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Late Results of I^–131 Treatment of Hyperthyroidism in Seventy-three Children and Adolescents^1,2,3,

Los Angeles

ABSTRACT

Seventy-three children and adolescents ranging in age from 28 months to 18 years were treated with radioiodine for hyperthyroidism.

Hypothyroidism is known to have developed some time after therapy in 43 of the 71 living cases, and only 12 others maintained normal thyroid capacity without exogenous thyroid hormone.

A nodule was found after therapy in five cases; one girl, on whom a subtotal thyroidectomy was performed before the first isotope therapy was completed, was found to have a "hot" nodule seven and one half years post-surgery; a second dose of 10 McI¹³¹ was given, with regression of the nodule and thyrotoxicosis. A nodule, in case #39, remaining after shrinkage of a large gland by I¹³¹ treatment was diagnosed at the time of surgery 2 years and 3 months after isotope administration as papillary adenocarcinoma. It has not recurred in the 5 years since this surgery.

Neither of the two deaths which occurred in less than one year after treatment is attributable to the I¹³¹ therapy. Three children were subjected to subtotal thyroidectomy after incomplete I¹³¹ treatment; one of these died of surgical shock.

Hyperthyroidism was controlled in all the cases adequately treated, even though repeated administration was required in some cases.

The growth and development of these patients, particularly those less than 11 years of age, has been normal.

A total of 31 healthy normal children have been born to 20 of the adolescents reported in this series. No abnormal children have been produced, although one pregnancy (of the wife of one of our patients) if completed, would have resulted in Siamese twins.

There were no deaths attributable to the I¹³¹ treatment of hyperthyroidism; nor is there any evidence of parathyroid gland deficiency, laryngeal cord paralysis, or blood dyscrasia, and there is no case, including the malignant nodule found in case #39, of thyroid cancer that is attributable to this internal radiation therapy.

FOOTNOTES

¹ From the Los Angeles County Hospital; Department of Medicine, University of Southern California; The Children's Hospital, and Division of Radiation Therapy, Cedars of Lebanon Hospital. With the cooperation of Robert Freeman, M.D.; and Norman Specht, M.D., White Memorial Hospital, Los Angeles. With the assistance of Mrs. Ruth M. Bourke.

² Supported by The American Cancer Society, Grant #E-152.

³ Presented at the American Thyroid Association, May, 1961.

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