Journal List > Int J Thyroidol > v.9(1) > 1082753

Int J Thyroidol. 2016 May;9(1):39-42. Korean.
Published online May 31, 2016.  https://doi.org/10.11106/ijt.2016.9.1.39
Copyright © 2016. the Korean Thyroid Association. All rights reserved.
Hyponatremia after Radioactive Iodine Treatment in Thyroid Cancer Patients
Oh Chan Kwon, Hoon Hee Lee, Kyung Hwan Oh and Tae Yong Kim
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence: Tae Yong Kim, MD, PhD, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: 82-2-3010-6962, Fax: 82-2-3010-3249, Email: tykim@amc.seoul.kr
Received December 16, 2015; Revised February 23, 2016; Accepted March 07, 2016.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Radioactive iodine treatment (RAIT) after surgery reduces local recurrence and cancer related death. Cases of hyponatremia after preparation for RAIT have rarely been reported. We report 4 cases of hyponatremia which developed after RAIT. The cause of hyponatremia seemed to be related with over ingestion of free water which is recommended during RAIT. These cases highlighted the importance of weight adjusted water ingestion during RAIT.

Keywords: Thyroid neoplasms; Iodine radioisotopes; Hyponatremia; Water intoxication

Tables


Table 1
Patient characteristics
Click for larger image

References
1. Davies L, Welch HG. Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA 2006;295(18):2164–2167.
2. Reiners C, Dietlein M, Luster M. Radio-iodine therapy in differentiated thyroid cancer: indications and procedures. Best Pract Res Clin Endocrinol Metab 2008;22(6):989–1007.
3. Lee SL. Complications of radioactive iodine treatment of thyroid carcinoma. J Natl Compr Canc Netw 2010;8(11):1277–1286.
quiz 1287.
4. Shakir MK, Krook LS, Schraml FV, Hays JH, Clyde PW. Symptomatic hyponatremia in association with a low-iodine diet and levothyroxine withdrawal prior to I131 in patients with metastatic thyroid carcinoma. Thyroid 2008;18(7):787–792.
5. Krishnamurthy VR, McDougall IR. Severe hyponatremia: a danger of low-iodine diet. Thyroid 2007;17(9):889–892.
6. Al Nozha OM, Vautour L, How J. Life-threatening hyponatremia following a low-iodine diet: a case report and review of all reported cases. Endocr Pract 2011;17(5):e113–e117.
7. Baajafer FS, Hammami MM, Mohamed GE. Prevalence and severity of hyponatremia and hypercreatininemia in short-term uncomplicated hypothyroidism. J Endocrinol Invest 1999;22(1):35–39.
8. Lee JE, Kim SK, Han KH, Cho MO, Yun GY, Kim KH, et al. Risk factors for developing hyponatremia in thyroid cancer patients undergoing radioactive iodine therapy. PLoS One 2014;9(8):e106840.
9. Luckey AE, Parsa CJ. Fluid and electrolytes in the aged. Arch Surg 2003;138(10):1055–1060.
10. Hirshberg B, Ben-Yehuda A. The syndrome of inappropriate antidiuretic hormone secretion in the elderly. Am J Med 1997;103(4):270–273.
11. Berl T, Schrier RW. Disorders of water metabolism. In: Schrier RW, editor. Renal and electrolyte disorders. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. pp. 1-44.
12. Skowsky WR, Kikuchi TA. The role of vasopressin in the impaired water excretion of myxedema. Am J Med 1978;64(4):613–621.