyspnea, dysphagia, choking sensation) in majority of patients.

Objectives: This study aims to show the successful reduction of thyroid and nodule volumes in large multinodular goiters using serial low dose 131Iodine therapy (10mci) at 3-6months interval.

Methodology: A retrospective analytical study was conducted. Records from 2010-2012 on eleven patients with enlarged multinodular (nodule/s ≥2cm) non-toxic goiter (females; age range 35-65 yrs.) given serial 131I therapy (8-10mci) at 3-6 months interval were reviewed.  Thyroid and nodule sizes were monitored by ultrasonographic measurements serially at baseline and subsequent 131I therapy.  Relief of compressive symptoms was monitored on follow-up at clinic.

Results: Reduction in thyroid size by 15-25% from the baseline and further by 14-18% after the 2nd RAI.  Significant nodule size reduction by 40-70% and 30-40% were noted serially. One subject underwent 3rd RAI with 80-85% overall reduction in nodule size.  Overall 50% increase in Levothyroxine replacement dose for post-RAI hypothyroidism after serial 131I therapy. Significant relief of compressive symptoms were noted in ninety-one percent of the population post therapy. Moreover, the disappearance of thyroid nodules resulted in reduced total number of thyroid nodules from 14 to 8 nodules post serial 131Iodine therapy.  Aesthetically, patients were satisfied with the results.

Conclusion: Serial 131I therapy proved to have goiter and nodular size reduction by more than 50% among patients with enlarged multinodular non-toxic goiter. Among patients who did not consent or have contraindications to surgery, serial 131I therapy may be considered a safe and better nonsurgical alternative.

Sia-Atanacio, Mercado-Asis L.  Radioactive Iodine Therapy is Effective in Diffuse and Nodular Non-Toxic Goiter.  Phil. J. Internal Medicine, Vol49 Apr-Jun 2011 Uy-Ho J, Mercado-Asis L.  Prevention of Recurrence of Diffuse and Nodular Non-toxic Goiter with Lifetime Physiologic Levothyroxine Maintenance Therapy.  Phil. J. Internal Medicine, 2009

Nothing to Disclose: AMDLTA, LBM

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm