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Pharmacology and toxicology.

Modification of maternal and fetal effects of radioiodine by pretreatment of the mother

Radioactive iodine as the isotope 1131 is readily available to all physicians and surgeons. With the aid of proper equipment, radioactive iodine (RAI) is the single most useful agent in the assessment of thyroid function and in the management of some disorders of the thyroid gland. With his colleagues, the author has previously reported several clinical uses of 1131 in the management of thyroid disease, in the assessment of thyroid function and in the differential diagnosis of nodules located within the thyroid gland (1-5). The tests we have found to be most useful arc the thyroidal 24-hour uptake’ of P1, and the thyroid scan. In 1950, Jaffe and Ottoman (7) remarked on the constancy of the thyroidal 24-hour 1’31 uptake. They implied that the test was accurate more than 90 per cent of the time and generally reflected the status of thyroid function. It might be considered, then, that the greater the uptake of 1131, the more thyrotoxic the patient. Nadler and Bloch (8) believed that the uptake was correct in about 85 per cent of the tests but that the correlation of the uptake with toxic symptoms was not necessarily a precise one. In 1952 a simple scanning or differential uptake between various areas of the thyroid gland was discussed (3). It was pointed out that a differential diagnosis between areas of “hot” or high uptake and areas of “cold” or low uptake was of value. The development of more precise scanning devices, called scintillators, has permitted the delineation of relatively small areas of differential function in the thyroid gland. The use of scintillators is a valuable aid in the management of thyroid enlargement. Dorta (9) in 1960 emphasized the value of various technics in which so-called (‘hot” and (‘cold” nodules could be accentuated. For example, a (‘hot’’ nodule (toxic adenoma) suppresses thyroid function in the remaining portion of the gland, but this function can be reactivated by administration of thyroid-stimulating hormone (TSH), as demonstrated by scanning. On the other hand, a toxic adenoma appears to be autonomous, probably in direct relationship to the amount of hyperfunction. Triiodothyronine (T-3) decreases the fixation of radioactive iodine by the extra-adenomatous gland tissue but does not produce tl corresponding drop in the adenomatous tissue. The response of “cold” nodules to

Friedell Mt

Papers

Radioiodine (i131) in the diagnosis and treatment of diseases of the thyroid.

Clinical observations on the use of radioactive iodine in diseases of the thyroid gland.