Compassionate use of recombinant human thyrotropin to facilitate radioiodine therapy: Case report and review of literature Journal Article

  

Authors:	Robbins, R. J.; Voelker, E.; Wang, W.; Macapinlac, H. A.; Larson, S. M.
Article Title:	Compassionate use of recombinant human thyrotropin to facilitate radioiodine therapy: Case report and review of literature
Abstract:	OBJECTIVE: To describe the use of recombinant human thyrotropin (thyroid-stimulating hormone) (rhTSH) to assist in radioiodine therapy in a patient with thyroid carcinoma who was unable to produce sufficient endogenous thyrotropin when hypothyroid and to review the related literature. METHODS: The study patient underwent formal dosimetric analysis and received radioiodine in conjunction with rhTSH. Follow-up scanning studies were performed. RESULTS: We found good localization of radioiodine on the posttherapy scans after administration of (131)I while the patient continued to receive thyroxine replacement after two intramuscularly administered injections of rhTSH. Some of his metastatic lesions disappeared and his serum thyroglobulin level decreased after the first rhTSH-assisted dose of (131)I was administered. His blood radioiodine clearance rate was unexpectedly more rapid in the hypothyroid state than when he was euthyroid (taking thyroxine) after administration of rhTSH. His whole-body clearance rate was more delayed when he was hypothyroid. Swelling of some of the metastatic thyroid cancer lesions developed when the patient was hypothyroid and after rhTSH was administered, the latter being much more rapid in onset. CONCLUSION: Therapeutic doses of radioiodine can be delivered with the assistance of rhTSH administration while patients continue to take suppressive doses of thyroxine. Metastatic thyroid carcinoma lesions can swell rapidly after administration of rhTSH. The commercially available form of rhTSH is approved only for diagnostic use. Its safety and efficacy in assisting radioiodine therapy have not been fully determined.
Keywords:	bone neoplasms; middle aged; bone tumor; review; case report; drug potentiation; brain tumor; brain neoplasms; adenocarcinoma; metastasis; pathology; drug synergism; diagnostic agent; radioactive iodine; iodine radioisotopes; recombinant proteins; recombinant protein; empathy; scintiscanning; thyroid neoplasms; thyroid tumor; adenocarcinoma, follicular; thyrotropin; thyroxine; humans; human; male
Journal Title:	Endocrine Practice
Volume:	6
Issue:	6
ISSN:	1530-891X
Publisher:	American Association of Clinical Endocrinologists
Date Published:	2000-11-01
Start Page:	460
End Page:	464
Language:	English
PUBMED:	11155220
PROVIDER:	scopus
DOI:	10.4158/EP.6.6.460
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-0034328026&partnerID=40&md5=853d25256930859c73c725f627e63e0d
Notes:	Export Date: 18 November 2015 -- Source: Scopus

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