Total thyroidectomy in the management of thyrotoxic and euthyroid Graves' disease

Catz, Boris; Perzik, S. L.

doi:10.1016/0002-9610(69)90151-2

Cited by 70 publications

(33 citation statements)

References 9 publications

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“…The possibility that TTA may be beneficial for GO was first proposed by Catz and Perzik in the 1960s [10]. In 1996, De Groot and Benjasuratwong, in a retrospective study conducted in a small group of patients, showed an improvement of GO following TTA [11].…”

Section: Ttamentioning

confidence: 98%

“…In particular, it has been proposed that GO would be the consequence of autoimmunity against antigens that are present both in the thyroid and in orbital tissues [7,8], based on which it has been proposed that complete elimination of thyroid antigens (total thyroid ablation, TTA), may be beneficial for GO [9]. In this regard, a number of studies, either retrospective or, more recently, prospective and randomized [10][11][12][13][14][15], support a possible role of TTA in GO. Here we review the data available on this procedure, preceded by a brief review of the relationship between GO and the thyroid gland, both concerning the pathogenesis of GO and the Abstract Graves' orbitopathy (GO) is an autoimmune condition almost always associated with autoimmune thyroid disease, especially Graves' disease (GD).…”

Section: Introductionmentioning

confidence: 94%

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Total thyroid ablation in Graves’ orbitopathy

Menconi

Leo

Vitti

et al. 2015

J Endocrinol Invest

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Graves' orbitopathy (GO) is an autoimmune condition almost always associated with autoimmune thyroid disease, especially Graves' disease (GD). According to the most widely accepted model, the autoantigens responsible for GO would include molecules expressed by thyroid epithelial cells that are present also in orbital tissues. The high likelihood that the etiologies of GO and of the underlying autoimmune thyroid diseases are somehow linked is confirmed by the very close relationship between GO, the onset and the course of Graves' diseases, the size of the thyroid gland, and most importantly, thyroid function and thyroid treatment. Based on these considerations, it has been proposed that complete removal of thyroid antigens and of thyroid infiltrating lymphocytes, the so-called total thyroid ablation (TTA), may be followed by an attenuation of the immune reaction against orbital antigens, and ultimately by an amelioration of GO. The possibility that TTA, achieved by near total thyroidectomy followed by radioiodine, may be beneficial for GO was initially suggested by two retrospective studies and more recently by two prospective, randomized clinical trials conducted in patients with moderate GO treated with intravenous glucocorticoids. Although there seemed to be no difference in the long term, compared with near total thyroidectomy alone TTA was associated with a shorter time required for GO to improve, or anyway to reach its best possible outcome, and with a lesser requirement for additional treatments for GO to improve. Whether this is sufficient to offer ablation to patients remains a matter of discussion. At present, this procedure could be offered only to patients scheduled to thyroidectomy and glucocorticoid treatment.

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Section: Ttamentioning

confidence: 98%

Section: Introductionmentioning

confidence: 94%

Total thyroid ablation in Graves’ orbitopathy

Menconi

Leo

Vitti

et al. 2015

J Endocrinol Invest

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“…The incidence of positive antimic:rosomal antibodies was reported to be higher in patients with Graves' disease who developed hypothyroidism than in other patients with normal thyroid functions after antithyroid drug treatment (Irvine et al 1977). Catz and Perzik (1969) reported that in euthyroid Graves' patients histological findings of chronic thyroiditis were observed but not in hyperthyroid Graves' patients. Furthermore the formation of lymphfollicles and degenerative changes of epitherium in Graves' thyroid were observed (Bonnyns et al 1972).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease.

Kaise

Yoshida

et al. 1987

Tohoku J. Exp. Med.

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“…Aueh wird fiber Patienten berichtet, deren maligne e.O. im Rahmen einer Hyperthyreose sich durch totale Thyreoidektomie zurfickbildete [7,40,49]. Auf diese Weise wurde die Aufmerksamkeit auf die Schilddrfise als urs&chlich beteiligtem Organ gelenkt.…”

Section: Diskussionunclassified

“…nachweisbar [6,45]. Oft sehwanden hohe LATS-Titer wie auch die Augensymptome nach totaler Thyreoidektomie [7,40]. Die pathogenetische Beziehung zwischen LATS und e.O.…”

Section: Diskussionunclassified

Zur Problematik der subtotalen Strumaresektion bei Hyperthyreose mit endokriner Ophthalmopathie

Schümann

Grabs

1975

Langenbecks Arch Chiv

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Observation of 39 patients who had undergone surgery for hyperthyroidism with or without endocrine ophthalmopathy between 1965 and 1972 indicate that this type of therapy involves no higher risk than do medication of radiological measures as far as the course of ophthalmic changes is concerned. Examination of the basal and the TRH-stimulated TSH concentrations i.s. argues against any primarily pituitary cause for progressive ophthalmopathy after surgery. In addition, it elucidates the almost inevitable postoperative development of preclinical hypothyroidism while the clinical condition is still euthyroid, and indicates the necessity of constant postoperative hormone substitution.

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Total thyroidectomy in the management of thyrotoxic and euthyroid Graves' disease

Cited by 70 publications

References 9 publications

Total thyroid ablation in Graves’ orbitopathy

Total thyroid ablation in Graves’ orbitopathy

Characteristics of anti-TSH receptor antibodies in two patients who developed spontaneous hypothyroidism after antithyroid drug therapy for hyperthyroid Graves' disease.

Zur Problematik der subtotalen Strumaresektion bei Hyperthyreose mit endokriner Ophthalmopathie

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