title: Recombinant human TSH for thyroid remnant ablation with (131)I in children and adolescents with papillary carcinoma.
abstract: BACKGROUND
  The objective of this study was to report the results of a series of 12 patients with papillary carcinoma aged 16 years or younger, who were prepared with recombinant human TSH (rhTSH) for remnant ablation with (131)I. The TSH levels achieved and the safety of 24 cycles of rhTSH administration (ablation and control assessment) are reported.
  
  
  METHODS
  All patients were prepared using the same protocol as recommended for adults. Eight to 12 months after initial therapy, the patients were submitted to neck ultrasound, measurement of stimulated Tg and anti-Tg antibodies (TgAb), and diagnostic whole-body scanning (DxWBS).
  
  
  RESULTS
  TSH levels >50 mIU/l were achieved in all patients. An adverse reaction (mild nausea and headache) was observed in 1/24 cycles (4.1%). Eight (88.8%) of 9 patients with uptake in the thyroid bed in post-therapy whole-body scanning (RxWBS) achieved complete remission. One patient presented TgAb in the absence of apparent disease. In addition, imaging methods showed no apparent disease in the 2 patients with lymph node metastases in RxWBS. Elevated Tg persisted in 1 patient with pulmonary micrometastases.
  
  
  CONCLUSIONS
  The present results demonstrate the efficacy and safety of rhTSH in children and adolescents.
authors.affiliation: Núcleo de Pós-graduação da Santa Casa de Belo Horizonte, Belo Horizonte, Brasil. pedrorosario@globo.com
authors.forename: Pedro Weslley
authors.initials: PW
authors.lastname: Rosario
authors.forename: Augusto Flávio Campos
authors.initials: AF
authors.lastname: Mineiro Filho
authors.forename: Rafaela Xavier
authors.initials: RX
authors.lastname: Lacerda
authors.forename: Maria Regina
authors.initials: MR
authors.lastname: Calsolari
mesh_terms: D055011:Ablation Techniques; D000293:Adolescent; D002291:Carcinoma, Papillary / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy; D013972:Thyrotropin / Q000008:administration & dosage* / Q000097:blood
chemical_list: D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D013972:Thyrotropin