PDF(Pubmed)
Abstract：
American Thyroid Association guidelines recommend to follow athyreotic differentiated thyroid cancer patients with measurement of serum thyroglobulin and thyroglobulin antibody as tumor markers. The guidelines recommend that rising thyroglobulin or thyroglobulin antibody should prompt additional investigations and potentially additional therapies. Two patients with differentiated thyroid cancer who also received intravenous immunoglobulin are presented. Their cancer history, serial thyroglobulin and thyroglobulin antibody measurements and imaging findings relative to the time course of intravenous immunoglobulin treatment are illustrated. Acute rise in thyroglobulin antibody led to further imaging which did not show cancer progression. Additional history documented an intravenous immunoglobulin treatment exposure had occurred within the past one to two months before the increased thyroglobulin antibody measurement. Follow-up serial thyroglobulin antibody levels declined over time after the intravenous immunoglobulin exposure. Intravenous immunoglobulin, which is a pooled human serum product, contains thyroglobulin antibody. Commercially available thyroglobulin antibody assays may detect the thyroglobulin antibody contained within the administered intravenous immunoglobulin, leading to alarm and further imaging to exclude progressive malignancy. Thyroglobulin antibody rise and fall can be demonstrated in relationship to intravenous immunoglobulin time of administration. Thyroglobulin antibody is higher at time-points sooner than at later time-points following intravenous immunoglobulin treatments. Intravenous immunoglobulin may be a benign source of transiently high thyroglobulin antibody measured in the follow-up of differentiated thyroid cancer patients. Repeat thyroglobulin and thyroglobulin antibody testing one to two months following a higher level in a patient treated with intravenous immunoglobulin may avoid unnecessary imaging to look for progressive malignancy.
摘要：
美国甲状腺协会的指南建议在甲状腺转阴分化型甲状腺癌患者后测定血清甲状腺球蛋白和甲状腺球蛋白抗体作为肿瘤标志物。指南建议甲状腺球蛋白或甲状腺球蛋白抗体的升高应促使进一步的研究和潜在的额外治疗。介绍了两名也接受静脉注射免疫球蛋白的分化型甲状腺癌患者。他们的癌症史,说明了一系列甲状腺球蛋白和甲状腺球蛋白抗体测量以及相对于静脉免疫球蛋白治疗时程的影像学发现。甲状腺球蛋白抗体的急性升高导致进一步的成像，但未显示癌症进展。其他病史证明，在甲状腺球蛋白抗体测量增加之前的过去一到两个月内，发生了静脉内免疫球蛋白治疗暴露。静脉注射免疫球蛋白暴露后，后续系列甲状腺球蛋白抗体水平随时间下降。静脉免疫球蛋白，这是一种汇集的人类血清产品，含有甲状腺球蛋白抗体。市售的甲状腺球蛋白抗体测定法可以检测所施用的静脉内免疫球蛋白中包含的甲状腺球蛋白抗体。导致警报和进一步成像以排除进展性恶性肿瘤。甲状腺球蛋白抗体的上升和下降可以证明与静脉内免疫球蛋白给药时间有关。静脉内免疫球蛋白治疗后，甲状腺球蛋白抗体在较早的时间点高于较晚的时间点。在分化型甲状腺癌患者的随访中，静脉免疫球蛋白可能是短暂高甲状腺球蛋白抗体的良性来源。在静脉注射免疫球蛋白治疗的患者中，在较高水平后一到两个月重复进行甲状腺球蛋白和甲状腺球蛋白抗体测试可以避免不必要的成像以寻找进行性恶性肿瘤。
