RADIOIODINE TREATMENT OF GRAVES-DISEASE IN YOUNG-PEOPLE

In Europe young patients with Graves' disease are usually treated with anti-thyroid drugs initially, then if hyperthyroidism recurs after a prolonged course of such medication, they are offered definitive treat ment by subtotal or total thyroidectomy. Neither nf these forms of tre atment is free from problems. thyroidectomy. Neither of these forms of treatment is free from problems. Impressed with the simplicity and sa fety record of radioiodine therapy, we have treated 8 young patients w ith radioiodine. The patients all presented with typical Graves' disea se and relapsed after 18-24 months of treatment with antithyroid drugs . They were then given the option of a further course of antithyroid m edication or definitive treatment with radioiodine or surgery. Those w ho opted for radioiodine were treated with (131)iodine in a dose of 30 0 MBq with the intention of ablating the thyroid. Antithyroid medicati on was resumed for 4-6 months and then withdrawn. Four patients became hypothyroid after a single dose of radioiodine but 4 needed a second dose. All became hypothyroid within 2 years. No adverse effects were o bserved, in particular no patient showed any deterioration in their ey e disease. Radioiodine offers a simple, effective and inexpensive meth od of treatment for Graves' disease in young patients. There are no im mediate adverse effects and, although some theoretical concerns remain , to date the long-term safety record of thyroid ablation is excellent and the potential risks seem to us to be outweighed by the advantages . Even when a moderately high initial dose of radioiodine is used, a s econd dose may be needed.