Estimulación iterativa (EI) de TSH endógena (TSH-En) mediante el uso de la hormona liberadora de tirotrofina (TRH) en pacientes portadores de carcinoma diferenciado de tiroides

in the follow up (f) of p with dtc it is necessary to obtain high figures of serum tsh for determination of serum tg and 131i scan (wbs). for this object, he method, for a long time, was to withdrawal thyroid hormone therapy (generally l-t4) that produce hypothyroidism with the inconvenient for the p, dramatics in certain cases. our objective was to increase tsh by is to shortening time of l-t4 withdrawal for f, ablation (a) or treatment (t) with 131i. in 37 p. with dtc (g-1), aged 19-78 y., 34 with pap. dtc and 3 with foll. form, 25 females, 12 males, 43 studies were carried out; 6 p carried 2 studies. the group was divided in 2 sub-groups: g-1a,7 p derived for a; g-1 b 36 p. for f or t with 131i. six p carried out 2 studies; 4 of them for a and for f and 2 realizes 2 times f. all p treated with l-t4 replaced this hormone for t3 during 3 weeks ,that was withdrawal the day before is. in g-1a, between 8/10 days after surgery they begin is. is: at days 1, 3, 5 and 6, the p were injected i.v. with 200 mcg of trh; at 30 minutes of the 3rd injec. blood tsh determination ; immediately 370 mbq of 99mt was administered and at 30 minutes a wbs was carried out. at 30 minutes of the 4th injec. blood figures of tsh, tg and tg-ab were determined; immediately the activity of 131i indicated for each group was given to the p; in g-1a, at 8 days and in g1-b, at 48 hours wbs were carried out. as a control group (g-2) 41 studies in 35 dtc p. that withdrawal l-t4 for 4/5 weeks, were studied, aged 18-81 years, 31 females and 4 males; 32 with pap. and 3 folli.c form; 18 for a (g-2a) and 23 for f (g-2b); 6 p carried out 2 studies. one for a and the second as the first control. in g-1, tsh values obtained were 26-360 ui/l ( 83 ± 54. in g-1a : 137 ± 109 and in g-1b 62 ± 52). the 2 tracers 131i and 99mtc-tc, produce show similar figures. in g-1a all p present thyroid remnants and elevated tg. in g-1b, 7 p showed positive wbs and tg; 8 p present tg positive and wbs negative and 21 wbs and tg