Radioiodine plus recombinant human thyrotropin do not cause acute airway compression and are effective in reducing multinodular goiter

被引:13
作者
Albino, C. C. [1 ,2 ]
Graf, H. [3 ]
Paz-Filho, G. [3 ,4 ]
Diehl, L. A. [5 ]
Olandoski, M. [6 ]
Sabbag, A. [6 ]
Buchpiguel, C. [7 ]
机构
[1] Whittier Inst Diabet & Endocrinol, Maringa, Parana, Brazil
[2] Nucleo Diagnost Maringa, Maringa, Parana, Brazil
[3] Univ Fed Parana, SEMPR, BR-80060000 Curitiba, Parana, Brazil
[4] Australian Natl Univ, John Curtin Sch Med Res, Canberra, ACT 2601, Australia
[5] Univ Estadual Londrina, Londrina, PR, Brazil
[6] Pontificia Univ Catolica Parana, Nucleo Bioestatist, Curitiba, Parana, Brazil
[7] Univ Sao Paulo, Dept Radiol, Sao Paulo, Brazil
关键词
Hyperthyroidism; Multinodular goiter; Tracheal airway; (131)I; Thyrotropin alpha; NONTOXIC NODULAR GOITER; DOUBLE-BLIND; THYROID VOLUME; 0.3; MG; THERAPY; REDUCTION; TRIAL; SIZE; SINGLE; PRETREATMENT;
D O I
10.1590/S0100-879X2010007500001
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
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.
引用
收藏
页码:303 / 309
页数:7
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