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Sébastien Verdickt Department of Endocrinology, University Hospitals of Leuven, Leuven, Belgium

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Falco Van Nes Department of Endocrinology, University Hospitals of Leuven, Leuven, Belgium

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Carolien Moyson Department of Endocrinology, University Hospitals of Leuven, Leuven, Belgium

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Toon Maes Department of Endocrinology, Imeldaziekenhuis Bonheiden, Bonheiden, Belgium

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Paul Van Crombrugge Department of Endocrinology, OLV Ziekenhuis Aalst-Asse-Ninove, Aalst, Belgium

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Annick Van den Bruel Department of Endocrinology, AZ Sint Jan Brugge, Brugge, Belgium

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Brigitte Decallonne Department of Endocrinology, University Hospitals of Leuven, Leuven, Belgium

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Introduction Radioactive iodine (RAI) has been used for the treatment of patients with Graves’ hyperthyroidism since the 1950s. After a single RAI administration, patients ideally become euthyroid but frequently develop hypothyroidism. On the

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Ferenc Péter Pediatric Endocrinology Unit, St. John's Hospital and United Hospitals of North-Buda, Buda Children's Hospital, Budapest, Slovakia

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Jan Podoba Department of Endocrinology, Slovak Medical University and St. Elizabeth Cancer Institute, Bratislava, Slovakia

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Ágota Muzsnai Pediatric Endocrinology Unit, St. John's Hospital and United Hospitals of North-Buda, Buda Children's Hospital, Budapest, Slovakia

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Dear Editor, Insufficient iodine nutrition is still an existing problem in some European countries [ 1 ]; however, the incidence of iodine deficiency has decreased during the last few decades. To prevent endemic goiter, a national iodization

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Fernanda Andrade Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Danielle Probstner Department of Orthopedics and palliative care, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Marcus Decnop Department of Radiology, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Daniel Bulzico Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Denise Momesso Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Rossana Corbo Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Mario Vaisman Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Fernanda Vaisman Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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radiation, thermal ablation, and cement injections [ 10 - 12 ]. Although rarely curative, radioactive iodine therapy (RAI) is recommended for all patients with bone metastases and may benefit individuals with RAI avid bone lesions. However, there is no

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Mustafa Dinc Department of Internal Medicine, Beytepe Military Hospital

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Mustafa Cakar Departments of Internal Medicine, Ankara, Turkey

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Sevket Balta Cardiology, Gulhane Medical Academy, Ankara, Turkey

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Muharrem Akhan Departments of Internal Medicine, Ankara, Turkey

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Hakan Sarlak Departments of Internal Medicine, Ankara, Turkey

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Sait Demirkol Cardiology, Gulhane Medical Academy, Ankara, Turkey

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Dear Editor, We read the article ‘Relative impact of iodine supplementation and maternal smoking on cord blood thyroglobulin in pregnant women with normal thyroid function' by Hiéronimus et al. [ 1 ] with great interest. The authors

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Jeanette Carlqvist J Carlqvist, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Ulf Nyman U Nyman, Division of Medical Radiology, Lund University Department of Translational Medicine, Malmo, Sweden

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John Brandberg J Brandberg, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Helena Filipsson Nyström H Nyström, Department of Endocrinology, Sahlgrenska University Hospital, Goteborg, Sweden

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Mikael Hellström M Hellström, Department of Radiology, University of Gothenburg Institute of Clinical Sciences, Goteborg, Sweden

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Objectives: When exposed to iodine contrast medium (ICM), thyroid dysfunction may develop, due to excess amounts of iodide. The incidence of contrast-induced thyroid dysfunction has been difficult to interpret, because of the observational and retrospective designs of most previous studies. With the Swedish CArdioPulmonary bioImage Study (SCAPIS), where randomly selected individuals aged 50–65 years, underwent contrast-enhanced coronary CT angiography (CCTA), we were able to prospectively assess the incidence, magnitude and clinical impact of contrast-induced thyroid dysfunction.

Methods: In 422 individuals, thyroid hormone levels were analysed before and 4–12 weeks after CCTA. Thyroid-related patient-reported outcome questionnaires (ThyPRO) at the time of pre and post CCTA blood samplings were provided by 368 of those individuals. Thyroid peroxidase antibodies (TPOab) were analysed and ultrasound of the thyroid gland was performed to detect any thyroid nodules.

Results: There was a small statistically significant effect on thyroid hormone levels but no cases of overt hypo- or hyperthyroidism after ICM. Subclinical hypo- or hyperthyroidism or isolated low/high levels of free thyroxine (fT4) developed in 3.5% of the population with normal hormone levels pre-CCTA, but without any increased thyroid-related symptoms compared to the remaining cohort. Elevated TPOab and being born outside Sweden were risk factors of developing subclinical hypothyroidism. Presence of thyroid nodules was not associated with ICM-induced thyroid dysfunction.

Conclusion: The results of this prospective study support the notion that in iodine-sufficient countries, ICM associated thyroid dysfunction is rare, usually mild, self-limiting and oligo/asymptomatic in subjects aged 50–65 years.

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Furio Pacini Department of Internal Medicine, Endocrinology and Metabolism and Biochemistry, Section of Endocrinology and Metabolism, University of Siena, Siena, Italy

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The initial treatment of differentiated thyroid cancer consists of total or near-total thyroidectomy. Surgery is usually followed by the administration of radioactive iodine activities (RAI) aimed to ablate any remnant thyroid tissue and

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Shi Hui Junice Wong Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore

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Insights Lymphadenitis can occur in association with RAI therapy for Graves’ disease. This can progress to abscess formation requiring surgical drainage. Introduction The use of radioactive iodine or iodine-131 (I-131) in the

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Christiaan F. Mooij Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Nitash Zwaveling-Soonawala Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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Eric Fliers Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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A.S. Paul van Trotsenburg Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

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. According to current guidelines, pre­operative treatment of (refractory) hyperthyroidism consists of the administration of a thionamide (e.g., methimazole), beta-blocker, glucocorticoid, and an iodine-containing preparation [ 1 ]. These treatment protocols

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Stasa Ivkovic Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia

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Dear Sir, Five months after radioactive iodine treatment for Graves’ hyperthyroidism, I developed severe hypothyroidism. Three months after treatment, TSH, FT4 and FT3 values were within reference range (0.44 mlU/l, 15.9 and 4.5 pmol

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Amanda La Greca Endocrinology Service, Department of Medicine, New York, N.Y., USA

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Bin Xu Department of Pathology, Memorial Sloan-Kettering Cancer Center and Weill-Cornell College of Medicine, New York, N.Y., USA

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Ronald Ghossein Department of Pathology, Memorial Sloan-Kettering Cancer Center and Weill-Cornell College of Medicine, New York, N.Y., USA

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R. Michael Tuttle Endocrinology Service, Department of Medicine, New York, N.Y., USA

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Mona M. Sabra Endocrinology Service, Department of Medicine, New York, N.Y., USA

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calculated low risk of recurrence of multifocal papillary thyroid microcarcinoma after total thyroidectomy, routine radioactive iodine (RAI) ablation is not recommended and close surveillance is advocated [ 10 ]. In the updated 2015 American Thyroid

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