J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-42713 | DOI: 10.4274/jcrpe.galenos.2024.2023-11-10

Acute Kidney Injury After Thyroid Hormone Withdrawal in an Adolescent with Papillary Thyroid Carcinoma

Yavuz Özer¹, Rüveyda Gülmez², Hande Turan¹, Gürkan Tarçýn¹, Dilek Bingöl Aydýn¹, Olcay Evliyaoðlu¹, Oya Ercan^1
1Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Pediatric Endocrinology, Istanbul, Turkey
²Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Department of Pediatric Nephrology, Istanbul, Turkey

Objectives: We report a patient with papillary thyroid carcinoma (PTC) who developed acute kidney injury (AKI) and elevated creatine kinase (CK) after thyroid hormone withdrawal (THW) prior to radioiodine therapy.
Case presentation: A 12-year-old female patient who had undergone total thyroidectomy for PTC one year ago presented with leg pain for the past 2 days. Following THW 3 weeks ago, the case had received 70 mCI radioiodine treatment 6 days ago. Serum creatinine (1.53 mg/dL, normal range [NR]: 0.3-1.1), aspartate aminotransferase (102 IU/L, NR: 0-40) and CK (3451 IU/L, NR: 26-174) levels were elevated. Thyrotropin level was elevated (>100 μIU/ml, NR: 0.51-4.3), and free T4 level was decreased (0.05 ng/dL, NR: 0.98-1.63). Serum creatinine and CK levels decreased after intravenous hydration and levothyroxine treatment.
Conclusion: In PTC cases with thyroidectomy, kidney function and CK elevation should be assessed after THW and dehydration should be prevented.

Keywords: Papillary Thyroid Carcinoma, Thyroid Hormone Withdrawal, Rhabdomyolysis, Acute Kidney Injury, Radioactive Iodine Therapy

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