High incidence of thyroid dysfunction despite prophylaxis with potassium iodide during ¹³¹I‐meta‐iodobenzylguanidine treatment in children with neuroblastoma

Abstract

We report a novel mutation of tau (L266V missense mutation in exon 9) which may cause a type of familial frontotemporal dementia. The brain of a patient showed Pick body–like inclusions and unique tau‐positive, argyrophilic astrocytes with stout filaments and naked, round, or irregular argyrophilic inclusions with deposits of both three‐repeat and four‐repeat tau. Recombinant tau with a L266V mutation showed a reduced ability to promote microtubule assembly, which may be the primary effect of the mutation. Ann Neurol 2003;53:000–000

Late effects in children treated with intensive multimodal therapy for high-risk neuroblastoma: High incidence of endocrine and growth problems

“…Like other studies of patients with NBL, 8,13,23 the occurrence of hypothyroidism was much higher than that seen after SCT in children for other malignancies. [24][25][26] The higher rate may be due to treatment at younger age as supported by data from Ishiguro et al 27 and/or due to damage from diagnostic 131 I-MIBG in spite of potassium iodide prophylaxis.…”

Improved radiation protection of the thyroid gland with thyroxine, methimazole, and potassium iodide during diagnostic and therapeutic use of radiolabeled metaiodobenzylguanidine in children with neuroblastoma

“…24 Radionuclide imaging in the historic control group was performed at the same time points after injection of radio-MIBG that were used in the prospective study group.…”

“…However, as we demonstrated earlier, this protection failed in 64% of surviving children who underwent 131 I-MIBG treatment. 24 At least for patients in this age group, a more effective method of protection is necessary. We developed the DBR protection using potassium iodide, methimazole and thyroxine respectively, based on the following hypotheses:…”

“…For instance, in nuclear accidents, such a radiation protection is advised for both adults and children. 19 -21 Using potassium iodide for radiation protection of the thyroid gland during 131 I-MIBG treatment in children, however, turned out to be less effective than expected (see Picco et al, 22 Garaventa et al, 23 and van Santen et al 24 ). In fact, up to 64% of children who survived neuroblastoma developed plasma thyrotropin elevations after an average of 1.4 years (range, 0.1-5.8 years), indicating thyroid dysfunction.…”

“…A possible cause for the failing prophylaxis is failure of the escape mechanism following the Wolff-Chaikoff effect. 24 Because thyroid hormone is essential for normal growth and differentiation of all tissues, it is of vital importance to have an optimal thyroid hormone state, especially during the prenatal and postnatal phases of brain development. 25 Maintaining a state of euthyroidism during early childhood is especially important for children who are confronted with severe malignant disease and heavy physical treatments.…”