My child had a thyroidectomy. Why did her TgAb levels increase?

Hi,

Welcome to icliniq.com.

I understand your concern, and I am truly sorry you and your daughter are going through this.

Your daughter was diagnosed with papillary thyroid carcinoma (PTC) at the age of 10 and underwent total thyroidectomy along with lymph node dissection (13 nodes removed, two positive for metastasis).

Based on this, she falls under the intermediate risk category for recurrence according to the American Thyroid Association (ATA) pediatric guidelines.

After total thyroidectomy (and possibly radioactive iodine therapy, if given), and once Levothyroxine is started, Tg levels are expected to be undetectable or very low.TgAb can interfere with Tg measurement, so the trend over time is what truly matters:

• Falling TgAb (thyroglobulin antibodies) usually indicates no active disease.

• Rising TgAb, even with undetectable Tg (thyroglobulin), may suggest biochemical recurrence (possible microscopic thyroid tissue or thyroid cancer activity).

Her TgAb has increased from 1.1 to 4.5 IU/mL (international units per milliliter) over one year, roughly a fourfold rise.

This can be significant if the trend continues. However, minor fluctuations can occur due to lab variability. It is important to repeat the test in the same laboratory and monitor the trend carefully over time.

I would recommend you take some tests. Please follow them to prevent future complications.

• High-resolution neck ultrasound to check for any recurrence.

• Consult the following specialists for a coordinated evaluation:

  • Medical Oncologist.

  • Radiologist.

  • Thyroid Surgeon.

  • Pathologist.

With a multidisciplinary approach and regular follow-up, her condition can be effectively managed.

You are doing your best in a difficult situation, and I want to assure you that help is always available.

Please feel free to reach out anytime with further questions.

Thank you.