Kim Chei Won, Park Ji Sun, Oh Se Hwan, Park Jae-Hyung, Shim Hyun-Ik, Yoon Jae Woong, Park Jin Seok, Hong Seong Bin, Kim Jun Mi, Le Trong Binh, Lee Jin Woo
Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Department of Pathology, Inha University School of Medicine, Incheon, Korea.
Clin Mol Hepatol. 2016 Jun;22(2):272-5. doi: 10.3350/cmh.2015.0037. Epub 2016 May 20.
Iodine-131 is a radioisotope that is routinely used for the treatment of differentiated thyroid cancer after total or near-total thyroidectomy. However, there is some evidence that iodine-131 can induce liver injury . Here we report a rare case of drug-induced liver injury (DILI) caused by iodine-131 in a patient with regional lymph node metastasis after total thyroidectomy. A 47-year-old woman was admitted with elevated liver enzymes and symptoms of general weakness and nausea. Ten weeks earlier she had undergone a total thyroidectomy for papillary thyroid carcinoma and had subsequently been prescribed levothyroxine to reduce the level of thyroid-stimulating hormone. Eight weeks after surgery she underwent iodine-131 ablative therapy at a dose of 100 millicuries, and subsequently presented with acute hepatitis after 10 days. To rule out all possible causative factors, abdominal ultrasonography, endoscopic ultrasonography (on the biliary tree and gall bladder), and a liver biopsy were performed. DILI caused by iodine-131 was suspected. Oral prednisolone was started at 30 mg/day, to which the patient responded well.
碘-131是一种放射性同位素，常用于全甲状腺切除或近全甲状腺切除术后分化型甲状腺癌的治疗。然而，有证据表明碘-131可导致肝损伤。在此，我们报告1例全甲状腺切除术后出现区域淋巴结转移的患者，因碘-131导致药物性肝损伤（DILI）的罕见病例。一名47岁女性因肝酶升高以及全身乏力和恶心症状入院。10周前，她因乳头状甲状腺癌接受了全甲状腺切除术，随后服用左甲状腺素以降低促甲状腺激素水平。术后8周，她接受了剂量为100毫居里的碘-131消融治疗，10天后出现急性肝炎。为排除所有可能的病因，进行了腹部超声、内镜超声检查（针对胆管树和胆囊）以及肝活检。怀疑是碘-131引起的DILI。开始口服泼尼松龙，剂量为每日30毫克，患者对此反应良好。
