van Leussen J J, Edelbroek M A, Talsma M A, de Heide L J
Department of Internal Medicine, Medical Centre Leeuwarden, The Netherlands.
Neth J Med. 2000 Nov;57(5):194-7. doi: 10.1016/s0300-2977(00)00068-1.
A 59-year-old woman developed manifestations of Graves' disease several months after treatment with radioiodine (Na(131)) for toxic multinodular goitre. During subsequent treatment with additional radioiodine therapy Graves' ophthalmopathy developed which was severe and required treatment with prednisone and orbital radiotherapy. The literature on development of Graves' disease following Na(131) therapy is reviewed and possible pathophysiological mechanisms are discussed. In this case, possibly the first radioiodine therapy has illicited Graves' thyrotoxicosis and the subsequently added radioiodine treatments for the persistent Graves' thyrotoxicosis led to serious ophthalmopathy. Physicians should recognise Graves-like disease as a complication of Na(131)I therapy for toxic multinodular goitre and carefully consider the timing of consecutive radioiodine therapy.
一名59岁女性在接受放射性碘（Na(131)）治疗毒性多结节性甲状腺肿数月后出现了格雷夫斯病的表现。在随后接受额外放射性碘治疗的过程中，格雷夫斯眼病发展起来，病情严重，需要用泼尼松和眼眶放射治疗。本文回顾了关于Na(131)治疗后格雷夫斯病发生的文献，并讨论了可能的病理生理机制。在该病例中，可能首次放射性碘治疗引发了格雷夫斯甲状腺毒症，随后针对持续性格雷夫斯甲状腺毒症进行的放射性碘治疗导致了严重的眼病。医生应认识到类格雷夫斯病是Na(131)I治疗毒性多结节性甲状腺肿的一种并发症，并仔细考虑连续放射性碘治疗的时机。
