Serum thyrotropin (TSH) levels after recombinant human TSH injections in children and teenagers with papillary thyroid cancer Journal Article


Authors: Iorcansky, S.; Herzovich, V.; Qualey, R. R.; Tuttle, R. M.
Article Title: Serum thyrotropin (TSH) levels after recombinant human TSH injections in children and teenagers with papillary thyroid cancer
Abstract: Context: In preparation for whole body radioactive iodine scanning, recombinant human TSH (rhTSH) is usually administered as 0.9-mg im injections on 2 consecutive days without regard to age, body size, or other comorbid conditions. Objective: Our objective was to determine whether the usual adult rhTSH dosing regimen would result in excessive elevations of serum TSH in children and teenagers with thyroid cancer. Design/Setting/Patients/ Interventions: A retrospective review identified 53 children and teenagers with thyroid cancer who underwent whole body radioactive iodine (RAI) scanning over a 12-yr period at two major medical centers (34 after thyroid hormone withdrawal and 19 after rhTSH treatment). Main Outcome Measures: The dynamic time course of changes in serum TSH after rhTSH administration and/or hypothyroid withdrawal was examined. Peak TSH levels were correlated with age, weight, and body surface area. Results: The mean serum TSH at the time of RAI administration was similar in patients undergoing hypothyroid preparation (188 ± 118 mIU/liter; range, 110-452 mIU/liter) and those treated with rhTSH (134 ± 75 mIU/liter; range, 32-290 mIU/liter; P = 0.07). Serial determinations after rhTSH injections revealed a mean serum TSH of 268 ± 76 mU/liter (range, 87-628) at 6 h and 130 ± 58 mU/liter (range, 67-250) at 24 h after the initial injection, and 361 ± 78 mU/liter (range 161-524) at 6 h and 134 ± 44 mU/liter (range, 32-290) at 24 h after the second injection. Conclusions: The mean TSH levels achieved in children after rhTSH injections are remarkably similar to values previously reported in adults despite marked differences in clinical characteristics between children and adults. These data suggest that dose adjustments are not generally required in children and teenagers undergoing rhTSH stimulation for RAI scanning or serum-stimulated thyroglobulin determinations. Copyright © 2005 by The Endocrine Society.
Keywords: adolescent; adult; child; school child; child, preschool; retrospective studies; major clinical study; drug withdrawal; cohort studies; carcinoma, papillary; body weight; retrospective study; time factors; correlation analysis; whole body radiation; radioactive iodine; iodine radioisotopes; recombinant proteins; thyroid cancer; thyroid neoplasms; thyroglobulin; thyroglobulin blood level; recombinant thyrotropin; whole-body irradiation; thyrotropin; injections; hormone blood level; body surface; thyrotropin blood level
Journal Title: Journal of Clinical Endocrinology and Metabolism
Volume: 90
Issue: 12
ISSN: 0021-972X
Publisher: Oxford University Press  
Date Published: 2005-12-01
Start Page: 6553
End Page: 6555
Language: English
DOI: 10.1210/jc.2005-1550
PUBMED: 16174712
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 20" - "Export Date: 24 October 2012" - "CODEN: JCEMA" - "Source: Scopus"
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  1. Rebecca Qualey
    4 Qualey
  2. Robert M Tuttle
    481 Tuttle