A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma

The presence of TSH receptor antibody (TRAb) is rarely responsible for hyperthyroidism due to metastatic lesions of thyroid carcinoma. A 70-year-old woman was incidentally found to be thyrotoxic around the time that external irradiation was performed for multiple bone metastases 9 years after subtot...

Full description

Saved in:
Bibliographic Details
Published in:ENDOCRINE JOURNAL 2002, Vol.49 (2), p.241-245
Main Authors: TAKASHI ISHIHARA, KATSUJI IKEKUBO, MAKIKO SHIMODAHIRA, TOSHlO IWAKURA, MASAHIRO KOBAYASHI, MEGUMU HINO, MOTOKO OOBAYASHI, KOUICHI KOHNO, KAZUHIKO KIMURA, SHUJI KAWAMURA, HIROYUKI KURAHACHI
Format: Article
Language:Japanese
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page 245
container_issue 2
container_start_page 241
container_title ENDOCRINE JOURNAL
container_volume 49
creator TAKASHI ISHIHARA
KATSUJI IKEKUBO
MAKIKO SHIMODAHIRA
TOSHlO IWAKURA
MASAHIRO KOBAYASHI
MEGUMU HINO
MOTOKO OOBAYASHI
KOUICHI KOHNO
KAZUHIKO KIMURA
SHUJI KAWAMURA
HIROYUKI KURAHACHI
description The presence of TSH receptor antibody (TRAb) is rarely responsible for hyperthyroidism due to metastatic lesions of thyroid carcinoma. A 70-year-old woman was incidentally found to be thyrotoxic around the time that external irradiation was performed for multiple bone metastases 9 years after subtotal thyroidectomy for follicular carcinoma. Hyperthyroidism persisted after oral administration of thiamazole. Relevant laboratory data were as follows： FT4 9.6 ng/L, FT3 7.3 ng/L, TSH
format article
fullrecord <record><control><sourceid>medicalonline</sourceid><recordid>TN_cdi_medicalonline_journals_cq6endoc_2002_004902_019_0241_0245984194</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>cq6endoc_2002_004902_019_0241_0245984194</sourcerecordid><originalsourceid>FETCH-LOGICAL-m1070-16ab515d932e9a170408e34d6d0c938551a242af4f6bfd783f7862d614d488073</originalsourceid><addsrcrecordid>eNotjdFKwzAYhXuh4Jh7h7xA4U-apMnlGNYJE2XO65Imf12kTWaTKXt7Nycczndz-M5NMQNNVam00HfFIiXfAWOiZlKwWeGXZGUSktiT3duabNHiIceJLEP2XXSn8jUmn_03kvXpgFPen6bonU8j-fF5T5pjsNnH4MMHecZs0jmY_mzX5dk-WR_iaO6L294MCRf_nBfvzcNutS43L49Pq-WmHCnUUFJpOkGF0xVDbWgNHBRW3EkHVldKCGoYZ6bnvex6V6uqr5VkTlLuuFJQV_OiuXpHdN6aIYbBB2w_43EK59_WfkkMLtqWAbAWgOsLqG6BcXopoRWnmle_FjhdXA</addsrcrecordid><sourcetype>Publisher</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma</title><source>J-STAGE (Japan Science &amp; Technology Information Aggregator, Electronic) - Open Access English articles</source><creator>TAKASHI ISHIHARA ; KATSUJI IKEKUBO ; MAKIKO SHIMODAHIRA ; TOSHlO IWAKURA ; MASAHIRO KOBAYASHI ; MEGUMU HINO ; MOTOKO OOBAYASHI ; KOUICHI KOHNO ; KAZUHIKO KIMURA ; SHUJI KAWAMURA ; HIROYUKI KURAHACHI</creator><creatorcontrib>TAKASHI ISHIHARA ; KATSUJI IKEKUBO ; MAKIKO SHIMODAHIRA ; TOSHlO IWAKURA ; MASAHIRO KOBAYASHI ; MEGUMU HINO ; MOTOKO OOBAYASHI ; KOUICHI KOHNO ; KAZUHIKO KIMURA ; SHUJI KAWAMURA ; HIROYUKI KURAHACHI ; Kobe City General Hospital ; Department of Endocrinology ; Department of Internal Medicine ; Hyogo Prefectural Nishinomiya Hospital</creatorcontrib><description>The presence of TSH receptor antibody (TRAb) is rarely responsible for hyperthyroidism due to metastatic lesions of thyroid carcinoma. A 70-year-old woman was incidentally found to be thyrotoxic around the time that external irradiation was performed for multiple bone metastases 9 years after subtotal thyroidectomy for follicular carcinoma. Hyperthyroidism persisted after oral administration of thiamazole. Relevant laboratory data were as follows： FT4 9.6 ng/L, FT3 7.3 ng/L, TSH &lt;0.19 mU/L, TBII 70, TSAb 735, and Tg 32,000 μg/L. 131I-total body scan showed 131I accumulation in the occipital bone, cervical vertebra, thoracic vertebra, ilium, and residual thyroid gland. Since the ilium uptake (11. 6) was markedly higher compared to the residual thyroid gland uptake (0.14), four subsequent 131I therapies were performed. The patient became hypothyroid, and TBII became negative. TSAb became negative after the first 131I-therapy but has increased again to 204 at present. Tg was 1,962μg/L despite high TSH levels. 131I accumulation in the residual thyroid, cervical vertebra, and thoracic vertebra disappeared. Also 131I accumulation in the ilium has gradually decreased, but the image in the occipital bone has become markedly distinctive. This is a rare case characterized by TRAb-positive hyperthyroidism, by T3-predominant thyrotoxicosis, and by stronger accumulation of 131I in the metastatic tumor than in the residual thyroid gland. Thus, the response to TRAb and 131I-therapy is different among metastatic thyroid tissues.</description><identifier>ISSN: 0918-8959</identifier><language>jpn</language><publisher>The Japan Endocrine Society</publisher><ispartof>ENDOCRINE JOURNAL, 2002, Vol.49 (2), p.241-245</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4022</link.rule.ids></links><search><creatorcontrib>TAKASHI ISHIHARA</creatorcontrib><creatorcontrib>KATSUJI IKEKUBO</creatorcontrib><creatorcontrib>MAKIKO SHIMODAHIRA</creatorcontrib><creatorcontrib>TOSHlO IWAKURA</creatorcontrib><creatorcontrib>MASAHIRO KOBAYASHI</creatorcontrib><creatorcontrib>MEGUMU HINO</creatorcontrib><creatorcontrib>MOTOKO OOBAYASHI</creatorcontrib><creatorcontrib>KOUICHI KOHNO</creatorcontrib><creatorcontrib>KAZUHIKO KIMURA</creatorcontrib><creatorcontrib>SHUJI KAWAMURA</creatorcontrib><creatorcontrib>HIROYUKI KURAHACHI</creatorcontrib><creatorcontrib>Kobe City General Hospital</creatorcontrib><creatorcontrib>Department of Endocrinology</creatorcontrib><creatorcontrib>Department of Internal Medicine</creatorcontrib><creatorcontrib>Hyogo Prefectural Nishinomiya Hospital</creatorcontrib><title>A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma</title><title>ENDOCRINE JOURNAL</title><description>The presence of TSH receptor antibody (TRAb) is rarely responsible for hyperthyroidism due to metastatic lesions of thyroid carcinoma. A 70-year-old woman was incidentally found to be thyrotoxic around the time that external irradiation was performed for multiple bone metastases 9 years after subtotal thyroidectomy for follicular carcinoma. Hyperthyroidism persisted after oral administration of thiamazole. Relevant laboratory data were as follows： FT4 9.6 ng/L, FT3 7.3 ng/L, TSH &lt;0.19 mU/L, TBII 70, TSAb 735, and Tg 32,000 μg/L. 131I-total body scan showed 131I accumulation in the occipital bone, cervical vertebra, thoracic vertebra, ilium, and residual thyroid gland. Since the ilium uptake (11. 6) was markedly higher compared to the residual thyroid gland uptake (0.14), four subsequent 131I therapies were performed. The patient became hypothyroid, and TBII became negative. TSAb became negative after the first 131I-therapy but has increased again to 204 at present. Tg was 1,962μg/L despite high TSH levels. 131I accumulation in the residual thyroid, cervical vertebra, and thoracic vertebra disappeared. Also 131I accumulation in the ilium has gradually decreased, but the image in the occipital bone has become markedly distinctive. This is a rare case characterized by TRAb-positive hyperthyroidism, by T3-predominant thyrotoxicosis, and by stronger accumulation of 131I in the metastatic tumor than in the residual thyroid gland. Thus, the response to TRAb and 131I-therapy is different among metastatic thyroid tissues.</description><issn>0918-8959</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNotjdFKwzAYhXuh4Jh7h7xA4U-apMnlGNYJE2XO65Imf12kTWaTKXt7Nycczndz-M5NMQNNVam00HfFIiXfAWOiZlKwWeGXZGUSktiT3duabNHiIceJLEP2XXSn8jUmn_03kvXpgFPen6bonU8j-fF5T5pjsNnH4MMHecZs0jmY_mzX5dk-WR_iaO6L294MCRf_nBfvzcNutS43L49Pq-WmHCnUUFJpOkGF0xVDbWgNHBRW3EkHVldKCGoYZ6bnvex6V6uqr5VkTlLuuFJQV_OiuXpHdN6aIYbBB2w_43EK59_WfkkMLtqWAbAWgOsLqG6BcXopoRWnmle_FjhdXA</recordid><startdate>2002</startdate><enddate>2002</enddate><creator>TAKASHI ISHIHARA</creator><creator>KATSUJI IKEKUBO</creator><creator>MAKIKO SHIMODAHIRA</creator><creator>TOSHlO IWAKURA</creator><creator>MASAHIRO KOBAYASHI</creator><creator>MEGUMU HINO</creator><creator>MOTOKO OOBAYASHI</creator><creator>KOUICHI KOHNO</creator><creator>KAZUHIKO KIMURA</creator><creator>SHUJI KAWAMURA</creator><creator>HIROYUKI KURAHACHI</creator><general>The Japan Endocrine Society</general><scope/></search><sort><creationdate>2002</creationdate><title>A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma</title><author>TAKASHI ISHIHARA ; KATSUJI IKEKUBO ; MAKIKO SHIMODAHIRA ; TOSHlO IWAKURA ; MASAHIRO KOBAYASHI ; MEGUMU HINO ; MOTOKO OOBAYASHI ; KOUICHI KOHNO ; KAZUHIKO KIMURA ; SHUJI KAWAMURA ; HIROYUKI KURAHACHI</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-m1070-16ab515d932e9a170408e34d6d0c938551a242af4f6bfd783f7862d614d488073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>jpn</language><creationdate>2002</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TAKASHI ISHIHARA</creatorcontrib><creatorcontrib>KATSUJI IKEKUBO</creatorcontrib><creatorcontrib>MAKIKO SHIMODAHIRA</creatorcontrib><creatorcontrib>TOSHlO IWAKURA</creatorcontrib><creatorcontrib>MASAHIRO KOBAYASHI</creatorcontrib><creatorcontrib>MEGUMU HINO</creatorcontrib><creatorcontrib>MOTOKO OOBAYASHI</creatorcontrib><creatorcontrib>KOUICHI KOHNO</creatorcontrib><creatorcontrib>KAZUHIKO KIMURA</creatorcontrib><creatorcontrib>SHUJI KAWAMURA</creatorcontrib><creatorcontrib>HIROYUKI KURAHACHI</creatorcontrib><creatorcontrib>Kobe City General Hospital</creatorcontrib><creatorcontrib>Department of Endocrinology</creatorcontrib><creatorcontrib>Department of Internal Medicine</creatorcontrib><creatorcontrib>Hyogo Prefectural Nishinomiya Hospital</creatorcontrib><jtitle>ENDOCRINE JOURNAL</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TAKASHI ISHIHARA</au><au>KATSUJI IKEKUBO</au><au>MAKIKO SHIMODAHIRA</au><au>TOSHlO IWAKURA</au><au>MASAHIRO KOBAYASHI</au><au>MEGUMU HINO</au><au>MOTOKO OOBAYASHI</au><au>KOUICHI KOHNO</au><au>KAZUHIKO KIMURA</au><au>SHUJI KAWAMURA</au><au>HIROYUKI KURAHACHI</au><aucorp>Kobe City General Hospital</aucorp><aucorp>Department of Endocrinology</aucorp><aucorp>Department of Internal Medicine</aucorp><aucorp>Hyogo Prefectural Nishinomiya Hospital</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma</atitle><jtitle>ENDOCRINE JOURNAL</jtitle><date>2002</date><risdate>2002</risdate><volume>49</volume><issue>2</issue><spage>241</spage><epage>245</epage><pages>241-245</pages><issn>0918-8959</issn><abstract>The presence of TSH receptor antibody (TRAb) is rarely responsible for hyperthyroidism due to metastatic lesions of thyroid carcinoma. A 70-year-old woman was incidentally found to be thyrotoxic around the time that external irradiation was performed for multiple bone metastases 9 years after subtotal thyroidectomy for follicular carcinoma. Hyperthyroidism persisted after oral administration of thiamazole. Relevant laboratory data were as follows： FT4 9.6 ng/L, FT3 7.3 ng/L, TSH &lt;0.19 mU/L, TBII 70, TSAb 735, and Tg 32,000 μg/L. 131I-total body scan showed 131I accumulation in the occipital bone, cervical vertebra, thoracic vertebra, ilium, and residual thyroid gland. Since the ilium uptake (11. 6) was markedly higher compared to the residual thyroid gland uptake (0.14), four subsequent 131I therapies were performed. The patient became hypothyroid, and TBII became negative. TSAb became negative after the first 131I-therapy but has increased again to 204 at present. Tg was 1,962μg/L despite high TSH levels. 131I accumulation in the residual thyroid, cervical vertebra, and thoracic vertebra disappeared. Also 131I accumulation in the ilium has gradually decreased, but the image in the occipital bone has become markedly distinctive. This is a rare case characterized by TRAb-positive hyperthyroidism, by T3-predominant thyrotoxicosis, and by stronger accumulation of 131I in the metastatic tumor than in the residual thyroid gland. Thus, the response to TRAb and 131I-therapy is different among metastatic thyroid tissues.</abstract><pub>The Japan Endocrine Society</pub><tpages>5</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0918-8959
ispartof ENDOCRINE JOURNAL, 2002, Vol.49 (2), p.241-245
issn 0918-8959
language jpn
recordid cdi_medicalonline_journals_cq6endoc_2002_004902_019_0241_0245984194
source J-STAGE (Japan Science & Technology Information Aggregator, Electronic) - Open Access English articles
title A Case of TSH Receptor Antibody-Positive Hyperthyroidism with Functioning Metastases of Thyroid Carcinoma
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-09T10%3A22%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-medicalonline&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Case%20of%20TSH%20Receptor%20Antibody-Positive%20Hyperthyroidism%20with%20Functioning%20Metastases%20of%20Thyroid%20Carcinoma&rft.jtitle=ENDOCRINE%20JOURNAL&rft.au=TAKASHI%20ISHIHARA&rft.aucorp=Kobe%20City%20General%20Hospital&rft.date=2002&rft.volume=49&rft.issue=2&rft.spage=241&rft.epage=245&rft.pages=241-245&rft.issn=0918-8959&rft_id=info:doi/&rft_dat=%3Cmedicalonline%3Ecq6endoc_2002_004902_019_0241_0245984194%3C/medicalonline%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-m1070-16ab515d932e9a170408e34d6d0c938551a242af4f6bfd783f7862d614d488073%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_id=info:pmid/&rfr_iscdi=true