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[Insufficient elevation of TSH before therapy with I131 in a patient with metastatic differentiated thyroid
Luis Agustín Ramírez Stieben1, Mariana Queralt2, Gustavo Sylvestre Begnis3
1Unidad de Tiroides y Paratiroides del Grupo Gamma. ramirez.stieben@gmail.com.
Abstract:
Guidelines suggest a thyrotropin (TSH) stimulation level ≥30 mIU/l for the administration of 131-iodine (I131) in patients with differentiated thyroid carcinoma (DTC). We present a patient with follicular thyroid carcinoma (FTC), with spinal metastasis as the initial manifestation, who after 6 weeks without levothyroxine did not present an elevation of ≥30 mIU/l of TSH. This situation was interpreted as secondary to the presence of functioning metastases and it was decided, regardless of the TSH level, to administer a therapeutic dose of I131, with iodine-uptake lesions in the liver and spine being confirmed.
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