[The use for recombinant human TSH in patients with toxic and non-toxic nodular goiter].

Radioiodine ((131)I) treatment for multinodular toxic and non-toxic goiter is therapeutic procedure especially used in patients with contraindication for surgery. (131)I treatment diminishes the size of the goiter and treats hyperthyroidism. Sometimes, due to low radio-iodine uptake (RAIU), this procedure should not be used. In patients with goiter, the elimination of medication or substances rich in iodine is the first step to increase RAIU. Recombinant TSH (rhTSH) enhances RAIU in metastases distant from thyroid cancer. Studies were performed in recent years using rhTSH to increase the radio-iodine uptake in multinodular toxic and non-toxic goiter. These methods led to enhanced radio-iodine uptake, decreased the level of activity of the (131)I administered, changed the distribution of (131)I in the thyroid, lowered the absorption dose, and increased the number of patients with hypothyroidism. The uses of rhTSH can lead to exacerbation of the signs and symptoms of hyperthyroidism, so patients should be hospitalized. Until now there has been no evidence that the adverse effects outweigh the positive results of using rhTSH. The use of rhTSH in benign goiter disease is not yet approved, but its positive activity in multinodular goiter is very interesting and promising.