Treatment of graves' ophthalmopathy by steroid therapy, orbital radiation therapy, plasmapheresis and thyroxine replacement.

Yamamoto, Kunihiro; Saito, Koshi; Takai, Takaji; Yoshida, Sho

doi:10.1507/endocrj1954.29.495

Cited by 22 publications

(2 citation statements)

References 11 publications

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“…Its efficiency here can be explained by the rapid decline of plasma hormones and antibodies responsible for Graves' disease (4). Its use was also reported in cases of amiodarone‐induced hyperthyroidism, inefficiency or toxicity of conventional treatments (such as leukopenia due to propylthiouracil), Hashimoto's encephalopathy (5), hyperthyroidism caused by molar pregnancy (6) and Graves' ophthalmopathy (7–13). Thyroid storm can be also caused by surgery or through the use of radioiodine therapy in unprepared hyperthyroid patients, and TPE is efficient in preparing for emergency surgery in severe cases (14).…”

Section: Review Of the Literature: Black Citations Concern Systemic Mmentioning

confidence: 99%

Role of Plasma Exchange in the Thyroid Storm

et al. 2011

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Abstract:Inadequately treated thyroid storm can lead to death. Therapeutic plasma exchange (TPE) is a suggested treatment when conventional treatments fail, but its indication is not well codified. We report our experience through three explicit cases. Three elderly patients were admitted to our hospital for cardiac or neurologic symptoms due to thyroid storm. After initiation of conventional therapy, TPE was performed with clinical and biological improvement. The speed of symptom resolution varies depending on the severity. This technique must be carried out by experienced medical staff as many complications can occur; nevertheless, in our patients with severe comorbidities, no complications occurred. The action of TPE mainly results from plasma removal of cytokines, putative antibodies, and thyroid hormones and their bound proteins. TPE has a transitory effect and thus should be associated with other thyroid blockers. When there are threatening symptoms, TPE should be done early, without waiting for the efficiency of conventional treatment, since it is the fastest method known for the improvement of the clinical condition. We also suggest starting TPE in case of neurologic symptoms because of very slow and incomplete regression. The Burch and Wartofsky score seems to be a helpful tool in establishing the diagnosis of thyroid storm and for deciding on when to initiate TPE.

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Section: Review Of the Literature: Black Citations Concern Systemic Mmentioning

confidence: 99%

Role of Plasma Exchange in the Thyroid Storm

et al. 2011

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“…It has been used in preoperative and post-operative management of severely hyperthyroid patients with contraindications to antithyroid drugs (13). It has also been used for the management of TS, predominantly in patients with Graves' disease with ophthalmopathy (14,15) or agranulocytosis (16,17) and in selected patients with toxic multinodular goiter (18). In a recent case of TS, plasmapheresis was done post surgery, where sleeve pneumonectomy was the precipitating event and the patient had not responded to standard antithyroid treatment (19).…”

Section: Discussionmentioning

confidence: 99%