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Published in: BMC Gastroenterology 1/2015

Open Access 01-12-2015 | Case report

I-131 remnant ablation after thyroidectomy induced hepatotoxicity in a case of thyroid cancer

Authors: Rong Lin, Omar Banafea, Jin Ye

Published in: BMC Gastroenterology | Issue 1/2015

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Abstract

Background

Radioactive iodine (I-131) is routinely used for the treatment of differentiated thyroid cancer following surgery. Drug-induced liver injury (DILI) is a leading cause of acute liver failure. Here we reported a rare case of diffuse hepatic uptake (DHU) of radioactive iodine (I-131) induced hepatotoxicity in patient with I-131 ablation therapy after thyroidectomy.

Case presentation

A 57-year-old woman was admitted due to jaundice, itching and dark urine with abnormally elevated liver function. She has performed thyroidectomy followed by 100mci radioactive I-131 ablation therapy 21 days ago. The basic hepatic protection could not efficiently prevent disease progression. The patient was further treated with methylprednisolone, the bilirubin and alanin aminotransferase were finally lowered back to normal in the follow-up visit.

Conclusion

To the best of our knowledge, this is the rare description of DILI complications in thyroidectomy patient due to I-131 ablation therapy. The patient responds to glucocorticoid therapy well, but not basic hepatic protection treatment. Even though this is only a single case, it reminds physicians make DILI in early consideration when patient present liver injury after I-131 ablation therapy.
Literature
1.
go back to reference Chung JK, Cheon GJ. Radioiodine therapy in differentiated thyroid cancer: the first targeted therapy in oncology. Endocrinol Metab (Seoul). 2014;29(3):233–9.CrossRef Chung JK, Cheon GJ. Radioiodine therapy in differentiated thyroid cancer: the first targeted therapy in oncology. Endocrinol Metab (Seoul). 2014;29(3):233–9.CrossRef
2.
go back to reference Ferris HA, Williams G, Parker JA, Garber JR. Endocr Pract. Therapeutic implications of diffuse hepatic uptake following I-131 therapy fordifferentiated thyroid cancer. Endocr Pract. 2013;19(2):263–7.CrossRefPubMed Ferris HA, Williams G, Parker JA, Garber JR. Endocr Pract. Therapeutic implications of diffuse hepatic uptake following I-131 therapy fordifferentiated thyroid cancer. Endocr Pract. 2013;19(2):263–7.CrossRefPubMed
3.
go back to reference Tatar FA, Morita E, Ituarte PH, Cavalieri RR, Duh QY, Price DC, et al. Association between residual thyroid carcinoma and diffuse hepatic uptake of 131I following radioiodine ablation in postoperative total thyroidectomy patients. World J Surg. 2001;25:718–22.CrossRefPubMed Tatar FA, Morita E, Ituarte PH, Cavalieri RR, Duh QY, Price DC, et al. Association between residual thyroid carcinoma and diffuse hepatic uptake of 131I following radioiodine ablation in postoperative total thyroidectomy patients. World J Surg. 2001;25:718–22.CrossRefPubMed
4.
go back to reference Rosenbaum RC, Johnston GS, Valente WA. Frequency of hepatic visualization during I-131 imaging for metastatic thyroid carcinoma. Clin Nucl Med. 1988;13:657–60.CrossRefPubMed Rosenbaum RC, Johnston GS, Valente WA. Frequency of hepatic visualization during I-131 imaging for metastatic thyroid carcinoma. Clin Nucl Med. 1988;13:657–60.CrossRefPubMed
5.
go back to reference Omür O, Akgün A, Ozcan Z, Sen C, Ozkiliç H. Clinical implications of diffuse hepatic uptake observed in postablative and post-therapeutic I-131 scans. Clin Nucl Med. 2009;34:11–4.CrossRefPubMed Omür O, Akgün A, Ozcan Z, Sen C, Ozkiliç H. Clinical implications of diffuse hepatic uptake observed in postablative and post-therapeutic I-131 scans. Clin Nucl Med. 2009;34:11–4.CrossRefPubMed
6.
go back to reference Teschke R, Frenzel C, Wolff A, Eickhoff A, Schulze J. Drug induced liver injury: accuracy of diagnosis in published reports. Ann Hepatol. 2014;13(2):248–55.PubMed Teschke R, Frenzel C, Wolff A, Eickhoff A, Schulze J. Drug induced liver injury: accuracy of diagnosis in published reports. Ann Hepatol. 2014;13(2):248–55.PubMed
7.
go back to reference Suzuki A, Brunt EM, Kleiner DE, Miquel R, Smyrk TC, Andrade RJ, et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. Hepatology. 2011;54:931–9.CrossRefPubMedPubMedCentral Suzuki A, Brunt EM, Kleiner DE, Miquel R, Smyrk TC, Andrade RJ, et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. Hepatology. 2011;54:931–9.CrossRefPubMedPubMedCentral
8.
go back to reference Danan G, Benichou C. Causality assessment of adverse reactions to drugs–I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46:1323–30.CrossRefPubMed Danan G, Benichou C. Causality assessment of adverse reactions to drugs–I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46:1323–30.CrossRefPubMed
12.
go back to reference Pacilio M, Bianciardi L, Panichelli V, Argirò G, Cipriani C. Management of 131I therapy for thyroid cancer: cumulative dose from in-patients, discharge planning and personnel requirements. Nucl Med Commun. 2005;26:623–31.CrossRefPubMed Pacilio M, Bianciardi L, Panichelli V, Argirò G, Cipriani C. Management of 131I therapy for thyroid cancer: cumulative dose from in-patients, discharge planning and personnel requirements. Nucl Med Commun. 2005;26:623–31.CrossRefPubMed
13.
go back to reference Van Nostrand D. The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid. 2009;19:1381–91.CrossRefPubMed Van Nostrand D. The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid. 2009;19:1381–91.CrossRefPubMed
14.
go back to reference Changlai SP, Chang PJ, Chen CY. Biodistribution and dosimetry of (131) I in thyroidectomy patients using semiquantitative gamma-camera imaging. Cancer Biother Radiopharm. 2008;23:759–66.CrossRefPubMed Changlai SP, Chang PJ, Chen CY. Biodistribution and dosimetry of (131) I in thyroidectomy patients using semiquantitative gamma-camera imaging. Cancer Biother Radiopharm. 2008;23:759–66.CrossRefPubMed
15.
Metadata
Title
I-131 remnant ablation after thyroidectomy induced hepatotoxicity in a case of thyroid cancer
Authors
Rong Lin
Omar Banafea
Jin Ye
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2015
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-015-0281-7

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