Nonautoimmune hyperthyroidism (NAH), caused by constitutively active mutants of the thyrotropin receptor () gene, is recommended to be treated with total thyroidectomy followed by radioiodine administration. Herein, we present a 39-year-old woman with sporadic NAH caused by a TSHR-L512Q mutation. At the age of 20 years, she presented with a large goiter of 370 mL, treated with thiamazole, and opted for radioiodine therapy as outpatient management. Over the next 17 years, she underwent 6 treatments of 13 mCi radioiodine each. She did not experience a relapse of hyperthyroidism, and thiamazole was reduced and later withdrawn during the final radioiodine treatment. The patient's goiter significantly reduced to 18 mL, and thyroid function tests showed that free thyroxine and free triiodothyronine levels were below the lower limit of the reference ranges, while TSH remained within the reference range for 20 months. Along with an almost normal TSH response to thyrotropin-releasing hormone stimulation, no pituitary atrophy was observed on magnetic resonance imaging. Contrary to the recommended treatment, this case showed that fractionated radioiodine therapy alone is effective in controlling thyroid function and in reducing goiter size. Low TSH levels during treatment should not be assessed as subclinical hyperthyroidism or as risk of relapse.
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http://dx.doi.org/10.1210/jcemcr/luad026 | DOI Listing |
Cancer Chemother Pharmacol
January 2025
Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Purpose: After initial approval of lenvatinib for radioiodine-refractory differentiated thyroid cancer (DTC), it has also shown promising outcomes in among others metastatic renal cell carcinoma (mRCC). Given that trial populations typically do not represent routine clinical care populations, questions arise about how applicable trial outcomes are in clinical practice. This study aims to compare the pharmacokinetics (PK), toxicity patterns, and survival data of lenvatinib in a real-world cohort with DTC and mRCC to those observed in pivotal clinical trials.
View Article and Find Full Text PDFNarra J
December 2024
Department of Physiology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia.
Iodine has an anti-proliferative effect on cancer cells; however, its effects have not been explored adequately. The aim of this study was to evaluate the therapeutic potential of iodine and radioiodine by assessing their effects on the viability of various breast cancer cell lines: MCF7, SKBR3, and MDA-MB231. The viability of cells was measured in treated cells exposed to six doses of iodine (5, 10, 20, 40, 60, 80 µM) and two doses of radioiodine (3.
View Article and Find Full Text PDFJRSM Open
January 2025
Department of Endocrinology, Diabetes and General (Internal) Medicine, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent ST4 6QG, UK.
The delayed onset of thyroid eye disease is well recognised but less commonly perceived in routine clinical practice and this case report serves as a reminder for a high index of suspicion in at-risk patients.
View Article and Find Full Text PDFEndocr Pract
January 2025
Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil. Electronic address:
Objectives: To evaluate the characteristics related to oral health and salivary production in patients with Differentiated Thyroid Carcinoma (DTC) after radioiodine therapy (RIT).
Methods: Cross-sectional study, which included patients with DTC after ablative and/or adjuvant RIT. Patients underwent assessment of oral health conditions, subjective assessment of xerostomia and measurement of salivary flow.
Int J Mol Sci
December 2024
Nuclear Medicine Department, University of Medicine and Pharmacy "Carol Davila" Bucharest, 050474 Bucharest, Romania.
Starting from the metabolic profile of type 2 diabetes mellitus (T2DM), we hypothesized that the mechanisms of ¹³¹I-induced cardiotoxicity differ between patients diagnosed with differentiated thyroid cancer (DTC) with/without T2DM, with metformin potentially acting as a cardioprotective agent by mitigating inflammation in patients with T2DM. To address this hypothesis, we quantified, using ELISA, the serum concentration of several key biomarkers that reflect cardiac injury (NT-proBNP, NT-proANP, ST2/IL-33R, and cTn I) in 74 female patients with DTC/-T2DM and 25 with DTC/+T2DM treated with metformin. All patients received a cumulative oral dose of I exceeding 150 mCi (5.
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