Thyrotropin α
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Reactions 1293 - 20 Mar 2010 ★ S Thyrotropin α First report of haemoptysis and hypoxia: case report A 53-year-old man started receiving IM thyrotropin α [Thyrogen] 0.9mg twice daily for radioablation of metastatic papillary thyroid cancer. About 3 hours after his second dose, haemoptysis, fever, hypoxia, progressive hip pain, and widespread respiratory crackles developed [time to reaction onset not stated]. His TSH level peaked at 111.79 µU/mL. A thoracic CT scan showed new nodules, and enlargement of his existing lesions, compared to 7 weeks earlier. Thyrotropin α-induced intratumoural oedema and haemorrhage was the suspected cause of his symptoms. Empirical therapy was started with dexamethasone, antibacterials, analgesics and oxygen. Within 6 days, his haemoptysis had completely resolved. He was re-scheduled for thyrotropin α-facilitated radioablation, this time with prophylactic steroids. [Patient outcome not clearly stated]. Author comment: "The temporal relationship between [thyrotropin α] administration and symptom onset, in the absence of clinical evidence of infection/pulmonary embolism, led us to conclude these events were most likely secondary to [thyrotropin α]-induced intra-tumoural oedema and haemorrhage." Vethakkan SR, et al. Sudden onset of haemoptysis and hypoxia after recombinant human thyroid-stimulating hormone use in a patient with papillary thyroid carcinoma and pulmonary metastases. Internal Medicine Journal 39: 854-855, No. 12, Dec 2009. Available from: URL: http://dx.doi.org/10.1111/ j.1445-5994.2009.02076.x - Australia 803007914 » Editorial comment: A search of AdisBase, Embase and Medline did not reveal any previous case reports of hypoxia or haemoptysis associated with thyrotropin α. The WHO ADR database contained one report of hypoxia and two reports of haemoptysis associated with thyrotropin α. 1 Reactions 20 Mar 2010 No. 1293 0114-9954/10/1293-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Thyrotropin α
Reactions 1293 - 20 Mar 2010
★ SThyrotropin αFirst report of haemoptysis and hypoxia: casereport
A 53-year-old man started receiving IM thyrotropin α[Thyrogen] 0.9mg twice daily for radioablation ofmetastatic papillary thyroid cancer. About 3 hours after hissecond dose, haemoptysis, fever, hypoxia, progressive hippain, and widespread respiratory crackles developed [timeto reaction onset not stated]. His TSH level peaked at111.79 µU/mL. A thoracic CT scan showed new nodules,and enlargement of his existing lesions, compared to7 weeks earlier. Thyrotropin α-induced intratumouraloedema and haemorrhage was the suspected cause of hissymptoms. Empirical therapy was started withdexamethasone, antibacterials, analgesics and oxygen.Within 6 days, his haemoptysis had completely resolved.He was re-scheduled for thyrotropin α-facilitatedradioablation, this time with prophylactic steroids. [Patientoutcome not clearly stated].
Author comment: "The temporal relationship between[thyrotropin α] administration and symptom onset, in theabsence of clinical evidence of infection/pulmonaryembolism, led us to conclude these events were most likelysecondary to [thyrotropin α]-induced intra-tumoural oedemaand haemorrhage."Vethakkan SR, et al. Sudden onset of haemoptysis and hypoxia after recombinanthuman thyroid-stimulating hormone use in a patient with papillary thyroidcarcinoma and pulmonary metastases. Internal Medicine Journal 39: 854-855, No.12, Dec 2009. Available from: URL: http://dx.doi.org/10.1111/j.1445-5994.2009.02076.x - Australia 803007914
» Editorial comment: A search of AdisBase, Embase andMedline did not reveal any previous case reports of hypoxiaor haemoptysis associated with thyrotropin α. The WHOADR database contained one report of hypoxia and tworeports of haemoptysis associated with thyrotropin α.
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Reactions 20 Mar 2010 No. 12930114-9954/10/1293-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
