European journal of case reports in internal medicine · 2017
TSH-Suppressive Therapy: A Thorny Issue.
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Baldini Itala Marina, Cocino Cristina, Seghezzi Sonia, Cappellini Maria Domenica
Аннотация
UNLABELLED: Thyroid stimulating hormone (TSH)-suppressive therapy with levothyroxine is a cornerstone of thyroid carcinoma follow-up therapy, but the achievement of therapeutic goals must be balanced against L-T4 side effects. We describe the case of a 64-year-old cardiopathic patient with papillary thyroid carcinoma and autoimmune thyroiditis, whose cardiac condition worsened during TSH-suppressive therapy. TSH concentrations also fluctuated widely because of changing intestinal absorption due to coeliac disease.
LEARNING POINTS: TSH-suppressive therapy with levothyroxine (L-T4) to prevent thyroid carcinoma relapse can be a tricky problem in the presence of comorbidities.The recent American Thyroid Association guidelines are a useful reference for complex cases of thyroid carcinoma.When strict TSH control is crucial, the L-T4 liquid solution may be a valuable tool.
LEARNING POINTS: TSH-suppressive therapy with levothyroxine (L-T4) to prevent thyroid carcinoma relapse can be a tricky problem in the presence of comorbidities.The recent American Thyroid Association guidelines are a useful reference for complex cases of thyroid carcinoma.When strict TSH control is crucial, the L-T4 liquid solution may be a valuable tool.