Recombinant human thyrotropin (rhTSH) reduces the activity of radioiodine required to treat multinodular goiter (MNG), but acute airway compression can be a life-threatening complication. In this prospective, randomized, double-blind, placebo-controlled study, we assessed the efficacy and safety (including airway compression) of different doses of rhTSH associated with a fixed activity of (131)I for treating MNG. Euthyroid patients with MNG (69.3 +/- 62.0 mL, 20 females, 2 males, 64 +/- 7 years) received 0.1 mg (group I, N = 8) or 0.01 mg (group II, N = 6) rhTSH or placebo (group III, N = 8), 24 h before 1.11 GBq (131)I. Radioactive iodine uptake was determined at baseline and 24 h after rhTSH and thyroid volume (TV, baseline and 6 and 12 months after treatment) and tracheal cross-sectional area (TCA, baseline and 2, 7, 180, and 360 days after rhTSH) were determined by magnetic resonance; antithyroid antibodies and thyroid hormones were determined at frequent intervals. After 6 months, TV decreased significantly in groups I (28.5 +/- 17.6%) and II (21.6 +/- 17.8%), but not in group III (2.7 +/- 15.3%). After 12 months, TV decreased significantly in groups I (36.7 +/- 18.1%) and II (37.4 +/- 27.1%), but not in group III (19.0 +/- 24.3%). No significant changes in TCA were observed. T3 and free T4 increased transiently during the first month. After 12 months, 7 patients were hypothyroid (N = 3 in group I and N = 2 in groups II and III). rhTSH plus a 1.11-GBq fixed (131)I activity did not cause acute or chronic changes in TCA. After 6 and 12 months, TV reduction was more pronounced among patients treated with rhTSH plus (131)I.
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Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, IsraelChaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Cohen, O
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Ilany, J
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Ilany, J
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Hoffman, C
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Hoffman, C
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Olchovsky, D
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Olchovsky, D
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Dabhi, S
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Dabhi, S
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Karasik, A
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Karasik, A
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Goshen, E
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Goshen, E
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Rotenberg, G
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Rotenberg, G
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Zwas, ST
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
机构:
Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, IsraelChaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Cohen, O
;
Ilany, J
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Ilany, J
;
Hoffman, C
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Hoffman, C
;
Olchovsky, D
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Olchovsky, D
;
Dabhi, S
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Dabhi, S
;
Karasik, A
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Karasik, A
;
Goshen, E
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Goshen, E
;
Rotenberg, G
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel
Rotenberg, G
;
Zwas, ST
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机构:Chaim Sheba Med Ctr, Inst Endocrinol, Dept Radiol, IL-52621 Tel Hashomer, Israel