Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease)

Ismailov, Said; Khayitboyeva, Komila Kh.

doi:10.21638/spbu11.2019.202

Cited by 2 publications

(3 citation statements)

References 9 publications

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Section: Hyperthyroidism and Hypothyroidismmentioning

confidence: 99%

“…According to Ismailov & Khayitboyeva, 2019) and Kh, (2019), this fact justifies a higher incidence of iatrogenic injury to the parathyroid glands. In addition, parathyroid vessels may be compromised by the autoimmune process of diffuse toxic goiter (Ismailov & Khayitboyeva, 2019;Kh, 2019). Sakr, (2022) showed that the incidence of postoperative hypocalcemia was significantly higher in women with diffuse toxic goiter (Mahmoud F Sakr, 2022e).…”

Section: Hyperthyroidism and Hypothyroidismmentioning

confidence: 99%

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Post-thyroidectomy hypocalcemia and related complications

Al-Roubaie

2022

ijhs

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The incidence of post-thyroidectomy hypocalcemia is high while the factors involved include age (> 50 years), type of operation, operative time, neck dissection, histology of the surgical specimen and vocal fold paralysis. Low ionic calcium concentrations are indicative of the presence of symptoms of hypocalcemia and the need for oral calcium. Progression to definitive hypoparathyroidism occurs only in patients with clinical manifestations of post-thyroidectomy hypocalcemia. In general, the problem with post-surgical hypoparathyroidism resides in the surgical procedure itself. The most common are related to neuronal hyperexcitability, which explains the paresthesias, cramps and numbness, which usually start in the perioral region and on the fingertips. Muscle spasms and muscle stiffness are also common. When severe, hypocalcemia can lead to life-threatening spastic tetany, laryngospasm, and seizures. The current manuscript aimed to present a review of the bibliography on thyroidectomy and negative impact of its complications on human health, mainly because of a higher risk for developing hypocalcemia. To achieve the study goal, this review covered most recent published articles from 2017 onward.

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Section: Hyperthyroidism and Hypothyroidismmentioning

confidence: 99%

Section: Hyperthyroidism and Hypothyroidismmentioning

confidence: 99%

Post-thyroidectomy hypocalcemia and related complications

Al-Roubaie

2022

ijhs

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“…), так и опасные для жизни (агранулоцитоз, гепатотоксичность и др.). Риск развития осложнений при приеме тиреостатиков является дозозависимым, токсичность в случае приема метимазола, карбимазола (в РФ не зарегистрирован) и пропилтиоурацила чаще всего перекрестная [5][6][7].…”

Section: Introductionunclassified

Predictors of the efficacy of radioiodine therapy of Graves’ disease in children and adolescents

Rumyantsev

Saenko

Dzeytova

et al. 2020

Probl Endokrinol (Mosk)

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RATIONALE: Insufficient world–wide clinical experience in radioiodine therapy (RIT) for Graves’ disease (GD) in children and adolescents, and limited knowledge of the predictors of RIT efficacy.AIMS: Analysis and identification of the most significant predictors of the efficacy of RIT in children and adolescents with Graves’ disease.MATERIALS AND METHODS: A total of 55 patients (48 females and 7 males) aged from 8 to 18 years receiving primary RIT for GD were enrolled. RIT planning was based on the dosimetric method. Analyzed parameters included gender, age, ultrasound thyroid volume before and 6 months after treatment, the presence of endocrine ophthalmopathy, duration of antithyroid drug (ATD) therapy, relapse of thyrotoxicosis after ATD dose reduction, blood fT3, fT4 and TSH levels initially and at 1, 3, 6 months after treatment, TSH receptor Ab initially and at 3 and 6 months after treatment, thyroid 99mTc–pertechnetate uptake at 10–20 minutes (%), maximum thyroid 131I uptake (%), specific 131I uptake (MBq/g) and therapeutic 131I activity (MBq). Fisher exact test, non–parametric Mann–Whitney test, Wilcoxon signed–rank test, logistic regression modelling, ROC–analysis, proportional hazard model (the Cox regression), the Kaplan–Meier method and log–rank test were used for statistical analysis as appropriate.RESULTS: Six months after RIT, hypothyroidism was achieved in 45 (81.8%), euthyroid state – in 2 (3.6%), and in 8 (14.6%) patients thyrotoxicosis persisted. On univariate statistical analysis, the smaller thyroid volume, higher fT4 and lower TSH receptor Ab levels, lower 99mTc–pertechnetate uptake and higher specific 131I uptake were associated with hypothyroidism. On multivariate logistic regression analysis, the older patient’s age (p=0.011), smaller thyroid volume (p=0.003) and higher fT4 (p=0.024) were independent predictors of RIT efficacy. Thyroid volume was also the only variable associated with achievement of hypothyroidism in time after RIT (p=0.011).CONCLUSION: The efficacy of dosimetry–based RIT in children and adolescents with GD 6 months after treatment was 81.2%. Older patients’ age, smaller thyroid volume and higher fT4 level were independent predictors of therapy success. Smaller thyroid volume was also a predictor of the favorable time–related outcome. Statistical models obtained in this work may be used to prospectively estimate the chance of efficient RIT for GD in pediatric patients.

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Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease)

Cited by 2 publications

References 9 publications

Post-thyroidectomy hypocalcemia and related complications

Post-thyroidectomy hypocalcemia and related complications

Predictors of the efficacy of radioiodine therapy of Graves’ disease in children and adolescents

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