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Master's Dissertation
DOI
https://doi.org/10.11606/D.10.2019.tde-17092019-111210
Document
Author
Full name
Isabela Fortuna Gasparello
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2019
Supervisor
Committee
Reche Junior, Archivaldo (President)
Fantoni, Denise Tabacchi
Lallo, Maria Anete
Title in Portuguese
Ocorrência de hipotireoidismo iatrogênico após terapia com iodo radioativo em gatos hipertireoideos
Keywords in Portuguese
Felino
Hipertireoidismo
Radioidina
Tireoide
Abstract in Portuguese
O hipertireoidismo é a doença endócrina mais comum em gatos de meia-idade, com prevalência de aproximadamente 10% nos animais com mais de 10 anos de idade. O tratamento de escolha para a maioria dos casos é a utilização da radioidina. O hipotireoidismo iatrogênico contribui para indução de azotemia e diminuição da sobrevida. O presente estudo objetivou avaliar a ocorrência de hipotireoidismo um mês após o tratamento com iodo radioativo I131 em gatos hipertireoideos e de comparar os achados laboratoriais de acordo com os desfechos pós tratamento. Foi realizado estudo clínico retrospectivo longitudinal avaliando 85 prontuários de gatos hipertireoideos submetidos à terapia com iodo radioativo (I-131), com avaliação prévia e 30 dias após o tratamento. Os animais foram reclassificados perante o resultado da intervenção terapêutica de acordo com os valores séricos de T4 em hipotireoideo, eutireoideo e hipertireoideo. Dos 85 animais avaliados, 30 se tornaram eutireoideos, 31 hipotireoideos e 14 hipertireoideos. Isto é, cerca de 36% dos animais se tornaram hipotireoideos. Não houve associação entre o desfecho após o tratamento com o sexo (p=0,691), faixa etária (p=0,24), presença de tireoide palpável (p=0,833), peso prévio ao tratamento (p=0,127) e dose mCi/ animal (p=0,753). Porém, foi observada diferença estatisticamente significativa entre as médias da razão mCi/Kg entre eutireoideos e hipertireoideos, onde a média da razão mCi/Kg dos animais hipertireoideos foi significativamente maior do que a média dos eutireoideos. A média de creatinina antes do tratamento foi de 1,10 mg/dL e estatisticamente inferior à média após o mesmo (p<0,001). As mensurações realizadas previamente ao tratamento demonstraram creatinina inferior a 1,6 mg/dL em 82,4% dos animais, dado que alterou significativamente após a terapia em quase metade dos animais. O resultado do estudo indica que a ocorrência do hipotireoidismo iatrogênico após a terapia com iodo radioativo no Brasil é superior a ocorrência mundial, geralmente inferior a 10%.
Title in English
Occurrence of iatrogenic hypothyroidism after radioactive iodine in hyperthyroid cats
Keywords in English
Feline
Hyperthyroidism
Radioidine
Thyroid
Abstract in English
Hyperthyroidism is the most common endocrine disorder in middle-aged cats. Its prevalence is up to 10% of cats older than 10 years. Radioidine is the treatment of choice for the disease. Iatrogenic hypothyroidism appears to contribute to the development of azotemia and reduced survival time in azotemic cats. The present study aimed to evaluate the occurrence of hypothyroidism one month after the treatment with radioactive iodine in hyperthyroid cats and to compare the laboratory findings according to posttreatment outcomes. A retrospective, longitudinal study was carried out, evaluating 85 charts of hyperthyroid cats submitted to radioactive iodine therapy (I-131), with a previous evaluation and 30 days after treatment. The animals were reclassified to the result of the therapeutic intervention according to the serum values of T4 in hypothyroid, euthyroid and hyperthyroid. Among the 85 animals, 30 became euthyroid, 31 hypothyroid and 14 hyperthyroid. About 36% of the animals became hypothyroid. There was no association between outcome after treatment with sex (p = 0.691), age range (p = 0.24), palpable thyroid (p = 0.833), weight prior to treatment (p = 0.127) and mCi / animal (p = 0.753). However, a statistically significant difference was observed between the mean mCi/ Kg ratio of euthyroid and hyperthyroid. The mean mCi/ kg of hyperthyroid animals was significantly higher than the average of the euthyroid. The pre-treatment mean creatinine was 1.10 mg/ dL and statistically below the mean post-treatment (p<0.001), pre-treatment measurements showed creatinine below 1.6 mg/ dL in 82.4% of the animals, since it changed significantly after the therapy in almost half of the animals. The result of the study indicates that the occurrence of iatrogenic hypothyroidism after radioiodine therapy in Brazil is higher than the world wide ocurrence, generally less than 10%.
 
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Publishing Date
2019-10-21
 
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