Therapeutic Plasma Exchange in Refractory Hyperthyroidism.

Hyperthyroidism Iodine-induced thyrotoxicosis Therapeutic plasma exchange Thyroid surgery Thyrotoxicosis

Journal

European thyroid journal
ISSN: 2235-0640
Titre abrégé: Eur Thyroid J
Pays: England
ID NLM: 101604579

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 31 12 2019
accepted: 05 03 2020
entrez: 29 3 2021
pubmed: 30 3 2021
medline: 30 3 2021
Statut: ppublish

Résumé

Hyperthyroid patients who are unresponsive to medical treatment remain a challenging clinical problem. The goal of our study was to evaluate the use of therapeutic plasma exchange (TPE) in hyperthyroid patients and their outcome after TPE. We retrospectively reviewed 22 patients who underwent TPE for refractory thyrotoxicosis in our institution: 13 with Graves' disease, 7 with amiodarone-induced thyrotoxicosis (AIT), 1 with toxic goiter, and 1 pregnant patient with familial nonautoimmune thyrotoxicosis. Before TPE, all patients had severe hyperthyroidism, and antithyroid drugs were either contraindicated or not sufficiently effective to restore euthyroidism promptly. After all the TPEs, free T TPE allowed a safe decrease of 50% in thyroid hormone levels, and it should be considered for refractory hyperthyroid patients when medical treatments are contraindicated or have failed to restore euthyroidism, irrespective of the etiology of the thyrotoxicosis.

Identifiants

pubmed: 33777824
doi: 10.1159/000507019
pii: etj-0010-0086
pmc: PMC7983568
doi:

Types de publication

Journal Article

Langues

eng

Pagination

86-92

Informations de copyright

Copyright © 2020 by European Thyroid Association Published by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

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Auteurs

Clotilde Saïe (C)

Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Cécile Ghander (C)

Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Samir Saheb (S)

Apheresis Unit, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France.

Christel Jublanc (C)

Department of Endocrinology, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Denis Lemesle (D)

Department of Anaesthesia, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Charlotte Lussey-Lepoutre (C)

Nuclear Medicine Department, Pitié-Salpêtrière Hospital APHP, Sorbonne Université, Inserm U970, Paris, France.

Laurence Leenhardt (L)

Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Fabrice Menegaux (F)

Department of Surgery, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Christophe Tresallet (C)

Department of Surgery, Avicennes Hospital, Paris, France.

Camille Buffet (C)

Thyroid and Endocrine Tumors Unit, Pitié-Salpêtrière Hospital APHP, Sorbonne University, Paris, France.

Classifications MeSH