Aims and objectives
Graves’ disease (GD) is an autoimmune,
diffuse,
chronic pathology of the thyroid gland,
firstdescribed by Robert Graves in 1835 [1].
It presents genetic predisposition and unknown etiology evidence,
which is influenced in its development by several factors,
including environment (dietary iodine intake,
stress,
drugs and infections).
The disease is characterized by one or more changes: hyperthyroidism,
goiter,
ophthalmopathy,
skin changes and pretibial myxedema,
around 5% less common,
and other symptoms 90 to 95%.
GD,
the T lymphocytes become sensitive to antigens presented in thyroid gland,...
Methods and materials
Fifty patients with Graves' disease were consecutively selected,
of both gender,
with no age distinction,
with positive clinical and laboratorial findings of the disease and no prior radioiodine therapy.
This prospective study was conducted with IRB approval,
after written informed consent be obtained from all participants.
An ultrasonography evaluation of the thyroid gland was performed before and after 131I therapy (1,
3 and 6 months).
The following aspects were evaluated: thyroid volume and parenchyma echogenicity,
echotexture and vascularization.
A systolic peak velocity for the inferior...
Results
A progressivereductionin the average volume of the thyroid gland was observed from pre to post treatment evaluations,
performed at 1,
3 and 6 months after radioiodo therapy (p < 0.05).
The meanpre-treatment thyroid volume was 34.8 cm3and 1 month after treatment was 24.5 cm3,
showing a reduction of 29%.
After the third month of treatment,
the mean thyroid volumewas 16.3 cm3,,
representing a decrease of 34% compared to 1 month post treatment evaluation.
After six months of tretment,
the meanthyroid volumewas 11.1 cm3,
represening adecrease...
Conclusion
Gland dimensions are usually enlarged,
with global gland volume above normality,
6 to 15 cm3 [11].
In many cases,
patients with GD are diagnosed and,
consequently treated,
when presenting large goiters,sometimes plunging,
causing compression/deviation of adjacent structures such as trachea,
esophagus and vascular structures,
leading todyspnea and dysphagia,
and also,
aesthetic discomfort to the patient.
Normal gland has an echogenicity characteristic in ultrasound,
easily distinguishable from adjacent muscular structures.
The thyroid gland ecogenicity is due to its follicular structure: the interface among thyroid cells and...
References
1.
Graves,
R.J.
(1835) Newly Observed Affection of the Thyroid.
London Medical and Surgical Journal,
7,
515.
2.
Weetman,
A.P.
(2000) Graves’ Disease.
The New England Journal of Medicine,343,1236-1248.http://dx.doi.org/10.1056/NEJM200010263431707
3.
Vieira,
L.O.,
Kubo,
R.,
Sapienza,
M.T.,
Willegaignon,
J.,
Chammas,
M.C.,
Coura-Filho,
G.B.,
Ono,
C.R.,
Watanabe,T.,
Sado,
H.N.
and Buchpiguel,
C.A.
(2011) Correlação entre Volume Tireoidiano Determinado pelo Método de UltrassonografiaVersus Cintilografia e sua Implicação em Cálculos Dosimétricos na Terapia com Radioiodo na Doençade Graves.
Arquivos Brasileiros de Endocrinologia & Metabologia,
55,
9.
4.
Davies,
T.F....