Determination of the rate of increase of TSH in patients submitted to thyroidectomy for papillary thyroid cancer

• Grant number: 12/01374-9
• Support Opportunities: Regular Research Grants
• Start date: June 01, 2012
• End date: May 31, 2013
• Field of knowledge: Health Sciences - Medicine - Medical Radiology
• Principal Investigator: Eduardo Nóbrega Pereira Lima
• Grantee: Eduardo Nóbrega Pereira Lima
• Host Institution: Hospital A C Camargo. Fundação Antonio Prudente (FAP). São Paulo , SP, Brazil

Abstract

The thyroid is an endocrine gland, whose cells are secretory proteins. Within cells is synthesized and secreted thyroglobulin, this combines with the iodine oxidized and produces thyroid hormones, thyroxine (T4) and triiodothyronine (T3). The rate of thyroid hormone production is mainly controlled by thyroid stimulating hormone (TSH ) that is secreted by the pituitary gland and regulated through the mechanism of feedback. Os thyroid hormones regulate the body's metabolic rate.Papillary carcinoma is the most common type and has a better prognosis. The diagnosis, treatment and monitoring of patients with papillary carcinoma are associated with the use of nuclear medicine techniques such as whole body scan with Iodine ¹³¹ (PCI) and ablative treatment with Iodine ¹³¹. The PCI is performed after total thyroidectomy with TSH e 30¼UI/dL and aims to assess the extent of residual thyroid tissue and to detect regional and distant metastases. The patient remains under hormonal suppression for 4 weeks showing a state of hypothyroidism and starts all undesirable symptoms that range from extreme sleepiness to congestive heart failure. A study conducted in our group of 154 consecutive patients in order to study the use of SPECT-CT method in the determination of topographical regions Iodo concentrantes neck after total thyroidectomy, we observed the examination date, the average 107.93 ¼UI TSH / dL, or three times larger than necessary to perform the whole body scan with Iodine ¹³¹. From this observation, we hypothesized to be possible to reduce the period of preparation based on the analysis of TSH levels after total thyroidectomy, determining the best time for the examination and thus reducing the adverse effects of hypothyroidism. (AU)