RADIOACTIVE IODINE IN THE TREATMENT OF THE HYPERTHYROIDISM OF NODULAR GOITER*

Abstract

37 patients having hyperthyroidism arising in nodular goiters were treated. 33 of the 37 patients were followed 6 mos. or more. 28 of the 33 patients followed 6 mos. or longer now have a remission of their disease and 4 patients observed less than 6 mos. were in remission when last seen. The goiters were divided into 4 classes based on estimation of their size. Total dosage of I131 to effect a remission was averaged for each class. The largest goiters required a total dosage of 66.2 millicuries; the next largest 37.6; the next 30.6 and the smallest 23.4 millicuries. 5 patients have been followed 6 mos. or longer and were not in remission when last seen. One of these, at the time the fifth dose of 27 millicuries was given, had a BMR of plus 34% and definite signs and symptoms of hyperthyroidism. The sum of the first 4 doses was 77 millicuries. This experience would point to the fact that in the treatment of the hyperthyroidism of nodular goiter with I131, the total dosage depends to a greater extent on the size of the gland than on the severity of the disease. Most of the patients with nodular goiter treated with I131 needed larger amts. of iodine than have usually been necessary for the production of remissions in Graves'' disease.