UPTAKE OF RADIOACTIVE IODINE IN THE THYROID OF PATIENTS WITH IMPAIRED LIVER FUNCTION*

Abstract

THIS publication concerns a group of patients with hepatic insufficiency in which a substantial number of the individuals studied had increased uptake of I¹³¹ by the thyroid gland. In the beginning, elevated I¹³¹ thyroidal uptakes were noted in a number of patients with concomitant liver disease. These unexplained elevations prompted the study of the possible relationship between liver function and iodine uptake by the thyroid. Accordingly, all patients in this series were selected on the basis of two criteria: 1) definite evidence of hepatic insufficiency, and 2) no gross evidence of thyroid disease. Some preliminary observations have been made on the mechanism of the high uptake of radioiodine in these patients. METHODS The study is based on a total of 50 patients—47 with Laennec's cirrhosis, ¹ 2 with cardiac cirrhosis and 1 with acute infectious hepatitis. Twentysix were males and 24 were females. For the principal part of this investigation all patients were studied on the hospital wards. Many had records of multiple admissions to the hospital with a diagnosis of cirrhosis and, in most instances, there was a history of excessive consumption of alcoholic beverages. Special attention was given to the presence of certain physical findings, such as spider angiomata, jaundice, size and contour of the liver, and evidences of portal hypertension. The presence or absence of ascites was noted, and care was taken to determine whether it was increasing, decreasing, or stationary at the time the I131 studies were made. Evidence for portal hypertension was based on visible abdominal veins, roentgenologic evidence of esophageal varices, and a history of gastrointestinal hemorrhage.