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    Uso do radioiodo na Doença de Graves: fatores preditores de resposta terapêutica e impacto sobre os anticorpos estimuladores anti-receptor de TSH (TSI)
    (Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Fiorin, Lia Borges [UNIFESP]; Martins, Joao Roberto Maciel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Graves’ disease is characterized by the presence of thyroid-stimulating hormone receptor autoantibodies (TRAb). The treatment of GD with 131I is efficacious; however, the patient responses are variable. Objectives: To evaluate specific factors that may interfere with the response and progression of autoimmunity after treatment. Methods: A total of 40 patients, who were treated with 131I, were continuously assessed before and after the dose of 131I, and their clinical and laboratory parameters were evaluated. Results: The patients were divided according to the outcome of treatment: Group I (87.5%) comprised the patients who achieved a control of hyperthyroidism after treatment, and Group II (12.5%) were the patients who remained hyperthyroid after the treatment. The groups did not exhibit a significant difference regarding the age, 131I dose, initial ATG, initial TRAb, and urinary iodine. However, males were more abundant in Group II, the thyroid volume and the initial concentrations of FT4 and T3T were significantly higher in Group II. The patients in Group I exhibited a significant increase in TRAb beginning in the third month, whereas the TRAb concentration at six months was significantly higher in Group II [40IU/L (30,03-40)] compared to Group I [19.72 IU/L (1,45- 40)] Conclusions: Patients with a large goiter, who were male, or who had higher levels of thyroid hormones responded less to 131I. The TRAb level was higher at six months in the patients who did not respond to 131I, and thus, TRAb is considered a marker of persistent hyperthyroidism.