Nontoxic Goiter

Bonnema, Steen Joop

doi:10.1007/978-3-319-29195-6_5-1

Cited by 1 publication

(2 citation statements)

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“…The reason might be associated with enhanced uptake of the radioactive iodine and prolonged permanency of the radioisotope within the gland thyroid. Experimental studies also showed that the plausible explanation of the preconditioning effect of rhTSH was a more homogeneous distribution of 131 I within the goiter [25]. Moreover, a rhTSH-induced reactivation of dormant thyroid tissue, increased thyroid sensitivity to ionizing radiation, and a higher rate of apoptosis of the thyrocytes could contribute to the enhancement of GV reduction [16,17,26].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the incidence of hypothyroidism was significantly higher in patients receiving high dose of rhTSH stimulated 131 I therapy. This most likely resulted from a higher retained and more homogeneous distribution of 131 I in thyroid [25]. LT4 replacement therapy is usually straightforward after 131 I therapy [28], thus hypothyroidism should not be a major argument against rhTSH-augmented GV reduction effect.…”

Section: Discussionmentioning

confidence: 99%

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Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with Multinodular Goiters: A Meta-Analysis of Randomized Controlled Trials

Wang

Miao

et al. 2020

Horm Metab Res

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A potential reduction of goiter volume (GV) of recombinant human thyrotropin (rhTSH) on multinodular goiters (MNG) was previously reported but controversial. Hence we conducted a meta-analysis to estimate the effect of rhTSH-stimulated radioiodine therapy in patients with MNG. PubMed, Cochrane, CNKI, VIP, and Wanfang databases were searched. Mean difference (MD) and odds ratios with 95% confidence intervals (95% CI) were derived by using an inverse variance random-effects model and fixed-effects model, respectively. Six studies (n=237) were involved in the analysis. For 12 months follow up, high dose (>0.1 mg) of rhTSH significantly reduced GV (MD=17.61; 95% CI=12.17 to 23.04; p<0.00001) compared with placebo. No effective pooled results of low dose of rhTSH (<0.1 mg) were applicable for only one study included. For 6 months follow up, the source of heterogeneity was determined by subgroup and sensitivity analysis. High dose group showed vast improvement in GV reduction (MD=16.62; 95% CI=1.34 to 31.90; p=0.03). The reduction of low dose group compared with placebo was inferior to high dose group. No available data were obtained to assess the influence of rhTSH after 36 months follow up for the only included study. Hypothyroidism incidence was higher for rhTSH group. No publication bias was seen. High dose of rhTSH treatment-stimulated radioactive 131I therapy after 6 months and 12 months follow up had a better effect in reducing GV, but with higher incidence of hypothyroidism. Owing to the limited methodological quality, more clinical researches are warranted in the future.

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