[The lacrimal apparatus as an organ at risk during radionuclide therapy]

Within the framework of the article, the authors analyzed the available information about the damage to the lacrimal apparatus during radionuclide therapy. In focus of article lesions of the lacrimal production system, the main and accessory lacrimal glands, as well as lacrimal drainage are considered. It was found that damage to the lacrimal apparatus is characteristic of 131I therapy for thyroid cancer, as well as for radioligand therapy using anti-PSMA antibodies labeled with 177Lu and 225Ac. 177Lu-PSMA and 225Ac-PSMA may damage the lacrimal gland with the formation of a clinically pronounced "dry eye syndrome". The pathogenesis of such lesions is associated with the accumulation of a radioisotope in the tissues of the lacrimal apparatus, while during therapy with 131I, accumulation is realized due to the expression of the sodium-iodine symporter in the nasolacrimal duct, and during therapy with 177Lu-PSMA and 225Ac-PSMA, the radiobiological effect is realized in connection with the expression PSMA by lacrimal tissue. An analysis of the available sources showed that to date there are no results of systematic studies on the problem, there is a lack of knowledge regarding the individual risks of developing these complications, methods for their prevention that have proven effectiveness have not been developed, and the treatment methods used, having relatively low efficiency, are not specialized. The authors concluded that the strengthening of interdisciplinary interaction, as well as the organization verification methodology and correct studies, can contribute to solving problems related to the study of the complications under consideration.

[Thyrotoxicosis in a patient with Turner syndrome: radioactive iodine therapy]

Turner syndrome (TS) is a chromosomal disorder affecting female and characterized by complete or partial monosomy of the X chromosome. These genetic changes lead to the abnormalities in growth and development and increase the risk of autoimmune diseases, including those affecting the thyroid. Thyroid pathology in TS may include autoimmune thyroiditis, hypothyroidism, thyrotoxicosis (Graves disease, AIT in the hyperthyroid state).Thyrotoxicosis is the clinical syndrome of excess circulating thyroid hormones. One of the main causes of thyrotoxicosis is Graves' disease (GD), an organ-specific autoimmune disease caused by the production of stimulating thyrotropin receptor antibodies. There are three treatment options for thyrotoxicosis: anti-thyroid drugs, radioactive iodine and thyroidectomy. A personalized approach to disease management is especially important in cases of genetic diseases.We present a clinical case of a patient with TS and GD, who has been referred to a radiologist at the Department of Radionuclide Therapy of Endocrinology Research Center. The patient was diagnosed with congenital hypothyroidism at neonatal screening, but thyroid hormones therapy was initiated aged three. Based on the survey, GD was diagnosed aged twenty one. Anti-thyroid drug therapy was started, which resulted in toxic hepatitis. Taking into account intolerance to anti-thyroid drugs, radioiodine therapy has been recommended, which led to hypothyroidism.

[The formation of endocrinology in the ancient times]

The formation of endocrinology as an independent medical discipline was preceded by the accumulation of medical experience during many centuries. The medicine of the ancient times was developing on the basis of continuity according to the basic principle «relata refero» (I tell what I have been told). Medicine and pharmacy in the countries of the ancient world had many similarities, but at the same time each civilization had its own geographical, cultural and historical particularities. The pathology of the thyroid was among the most studied pathologies in Ancient world. There are frequent mentions of the endemic goiter in the works of doctors from Ancient China, Ancient India and Ancient Greece.Although the link between iodine and the thyroid was not known, algae and dried sea sponges were using for treating swollen neck.There are many descriptions of neuroendocrine pathologies in historical sources, for example the Bible describes gigantism and the Talmud - hypoprolactinaemia.Special attention was paid to the study of diabetes mellitus, although the pathogenesis and treatment of the disease remained unknown until the 20th century.

[The use of radioactive substances in medicine - history and development prospects]

Nuclear medicine (NM) is a medical specialty that uses radionuclides (radioactive tracers) and ionising radiation for diagnostic and therapeutic (theranostic) purposes. Nuclear medicine arose and developed at the intersection of physics, chemistry and clinical medicine. The radiation emitted by radioisotopes can consist of gamma-, beta- and alpha emission, or it's combination. Radioisotope of choice for medical purposes should have futher requirements: low radiotoxicity, suitable type of radiation, energy and half-life (several minutes to several hours and days), and also convenient detection of gamma ray radiation. The radionuclide is part of radiopharmaceutical (RP) and acts as its indicator. RP accumulates in morphological structures, becomes a carrier of coordinated information from patient to gamma camera or other equipment and reflects the dynamics of processes occurring in the examined organ. In 2021 NM celebrates its 80th anniversary. The trajectory of NM combines modern methods of radiotheranostics and applied genomic and post-genomic technologies.