Use of the recombinant human TSH stimulated thyroglobulin level and diagnostic whole body scan in children with differentiated thyroid carcinoma.

The recombinant human thyrotropin (TSH) (rhTSH) stimulated thyroglobulin (Tg) level is a useful tumor marker for disease surveillance in adults with differentiated thyroid carcinoma (DTC). We report our institution's experience using rhTSH in children. Seven children with DTC on thyroid hormone suppressive therapy after total thyroidectomy and radioablation received rhTSH (0.9 mg i.m.) on day 1 and 2. TSH rose to 224 +/- 93 mIU/l on day 2 and 13 +/- 5 mIU/l on day 5. Serum Tg level and diagnostic whole body radioiodine scan (DxWBS) were assessed on day 5. Five children were disease free: all had negative DxWBS; two had Tg < or = 2.1 ng/ml; two had anti-Tg antibodies; and one had no Tg measured. Two children had recurrent disease: one had a negative DxWBS and Tg of 15 ng/ml; and one had a positive DxWBS and no Tg measured. There were no adverse effects from rhTSH. These results suggest that rhTSH can be safely used for disease surveillance in children with DTC.