Development of severe thyroid-associated ophthalmopathy in a patient with disseminated thyroid cancer treated with recombinant human thyrotropin/radioiodine and retinoic acid.

Berg, Gertrud,1944Gothenburg University,Göteborgs universitet,Institutionen för särskilda specialiteter, Avdelningen för onkologi,Institute of Selected Clinical Sciences, Department of Oncology (author)

We present a case in which a patient with disseminated well-differentiated papillary thyroid cancer developed severe thyroid-associated ophthalmopathy. Eight years after initial surgery and ablative radioiodine therapy the patient was found to have multiple pulmonary metastases. The metastases showed poor uptake of radioiodine. An attempt was made to use 13-cis-retinoic acid in order to achieve a redifferentiation of the thyroid cancer cells before recombinant human thyrotropin (rhTSH) stimulated radioiodine therapy. The treatment did not improve the uptake of radioiodine. However, approximately 2 weeks after completion of the treatment the patient experienced discomfort in her eyes and then over the next months she developed a severe ophthalmopathy. The analyses of TSH receptor antibodies and S-thyroglobulin simultaneously showed a pronounced increase. An association between therapy given and severe ophthalmopathy cannot be excluded.

Andersson, B Tommy,1964Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin,Institute of Internal Medicine(Swepub:gu)xandbt (author)
Sjödell, Lena,2000Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna,Institute of Surgical Sciences (author)
Jansson, Svante,1948Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi,Institute of Surgical Sciences, Department of Surgery(Swepub:gu)xjanss (author)
Nyström, Ernst,1941Gothenburg University,Göteborgs universitet,Institutionen för invärtesmedicin, Avdelningen för internmedicin,Institute of Internal Medicine, Dept of Medicine(Swepub:gu)xnyser (author)
Göteborgs universitetInstitutionen för särskilda specialiteter, Avdelningen för onkologi (creator_code:org_t)

In:Thyroid : official journal of the American Thyroid Association: Mary Ann Liebert Inc15:12, s. 1389-941050-7256
In:Thyroid: Mary Ann Liebert Inc15:12, s. 1389-941557-9077

By the author/editor: Berg, Gertrud, 1 ...; Andersson, B Tom ...; Sjödell, Lena, 2 ...; Jansson, Svante, ...; Nyström, Ernst, ...

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