Einfluss der Radioiodtherapie auf Tg-, TPO- und TSH-Rezeptor-Antikörpertiter bei Patienten mit Schilddrüsenautonomie und Autoimmunthyreopathie und mögliche Konsequenzen für das Qualitätsmanagement der Klinik für Nuklearmedizin

The radioiodine therapy is a commenly used therapy in nuclear medicine. After the radioiodine therapy antibodies may change in quantity, therefor it is useful to check them. With the titres of these antibodies, it is possible to identify patients at risk to develope a autoimmune reaction such as Graves disease. Raised antibodies for TPO and Tg increase the risk for hypothyroidism. In the consequence to a radioiodine therapy, in 3,9% TRAK-antibodies appear an lead to autoimmune hyperthyroidism or Graves disease. If the TRAK-titre before the radioiodine therapy is detectable within the normal range but not zero, patients have a five-time higher risk than people with no detectable TRAK to suffur from autoimmune hyperthyroidism after the radioiodine therapy for thyroid adenoma. Because of these findings it is proposed to prescribe corticosteroids in advance to people with thyroid adenoma and detectable TRAK-titres who plan to undergo radioiodine therapy. This is thought to prevent the developement of autoimmune hyperthyroidism or Graves´ disease for these people at risk. Since the radioiodine therapy is commonly used, flowcharts were developed and the new findings were integraded.