Endocrinology and Metabolism

Original Article

Clinical Study
Prevalence of Hyponatremia in Hypothyroid Patients during Radioactive ¹³¹I Ablation for Differentiated Thyroid Cancer: Single Institution Experience: Juan Carlo P. Dayrit, Elaine C. Cunanan, Sjoberg A. Kho; Endocrinol Metab. 2016;31(3):410-415. Published online August 17, 2016; DOI: https://doi.org/10.3803/EnM.2016.31.3.410

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Background

Hyponatremia developing in hypothyroid patients has been encountered in clinical practice; however, its prevalence has not been well established.

Methods

Thirty patients diagnosed with differentiated thyroid cancer, rendered hypothyroid after surgery and levothyroxine withdrawal, and who are for radioactive iodine (RAI) ablation were included. Serum sodium concentrations were measured twice, at the time of admission for RAI ablation, and before discharge after increased oral fluid intake. The outcome measures were to determine the prevalence of hyponatremia among hypothyroid patients prior to RAI ablation and after oral hydration post-RAI, and to correlate the serum sodium levels pre-RAI and post-RAI with thyroid-stimulating hormone (TSH) concentration and age.

Results

Thirty patients were included, with ages from 23 to 65 years old (median, 40). Two patients (6.7%) were hyponatremic prior to RAI ablation, and eight patients (26.7%) had mild hyponatremia (130 to 134 mEq/L) after RAI and hydration. There was no significant correlation between TSH levels and serum sodium levels prior to or after RAI. There was also no significant correlation between pre- and post-RAI sodium concentration and age.

Conclusions

The prevalence of hyponatremia pre-RAI was 6.7%, and 26.7% post-RAI. No significant correlation was noted between TSH concentration and age on pre- or post-RAI sodium concentrations. Routine measurement of serum sodium post-RAI/isolation is still not advised. Measurement of sodium post-RAI may be considered in patients who are elderly, with comorbid conditions or on medications.

Citations

Citations to this article as recorded by

Is there a causal relationship between hypothyroidism and hyponatremia?
Julie Chen
Therapeutic Advances in Endocrinology and Metabolism.2023;[Epub] CrossRef
Endocrinopathy-induced euvolemic hyponatremia
Talia Diker-Cohen, Benaya Rozen-Zvi, Dana Yelin, Amit Akirov, Eyal Robenshtok, Anat Gafter-Gvili, Daniel Shepshelovich
Internal and Emergency Medicine.2018; 13(5): 679. CrossRef

Case Report

Thyroid
Anaplastic Thyroid Carcinoma Following Radioactive Iodine Therapy for Graves' Disease: Sun Hwa Kim, Hee Young Kim, Kwang Yoon Jung, Dong Seop Choi, Sin Gon Kim; Endocrinol Metab. 2013;28(1):61-64. Published online March 25, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.1.61

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Abstract PDF PubReader

Radioactive iodine (RAI) therapy has been used as a treatment option for Graves' disease, and it has been widely accepted to be safe. On the other hand, some evidence suggests that RAI therapy is possibly associated with a small increased risk of thyroid cancer. Herein, we report a rare case of anaplastic thyroid carcinoma (ATC) associated with Graves' disease, following RAI treatment. A 42-year-old woman had been diagnosed with Graves' disease and although she was treated with an antithyroid drug, she remained in a hyperthyroid state, which led to two RAI treatments. More than 10 years later, the patient revisited our clinic due to hoarseness, dysphagia, and dyspnea, which had lasted for 2 months. Neck computed tomography suggested thyroid carcinoma and a lymph node biopsy showed metastatic papillary carcinoma. The patient underwent total thyroidectomy and was finally diagnosed as having an ATC. It is not clear if the occurrence of ATC reported here was influenced by the RAI therapy or alternatively, it may only represent the delayed recognition of a rare change in the natural history of Graves' disease. Nevertheless, this report is worthwhile since it presents a very rare case of ATC that occurred eleven years after the RAI therapy for Graves' disease.

Citations

Citations to this article as recorded by

Evaluation of ultrasonographical and cytological features of thyroid nodules in patients treated with radioactive iodine for hyperthyroidism
Muhammet C. Bilginer, Didem Ozdemir, Fatma N. C. Seyrek, Nilufer Yildirim, Aylin K. Yazgan, Mehmet Kilic, Reyhan Ersoy, Bekir Cakir
Diagnostic Cytopathology.2020; 48(1): 3. CrossRef
Papillary thyroid carcinoma in cervical lymph nodes with vanished thyroid gland after ablation of Graves’ disease by radioactive iodine
O Hamdy, S Raafat, GA Saleh, K Atallah, Mahmoud M Saleh, AM Shebl, MA Hegazy
The Annals of The Royal College of Surgeons of England.2019; 101(5): e122. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

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