Long-term outcomes of renal function after radioactive iodine therapy for thyroid cancer according to preparation method: thyroid hormone withdrawal vs. recombinant human thyrotropin

Endocrine ◽  
2018 ◽  
Vol 64 (2) ◽  
pp. 293-298
Author(s):  
Yoon Young Cho ◽  
Soo Kyoung Kim ◽  
Jung Hwa Jung ◽  
Jong Ryeal Hahm ◽  
Tae Hyuk Kim ◽  
...  
Keyword(s):  
Renal Function ◽  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Radioactive Iodine ◽  
Preparation Method ◽  
Radioactive Iodine Therapy ◽  
Long Term Outcomes ◽  
Thyroid Hormone Withdrawal ◽  
Recombinant Human Thyrotropin

scholarly journals Acute-on-Chronic Kidney Injury in Thyroid Hormone Withdrawal: A Case with Possible Implications for Radioactive Iodine Planning

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Elizabeth A. McAninch ◽  
Violet S. Lagari
Keyword(s):  
Renal Function ◽  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Renal Insufficiency ◽  
Radioactive Iodine ◽  
Kidney Injury ◽  
Unilateral Renal Agenesis ◽  
Thyroid Hormone Withdrawal ◽  
Ckd Stage ◽  
Acute Hypothyroidism

The association between renal dysfunction and hypothyroidism is of increasing clinical importance as thyroid hormone replacement may attenuate decline in renal function and improve cardiovascular outcomes in patients with chronic kidney disease (CKD). Although multiple mechanisms for the induction of renal insufficiency in hypothyroidism have been described, the renal impact of short-term, acute hypothyroidism is unknown, which has possible implications for thyroid cancer patients preparing to receive radioactive iodine (RAI). A 56-year-old gentleman with history of unilateral renal agenesis and CKD stage III presented with intermediate-risk papillary thyroid cancer. In preparation for RAI, he underwent thyroid hormone withdrawal (THW) associated with acute kidney injury (AKI), as marked by a decrease in his estimated GFR from 53 to 32 mL/min/1.73 m2. Upon resumption of thyroid hormone, renal function returned to baseline within months. Although AKI in this case was not otherwise associated with adverse outcome and reversed upon resumption of thyroid hormone, it is possible that this phenomenon could result in potential harm, particularly in the patient with baseline renal insufficiency. In CKD patients, preparation for RAI therapy may require special consideration; future studies should address the role of recombinant TSH to mitigate deleterious renal effects of acute hypothyroidism in this setting.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: The role of rhTSH in the management of differentiated thyroid cancer: pros and cons

2019 ◽  
Vol 181 (4) ◽  
pp. R133-R145 ◽  
Author(s):  
Luca Giovanella ◽  
Leonidas H Duntas
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Clinical Role ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal ◽  
Clinical Sensitivity ◽  
Pros And Cons ◽  
Recombinant Human Thyrotropin

The use of recombinant human thyrotropin (rhTSH) testing in the diagnosis and therapy of differentiated thyroid cancer (DTC) has been adopted over the last two decades as an alternative to the classical thyroid hormone withdrawal avoiding the threat of hypothyroidism. Serum thyroglobulin (Tg) measurement is crucial for monitoring DTC patients over time. Until about a decade ago, optimal sensitivity of Tg assays for the detection of smaller disease foci required Tg measurement after thyrotropin (TSH) stimulation, carried out following thyroid hormone withdrawal or rhTSH administration. In very recent years, significant improvements in assay technology have resulted in highly sensitive Tg (hsTg) assays, sufficiently sensitive to obviate the need for rhTSH stimulation in most DTC patients. The aim of this paper is to review and discuss, via a ‘pros and cons’ approach, the current clinical role of rhTSH to stimulate radioiodine (RAI) uptake for treatment and/or imaging purposes and to increase the clinical sensitivity of Tg measurement for monitoring DTC patients when high-sensitive Tg assays are available.

Sign in / Sign up

Export Citation Format

Share Document