Japanese
Titleリチウム併用によるバセドウ病131I治療
Subtitle原著
Authors佐藤賢士*
Authors(kana)
Organization*長崎大学医学部第一内科
Journal核医学
Volume20
Number2
Page171-177
Year/Month1983/3
Article原著
Publisher日本核医学会
Abstract「要旨」バセドウ病の131I治療にリチウムを併用し, その有用性を検討した. 9例のバセドウ病において炭酸リチウム一日量600mgを投与し, 1) 131I甲状腺摂取率に及ぼす影響, 2) 甲状腺からの131I放出に及ぼす影響, 3) 血中甲状腺ホルモンに及ぼす影響を検討した. その結果リチウム投与前では, 131I甲状腺摂取率は63.6±31.6% (n=5), 甲状腺131I有効半減期は5.4±1.1日 (n=6), 血中T4は21.3±8.4μg/dl, T3は490±194ng/dl (n=9) であった, リチウム投与後では, それぞれ61.4±27.3%, 7.9±0.3日, 12.4±2.6μg/dl, 287±135ng/dlであった. すなわち131I甲状腺摂取率には影響せず131I有効半減期は約1.5倍に延長した. また血中甲状腺ホルモンは低下し臨床症状も改善した. したがってバセドウ病の131I治療にリチウムを併用することにより131Iの投与量を減らすことができ全身被曝線量も減少する. さらにリチウムによって甲状腺機能を改善させつつ131I治療が行える利点がある.
Practice臨床医学：一般
KeywordsGraves' disease, Radioiodine therapy, Lithium
English
Title131I Therapy of Graves' Disease Using Lithium
SubtitleOriginal Articles
AuthorsKenshi SATO
Authors(kana)
OrganizationThe First Department of Internal Medicine, School of Medicine, Nagasaki University
JournalThe Japanese Journal of nuclear medicine
Volume20
Number2
Page171-177
Year/Month1983/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Lithium is known to cause goiter and hypothyroidism. In the mechanism of goitrogenesis, there is general agreement that lithium inhibits the release of the thyroid hormones from the thyroid gland without significantly impairing other thyroid functions. The present study was undertaken, therefore, to investigate the usefulness of lithium in the radioiodine treatment of Graves' disease. Nine patients with Graves' disease who were all, except one, previously treated with antithyroid drugs were studied. 600 mg of lithium carbonate were administered daily to investigate the effects on thyroidal 131I uptake, disappearance rate of 131I from the prelabeled thyroid and the serum concentrations of thyroid hormones. Lithium showed no significant effect on the thyroidal 131I uptake when the 24 hour thyroidal 131I uptakes were determined both before and during lithium treatment in the five cases. On the other hand, lithium clearly prolonged the mean value of effective half-lives of 131I to approximately 8 days vs. 5.1 days before lithium treatment (p<0.005). Both mean T4 and T3 levels significantly decreased during lithium treatment, from 21.3 to 12.4μg/dl (n=9, p<0.005) and from 490 to 287 ng/dl (n=9, p<0.005), respectively. Clinical signs and symptoms were also improved without lithium toxicity except one who had transient diarrhea. In conclusion, since therapeutic dose of 131I for the Graves' disease can be reduced by using lithium, the radiation exposure to the total body is decreased. Moreover, it is possible to perform the 131I therapy while improving the thyrotoxicosis with lithium. Finally, it is concluded that lithium is a very useful drug to be combined with the 131I therapy of Graves' disease.
PracticeClinical medicine
KeywordsGraves' disease, Radioiodine therapy, Lithium

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