Revisões, Atualizações e Artigos Originais February 01, 2004 February 01, 2004

Radioactive iodine therapy in Graves’ hyperthyroidism

DOI: 10.1590/S0004-27302004000100017

Graves’ disease is the most frequent cause of hyperthyroidism. Clinical thyrotoxicosis is directly caused by autoantibodies that activate the TSH receptor. The etiology is multifactorial, with genetic and nongenetic factors involveld. Current treatment options are antithyroid drugs (ATD), radioiodine (¹³¹I) and surgery. Radioactive iodine is increasingly being used as definitive therapy, because it long has proven to be a safe, nonexpensive and effective treatment. Recent publications have discussed the use of ¹³¹I associated with ATD as well as the identification of predictors of treatment failure, which are discussed in this review. Antityhyroid drugs are still the first choice therapy in patients with mild disease, small goiters, children, adolescents, and in pregnancy. Surgery is now rarely performed. It is indicated only in cases where ATD have not been effective and radioiodine is contraindicated or not acceptable by the patients.