ABSTRACT
The absence of iodine uptake in metastases of differentiated thyroid carcinoma makes them unresponsive to treatment with radioiodine 131I. In many of such cases symptomatic treatment remains the only available therapy. The results of studies on partial redifferentiation of metastases of thyroid cancer achieved after cis-retinoid acid therapy have drawn attention to the possibility of restoration of iodine uptake in metastases after pretreatment with cis-retinoic acid (Roaccutane). 5 patients with iodine uptake-negative metastases of differentiated thyroid carcinoma were given Roaccutane in a dose 1.5 mg/kg/24 h daily for 6 weeks before the therapy with radioiodine. In none of the patients restoration of radioiodine uptake in metastases has occurred as shown in post-therapeutic total body scintigraphy.
Subject(s)
Adenocarcinoma, Follicular/secondary , Carcinoma, Papillary/secondary , Iodine Radioisotopes/pharmacokinetics , Isotretinoin/administration & dosage , Premedication , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/radiotherapy , Adenocarcinoma, Follicular/metabolism , Adenocarcinoma, Follicular/radiotherapy , Adult , Aged , Bone Neoplasms/metabolism , Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary , Carcinoma, Papillary/metabolism , Carcinoma, Papillary/radiotherapy , Female , Humans , Isotretinoin/adverse effects , Lung Neoplasms/metabolism , Lung Neoplasms/radiotherapy , Lung Neoplasms/secondary , Thyroglobulin/metabolism , Thyroid Neoplasms/drug therapyABSTRACT
UNLABELLED: Technetium 99mTc(TF), non-specific tumor-searching tracer was evaluated for its ability to detect distant metastases of differentiated thyroid carcinoma (DTC) and its reliability in the follow-up of DTC. Whole body scintigraphy (wbs) was performed 20-30 min after intravenous injection of 740 MBq 99mTc tetrofosmin by means of a dual-head gamma-camera (followed by spot images if needed) in 61 patients (pts) with DTC; 52 pts with distant metastases in 131I whole body scintigraphy (34) or in other methods (x-ray, CT, ultrasound) (7) or with negative 131I whole body scan and elevated thyroglobulin (11). In the group of 52 pts with signs of neoplasm dissemination, 36 showed positive TF whole body scan (69%), 16 (31%) pts were TF-negative. 23 of 34 131I positive wbs were also TF positive (68%), 11 out of 34 were TF negative (32%). In a group of 7 pts with metastases in x-ray, CT or ultrasound 4/7 were positive (57%), 3/7 were TF negative (18%). In a control group of 11 persons (2 diseases-free, 9 with DTC in clinical remission) TF whole body scans were negative in all cases. CONCLUSIONS: Technetium 99mTc tetrofosmin is clinically useful for detecting distant metastases of differentiated thyroid carcinoma and deserves complementary clinical application in follow-up in such patients.
Subject(s)
Bone Neoplasms/secondary , Lung Neoplasms/secondary , Neoplasm Recurrence, Local/diagnostic imaging , Organophosphorus Compounds , Organotechnetium Compounds , Thyroid Neoplasms/diagnostic imaging , Bone Neoplasms/diagnostic imaging , Follow-Up Studies , Humans , Lung Neoplasms/diagnostic imaging , Lymphatic Metastasis , Radionuclide Imaging , Reproducibility of ResultsABSTRACT
This study aimed at evaluating the frequency of autoimmune disorders in Addison's disease. We have observed 180 patients (113 females, 67 males, aged 9-74 years) for 1 to 26 years. Tuberculosis was noted in 54 patients. Autoimmune disorders were found in 80 patients (44%); however, 125 (69%) patients were believed to have an autoimmune origin of adrenocortical insufficiency. In 20 patients two or more autoimmune disorders were found to coexist with Addison's disease.
Subject(s)
Addison Disease/complications , Autoimmune Diseases/complications , Adolescent , Adult , Aged , Autoimmune Diseases/epidemiology , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prevalence , Sex Factors , Thyrotoxicosis/complications , Tuberculosis/complicationsABSTRACT
Sodium valproate, a gamma-aminobutyric acid (GABA) agonist, was found to decrease plasma ACTH concentration in some cases of Cushing's disease and Nelson's syndrome. In this study we have investigated the influence of magnesium valproate (MV), a newly introduced salt of valproic acid, on plasma ACTH levels in 8 patients with Nelson's syndrome. The daily dose, 1200 mg of MV, significantly decreased plasma ACTH level at 10 p.m. compared with placebo. A single dose of 400 mg of MV, led to a reduction in plasma ACTH concentration only in two out of seven patients during a four-hour observation. The fall in plasma ACTH level in the same patients at 10 p.m., after the next two doses of this drug, suggests that single dose may be insufficient for introducing GABA-dependent reduction in ACTH release. During a long-term therapy with MV, in all three patients investigated a marked decrease in plasma ACTH was observed. Our results suggest that magnesium valproate may be useful during chronic therapy in some patients with ACTH hypersecretion.
