Document Detail

eleRecombinant human thyrotropin to help confirm lack of evidence of radiation-induced differentiated thyroid cancer in young women seeking pregnancy.
MedLine Citation:
PMID:  22936503     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Women with a history of differentiated thyroidcarcinoma who are contemplating pregnancy may wish reassuranceregarding apparent remission. However, the thyroidhormone withdrawal needed to obtain serum thyroglobulintesting (Tg) results in weeks-long biochemical and clinical hypothyroidism,which could increase miscarriage and fetal deathrates if pregnancy occurred during withdrawal of thyroxine orsoon thereafter. Recombinant human thyrotropin (rhTSH) elevates thyrotropin exogenously, allowing uninterrupted thyroidhormone therapy and avoids hypothyroidism.
MATERIAL AND METHODS: Thirty female radiation-inducedpapillary thyroid carcinoma survivors who had undergonetotal- or near-total thyroidectomy and who were now seekingpregnancy (mean age 23.9 ± 1.8 years), and who were consideredcancer-free by local standards, underwent rhTSH-aided Tgtesting to help confirm remission. At the time of rhTSH testing,mean follow-up after primary surgical treatment was 11.1 ±3.9 years, and all patients had negative neck ultrasonography,undetectable unstimulated serum Tg (< 0.2 ng/mL) and nointerfering anti-Tg antibodies. However, based on T3, N1 or M1status, 28/30 (93.3%) patients had high recurrence risk.
RESULTS: rhTSH produced no serum Tg increase in 27/30women (90.0%). Serum Tg increases to 0.4-0.9 ng/ml wereobserved in 3 women, but careful neck ultrasonography foundno lymphadenopathy. Reassured about their remission, 14/30women (46%) have become pregnant and delivered healthychildren in the 3 years since rhTSH-aided testing.
CONCLUSIONS: rhTSH-aided Tg testing is useful in confirmingabsence of tumor in female patients with a history of radiation-inducedthyroid cancer who are seeking pregnancy, but who alsohave a high risk of thyroid cancer recurrence.
Valentina Drozd; Tatjana Leonova; Tatjana Mitjukova; Maxim Lushchik; Sergey Koritko; James A Magner; Johannes Biko; Christoph Reiners
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Publication Detail:
Type:  Journal Article     Date:  2012-08-28
Journal Detail:
Title:  Nuclear medicine review. Central & Eastern Europe     Volume:  15     ISSN:  1644-4345     ISO Abbreviation:  Nucl Med Rev Cent East Eur     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886103     Medline TA:  Nucl Med Rev Cent East Eur     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  108-12     Citation Subset:  IM    
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