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Graves' Disease Following Irradiation for Hodgkin's Disease
Miljenko V. Pilepich, MD;
Ivor Jackson, MD;
John E. Munzenrider, MD;
Rosalind S. Brown, MD
JAMA. 1978;240(13):1381-1382.
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THE THYROID gland is commonly included in the radiation field in patients with Hodgkin's disease treated with radiation therapy. The so-called mantle field routinely includes the neck. A substantial number of patients with non-Hodgkin's lymphoma, head and neck tumors, and breast carcinoma also receive neck irradiation.
The thyroid was traditionally considered a radioresistant organ. However, several reports on thyroid dysfunction following neck irradiation have appeared in recent years. Glatstein et al1 reported a 44% incidence of elevated serum thyroid-stimulating hormone (TSH) concentration in patients with lymphomas who had lymphangiography and received neck irradiation. In 11% of these patients, clinical hypothyroidism or evidence of thyroid hypofunction (according to laboratory tests other than serum TSH determination) developed. Although the exact incidence and pathogenesis are not known, hypothyroidism is a recognized complication of thyroid irradiation.
Graves' disease following thyroid irradiation, manifested either as hyperthyroidism or ophthalmopathy, is not a well-recognized entity.
Report
. . . [Full Text PDF of this Article]
Author Affiliations
From the Departments of Radiotherapy (Drs Pilepich and Munzenrider) and Medicine (Drs Jackson and Brown), Tufts-New England Medical Center, Boston. Dr Munzenrider is now with the Massachusetts General Hospital, Boston.
Footnotes
Reprints not available.
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