DIAGNOSIS AND RADIOABLATION TREATMENT OF TOXIC MULTINODULAR GOITER INA HEMODIALYSIS PATIENT

Toxic multinodular goiter is rare in hemodialysis patients. In additio n, establishing the diagnosis of hyperthyroidism in the elderly patien t with renal failure is difficult because abnormal thyroid function te sts can erroneously be attributed to euthyroid sick syndrome, Treatmen t of hyperthyroidism in dialysis patients by radioiodine ablation invo lves careful calculation of I-131 dose, determination of interval betw een I-131 administration and its removal by hemodialysis, and minimiza tion of radiation hazards during dialytic removal of I-131. We describ ed the clinical presentation of an elderly dialysis patient with toxic multinodular goiter and discussed our diagnostic and therapeutic appr oaches, The patient's recovery therapeutic approaches. The patient's r ecovery after I-131 ablation was complete and uneventful. (C) 1998 by the National Kidney Foundation, Inc.