분화성 갑상선 암 환자에서 갑상선 전절제술후 또는 갑상선 호르몬 억제 요법 중단에 따른 갑상선 자극 호르몬의 변화 (Serial Changes of Serum Thyroid-Stimulating Hormone after Total Thyroidectomy or Withdrawal of Suppressive Thyroxine Therapy in Patients with Differentiated Thyroid Cancer) |
Author |
배진호, 이재태, 서지형, 정신영, 정진향2, 박호용2, 김정국1, 안병철, 손진호3, 김보완1, 박준식3,이규보, |
Jin-Ho Bae, M.D., Jaetae Lee, M.D., Ji-Hyoung Seo, M.D., Shin Young Jeong, M.D.,Jin-Hyang Jung, M.D.2, Ho-Yong Park, M.D.2, Jung-Guk Kim, MD.1, Byeong-Cheol Ahn, M.D.,Jin Ho Sohn, M.D.3, June Sik Park, M.D.3, Bo-Wan Kim, M.D.1, Kyu-Bo Lee, M.D. |
Affiliation |
경북대학교 의과대학 핵의학교실, 내과학교실1, 외과학교실2, 이비인후과학교실3 Department of Nuclear Medicine, Internal Medicine1, General Surgery2 and Otolaryngology3, School of Medicine,Kyungpook National Unversity, Daegu, Korea |
Abstract |
Background: Radioactive iodine (RAI) therapy and whole-body scanning are the fundamentals of treatment and
follow-up of patients with differentiated thyroid cancer. It is generally accepted that a Thyroid-Stimulating
Hormone (TSH) level of at least 30 μU/ml is a prerequisite for the effective use of RAI, and that it requires 4-6
weeks of off-thyroxine to attain these levels. Because thyroxine withdrawal and the consequent hypothyroidism are
often poorly tolerated, and occasionally might be hazardous, it is important to be certain that these assumptions
are correct. We have measured serial changes in serum TSH after total thyroidectomy or withdrawl of thyroxine
in patients with thyroid cancer. Subjects and Methods: Serum TSH levels were measured weekly after
thyroidectomy in 10 patients (group A) and after the discontinuation of thyroxine in 12 patients (group B).
Symptoms and signs of hypothyroidism were also evaluated weekly by modified Billewicz diagnostic index. Results: By
the second week, 78% of group A patients and 17% of group B patients had serum TSH levels ≥ 30 μU/ml. By
the third week, 89% of group A patients and 90% of group B patients had serum TSH levels ≥ 30 μU/ml. By
the fourth week, all patients in two groups achieved target TSH levels and there were no overt hypothyroidism.
Conclusion: In all patients, serum TSH elevated to the target concentration (≥30 μU/ml) within 4 weeks without
significant manifestation of hypothyroidism. The schedule of RAI administration could be adjusted to fit the needs
and circumstances of individual patients with a shorter preparation period than the conventional.(Korean J Nucl
Med 38(6):516-521, 2004) |
Keyword |
Differentiated thyroid cancer, Thyroid-Stimulating Hormone, Radioactive iodine, hypothyroidism. |
Full text Article |
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