Would I-123 di-iodotyrosine provide a harmless deiodination test?
Defective iodotyrosine deiodinase activity may benefit from a specific treatment, thus requiring an unequivocal diagnosis. In reported cases this diagnosis has been obtained from an in vivo deiodination test making use of di-iodotyrosine (DIT) labeled either with I-131 or I-125. Dosimetric calculation indicates that such tests may result in unacceptable irradiation of the thyroid of a child wrongly suspected of having defective iodotyrosine deiodinase activity; therefore other methods are needed. The use of I-123 DIT is shown to be feasible, but even a 1:30 reduction in the thyroid dose still remains too high. Suppression of thyroid I- uptake by ClO4-, together with I-125 DIT, eliminates almost all thyroid irradiation and provides a sensitive, harmless, and rapid test.