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Aubert, Schlumberger, Tubiana
Thyroid iodine content and serum thyroid hormone levels in autoimmune thyroiditis: effect of iodide supplementation.Fragu P, Schlumberger M, Tubiana M. J Nucl Med. 1985 Feb;26(2):133-9.
"The relationship between thyroid iodine content (TIC) measured by x-ray fluorescence and serum TSH, T4, and T3 levels was investigated under iodide supplementation (0.5 mg/day for 1 to 9 mo). In five euthyroid control patients, whose TIC ranged from 2.5 to 14 mg, the TIC increased from 1.5 to 4 mg after 4 wk of treatment and had a tendency to plateau when the treatment was pursued. No significant changes in serum T4, T3, and TSH levels have been observed in these control subjects. Fourteen patients with autoimmune thyroiditis with low TIC (0-5 mg) were also studied. In six patients, the TIC increased significantly (3-10 mg over initial value after 3-7 mo of treatment). In parallel, there was a significant increase in serum T4 levels (35-150% over initial value) while T3 levels were modified in only two patients. In five patients serum TSH level decreased and was two- to seven-fold lower than before treatment whatever was its initial value; however, the spectrum of changes varied among patients from slight increase to a complete normalization of hormonosynthesis. In the eight other patients, iodide supplementation aggravated the thyroid disorders during the first months of treatment. The thyroid hormone blood levels dropped significantly in six patients (percent decrease below initial value: 20-100%) and was unchanged in the two others. An increase in the TSH blood level (X2-6) was observed in all patients except one. Concomitantly, the iodine stores were progressively depleted in three patients, unchanged in three and increased in two. When iodide treatment was pursued, an escape from this organification block was observed in two patients."
Thyroid iodine content measured by x-ray fluorescence in amiodarone-induced thyrotoxicosis: concise communication.Leger AF, Fragu P, Rougier P, Laurent MF, Tubiana M, Savoie JC. J Nucl Med. 1983 Jul;24(7):582-5.
"Iodine-induced thyrotoxicosis (liT) is characterized by (a) a low radioiodine uptake, increased by exogenous TSH, and (b) a spontaneous evolution towards cure within a few months. An hypothetical pathogenesis of liT is an initial inflation in the stores of thyroid hormones during iodine excess, followed by their sudden discharge into the circulation. Thyroid iodine content was measured by fluorescent scanning in 10 patients with amiodarone-induced thyrotoxicosis and in various control groups. Results were found to be high at the onset of the disease and to decrease during its course. The data agree with the hypothetical pathogenesis. Furthermore they may permit exclusion of a painless subacute thyroiditis, which is the main differential diagnosis of liT."
Evolution of thyroid 127I stores measured by X-ray fluorescence in subacute thyroiditis.Fragu P, Rougier P, Schlumberger M, Tubiana M. J Clin Endocrinol Metab. 1982 Jan;54(1):162-6.
"Evaluation of the thyroid iodine content by x-ray fluorescence was performed in 13 patients throughout the course of subacute thyroiditis. In the initial hyperthyroid phase of the disease, the iodine stores of the thyroid were not completely depleted. The iodine content (6.5 +/- 3 mg) was about 2.5 times lower than normal values when thyroiditis had developed in a normal thyroid (10 patients); in 3 patients with goiter, it was elevated (29.6 +/- 6.7 mg) but was still within the normal range of euthyroid goitrous patients. After clinical remission, the iodine content of the gland increased only in two patients (+105% and +43% over the initial value, respectively). For the other patients, the iodine content decreased (from -5% to -100% of the initial value). Restoration of iodine stores occurred subsequently and appeared to be a slow and progressive phenomenon; in six patient, the iodine content was still below normal values 12 months after clinical remission (6.6 +/- 1.6 mg). These data suggest that the course of subacute thyroiditis might be longer than would appear from the clinical data, the hormonal assays, or the radioactive thyroid uptake data."
Application of x-ray fluorescence to the study of iodine distribution and content in the thyroid.Aubert B, Fragu P, Di Paola M, Rougier P, Tubiana M. Eur J Nucl Med. 1981;6(9):407-10. [abstract only]
"We have been developing an X-ray fluorescence system designed to determine iodine distribution and content in the thyroid. The X-ray fluorescence unit is composed of a 80 KV X-ray excitation beam and a Si(Li) semi-conductor detector. The angle between the X-ray beam and the axis of the detector is 24 degree. Two single channel analyzers (SCA) are used, the first one corresponding to the K alpha peak and the other to the background. The SCA signals are digitised so that the two corresponding images may be processed using a computer. After subtracting the background, an image is obtained that represents the iodine distribution alone, and the iodine content of the whole thyroid or a part of it can be determined with a reproducibility of +/- 5%. A good correlation (r=0.98) between iodine chemical analysis and iodine fluorescence analysis was obtained for 13 patients."
[Measurement of intrathyroidal iodine content by X fluorescence: usefulness and application (author's transl)]Rougier P, Fragu P, Aubert B, Parmentier C, Tubiana M. Pathol Biol (Paris). 1981 Jan;29(1):31-7. French. [abstract only]
"X fluorescence quantification of thyroid gland iodine content was performed in 113 subjects. Euthyroid patients averaged 15.6 +/- 4.8 mg in the absence of goiter (18 subjects) and 23.7 +/- 11 mg when the gland was goitrous (11 subjects p less than 0.05). In Grave's disease (28 patients), thyroid iodine content increased significantly (21.7 +/- 11 mg, p less than 0.05. No correlation was found between this parameter and thyroid hormone blood level. During the treatment by carbimazole, patients can be divided in 2 groups; the first group with high initial iodine content (30.3 +/- 15.6 mg 9 patients) decreased it under treatment; on the contrary, the second group with normal initial iodine content (16.9 +/- 7.5 mg 10 patients) increased its iodine content under treatment. No significant difference in T3 and T4 serum levels was found between these two groups. In toxic goiter (6 patients) the initial iodine content was elevated (43.4 +/- 33 mg) and decreased under carbimazole in all the cases. 15 patients with solitary autonomous thyroid nodules were scanned with 99mTc and by X fluorescence imaging. The iodine content of the nodule was 9.9 +/- 4.7 mg; controlateral non suppressed tissue was observed in 11 patients while no 99mTc accumulation was found. The association of these 2 techniques allow to avoid a TSH stimulation test in 70% of the cases. In hypothyroid patients, a low iodine content was found in acquired disease (4.5 +/- 5.6 mg 9 patients); it was increased in congenital hypothyroid goiter. In iodine load (12 patients) the iodine content was increased especially after lymphography. In the initial phase of subacute thyroiditis (11 patients) X fluorescence showed 127I thyroid stores were still normal (14.3 +/- 11.6 mg) while there was no radioactive uptake."
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