Outcome of 3 forms of therapy for diffuse toxic goiter in an area of iodine deficiency

ABSTRACT

In order to evaluate the long-term effects of antithyroids and ablative therapy on patients with diffuse toxic goiter [TDG] in an iodine deficient region, 206 patients were studied in Tehran. Hyperthyroidism recurred in 50% of 80 patients treated with methimazole [MMI], from one week to 48 months after cessation of therapy. Another 40 patients remained in remission. Of 102 patients treated with radioactive iodine [RAI], 45% became hypothyroid, 49% were euthyroid and 6% had relapse. The rate of hypothyroidism was 58% and that of relapse was 17% in 24 patients who underwent subtotal thyroidectomy. By the end of 4 years of follow-up, 50% treated with antithyroids, 51% given RAI and 25% of patients who had surgery have remained euthyroid. This study demonstrates good rate of remission after antithyroid therapy and high rate of hypothyroidism following thyroidectomy for patients with TDG in an area of iodine deficiency