Sjögren syndrome and fibromyalgia after radioiodine therapy in cancer thyroid patients

Long-term biological effects after acute 131I-administration of two rat models (with and without thyroid)

PURPOSE

Radioiodine-131 (RAI or iodine-131) is one of the most frequently used radionuclides for diagnosis and therapy of thyroid diseases (90% of all therapies in nuclear medicine). In order to optimize the patient protection, it is important to evaluate the long-term biological effects of RAI therapy on non-target organs.

MATERIALS AND METHODS

An experimental animal model has been adopted, it consists on miming RAI therapy. An activity of RAI has been administrated in two models of Wistar rats: the first model with an intact thyroid gland (Thy + model), and the second one was thyroidectomized (Thy- model). For each model, 6 rats were orally contaminated with a solution 18.5 ± 1MBq of [131I]NaI and 6 others rats were used as controls. The 24 rats have been placed in individual cages for a period of 08 months then they were euthanized. The blood was collected by cardiac puncture and all organs were immediately removed. A fraction of thyroid, liver, kidneys and testicles was put in vials containing formaldehyde (10%) for histological investigation.

RESULTS

Histological observations show some liver disorders more accentuated in the case of the Thy- model, the appearance of kidney tissue effects (hemosiderin deposits, fibrosis and glomerular necrosis) for both models and an absence of any anomaly for the testicles slides. The disturbance of blood parameters specific to each organ has been revealed.

CONCLUSIONS

Long-term biological effect of 131I-administration shows the appearance of various histological disorders confirmed by disturbances in hepatic and renal functions.

Eye-Related Adverse Events After I-131 Radioiodine Therapy: A Systematic Review of the Current Literature

OBJECTIVE

Although I-131 is relatively safe, there is limited focus on probable eye-related side effects after radioactive iodine (RAI) therapy. Thus, we aimed to provide evidence for the adverse outcomes of I-131, exclusively in patients with thyroid cancer.

METHODS

A systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was designed to examine the ocular complications of RAI therapy. Databases including PubMed, Scopus, and Web of Science were searched until October 2023 with specific thyroid neoplasms, ophthalmology and iodine terms. After thorough screening and review, relevant data were extracted.

RESULTS

The database search yielded 3434 articles, which resulted in the final 28 eligible studies. These studies investigated ophthalmic symptoms following RAI therapy, classifying them as obstructive diseases (for example, nasolacrimal duct obstruction; median incidence rate: 6.8%), inflammatory symptoms (median incidence rate: 13%), and cataracts (median incidence rate: 2.5 and 5%). The most common time interval between RAI therapy and the onset of symptoms was within the first 12 months and then declined in the preceding years. A strong positive correlation was observed between higher I-131 doses of more than 100 to 150 mCi (3.7-5.55 GBq) and the risk of symptom development. Ages older than 45 also showed a significant association with nasolacrimal duct obstruction.

CONCLUSION

The risk of ophthalmic complications is associated with various factors, including the administration of high I-131 doses, age of more than 45 years, and time to event within the first 12 months. Considering these conditions may help enhance patient care and prevent adverse outcomes that may limit patients' quality of life.