Graves' disease induced by (NaI)-I-131 therapy for toxic multinodular goitre

A 59-year-old woman developed manifestations of Graves' disease several mon ths after treatment with radioiodine ((NaI)-I-131) for toxic multinodular g oitre. During subsequent treatment with additional radioiodine therapy Grav es' ophthalmopathy developed which was severe and required treatment with p rednisone and orbital radiotherapy. The literature on development of Graves ' disease following (NaI)-I-131 therapy is reviewed and possible pathophysi ological mechanisms are discussed. In this case, possibly the first radioio dine therapy has illicited Graves' thyrotoxicosis and the subsequently adde d radioiodine treatments for the persistent Graves' thyrotoxicosis led to s erious ophthalmopathy. Physicians should recognise Graves'-like disease as a complication of (NaI)-I-131 therapy for toxic multinodular goitre and car efully consider the timing of consecutive radioiodine therapy. (C) 2000 Els evier Science BN. All rights reserved.