Plasma Exchanges Overcome Persistent Iodine Overload to Enable 131I Ablation of Differentiated Thyroid Carcinoma
| Autor: | Nathalie Parquet, Anne Dib-Deperrest, Elif Hindié, Pascal Houzé, Jean-Luc Moretti, Marie-Elisabeth Toubert |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism medicine.medical_treatment Urology Amiodarone chemistry.chemical_element Iodine Iodine Radioisotopes Thyroid carcinoma Excretion chemistry.chemical_compound Endocrinology Internal medicine medicine Humans Obesity Thyroid Neoplasms Creatinine Plasma Exchange business.industry Thyroidectomy Cancer Middle Aged Ablation medicine.disease Treatment Outcome chemistry Lymphatic Metastasis Radiopharmaceuticals business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Thyroid. 18:469-472 |
| ISSN: | 1557-9077 1050-7256 |
| DOI: | 10.1089/thy.2007.0184 |
| Popis: | Amiodarone has a high iodine content that can induce persistent iodine excess and may prevent radioiodine (RI) treatment.A 55-year-old obese man had taken amiodarone (200 mg/d) for 3 years and stopped 2 years earlier. He underwent total thyroidectomy for papillary cancer with extrathyroidal extension and a metastatic central lymph node, requiring RI treatment. But iodine overload, with no other documented iodinated drug intake, was found (urinary iodine excretion = 472 microg/24 h; normal150 microg/24 h), and persisted 3 months later. Plasma exchanges (PE) were prescribed.Eight PE over 4 weeks were needed to eliminate 39,295 nmol of iodine. Urinary iodine excretion and serum iodine concentrations, before PE and after eight sessions were, respectively: 230 and 84 nmol/mmol of creatinine, and 811 and 71 nmol/L, enabling RI treatment (4 GBq (131)I). Post-therapy whole-body scan revealed cervical uptake (0.48% of the total administered dose) corresponding to usual thyroid remnants. Ablation efficacy was confirmed 6 and 24 months later by cervical ultrasonography combined with an undetectable serum thyroglobulin level after recombinant human thyrotropin stimulation.When spontaneous iodine elimination is too slow to allow RI treatment of high-risk thyroid carcinoma within a reasonable time after thyroidectomy, PE are reliable and effective to overcome iodine overload. |
| Databáze: | OpenAIRE |
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