Recombinant human thyrotropin stimulation prior to 131I therapy in toxic multinodular goiter with low radioactive iodine uptake
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- 作者：M.J. Azorí ; n Belda ; mariajoazo@gmail.com ; A. Martí ; nez Caballero ; G.C. Figueroa Ardila ; M. Martí ; nez Ramí ; rez ; C.A. Gó ; mez Jaramillo ; J.I. Dolado Ardit ; J. Verdú ; Rico
- 关键词：Multinodular goiter ; Hyperthyroidism ; Radioiodine ; rhTSH ; Toxic multinodular goiter
- 刊名：Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
- 出版年：2017
- 出版时间：January-February 2017
- 年：2017
- 卷：36
- 期：1
- 页码：7-12
- 全文大小：249 K
- 卷排序：36
文摘
Stimulation with recombinant human thyrotropin (rhTSH) increases thyroid radioiodine uptake, and is an aid to 131I therapy in non-toxic multinodular goiter (MNG). However, there are not many studies using rhTSH prior to 131I in toxic multinodular goiter to improve hyperthyroidism and compressive symptoms.Materials and methodsA prospective study was conducted on patients with MNG and hyperthyroidism. Patients were recruited consecutively and divided into group I, stimulated with 0.3 mg of rhTSH before radioiodine therapy, and a control group or group II, without stimulation. Thyroid function, radioiodine thyroid uptake, thyroid weight, and compressive symptoms were measured, and patients were followed-up for 9 months.ResultsGroup I consisted of 16 patients (14 women), with a mean age 69.7 years, and group II with 16 patients (12 women), with a mean age 70.7 years. After stimulation with 0.3 mg rhTSH in group I, 131I uptake (RAIU) at 24 h increased by 78.4%, and the estimated absorbed dose by 89.3%. In group II, the estimated absorbed dose was lower than group I after stimulation with rhTSH (29.8 Gy vs. 56.4 Gy; P = 0.001).At 9 months of follow-up, hyperthyroidism was controlled in 87.5% of patients in group I, and 56.2% in group II (P = 0.049). The mean reduction in thyroid weight was higher in group I than in group II (39.3% vs. 26.9%; P = 0.017), with a tendency toward subjective improvement of compressive symptoms in group I, although non-significant. Only 2 patients described tachycardias after rhTSH administration, which were resolved with beta-blockers.ConclusionStimulation with 0.3 mg of recombinant human thyrotropin prior to radioiodine therapy achieves a reduction in thyroid weight and functional improvement in patients with hyperthyroidism and multinodular goiter with low uptake, and with no need for hospital admission.