High Thyroglobulin Antibody Following Intravenous Immunoglobulin Therapy in Athyreotic Differentiated Thyroid Cancer Patients.
false positive
intravenous immunoglobulin
intravenous immunoglobulin (ivig)
intravenous immunoglobulin therapy
thyroglobulin antibody
thyroid cancer
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
accepted:
29
11
2022
entrez:
5
1
2023
pubmed:
6
1
2023
medline:
6
1
2023
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 36601182
doi: 10.7759/cureus.32103
pmc: PMC9805341
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e32103Informations de copyright
Copyright © 2022, Lau et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Clin Invest. 1990 Mar;85(3):620-5
pubmed: 2312717
Biochem Biophys Res Commun. 1988 Aug 30;155(1):224-9
pubmed: 3046611
J Clin Endocrinol Metab. 2012 Jul;97(7):2380-7
pubmed: 22539585
Clin Med (Lond). 2015 Apr;15(2):125-9
pubmed: 25824062
Endocr Pract. 2016 Dec;22(12):1468-1469
pubmed: 27929682
Thyroid. 2013 Oct;23(10):1211-25
pubmed: 23692026
Biomolecules. 2016 Mar 09;6(1):15
pubmed: 27005671
J Immunol. 1982 Jun;128(6):2779-87
pubmed: 6176652
Endocr Pract. 2020 Sep;26(9):1031-1038
pubmed: 33471692
Thyroid. 2016 Jan;26(1):1-133
pubmed: 26462967
J Immunol. 1989 Dec 15;143(12):4104-9
pubmed: 2592768
J Clin Endocrinol Metab. 2002 Feb;87(2):489-99
pubmed: 11836274
J Immunol Methods. 1998 Jul 1;216(1-2):117-37
pubmed: 9760219