Will postpartum recurrence of Graves' hyperthyroidism become a thing of the past?

Singer, P. Alonso

doi:10.1210/jcem.75.1.1619031

Cited by 4 publications

(2 citation statements)

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“…In two editorial notes, iodine intake has been suggested as an explanation why treatment with exogenous thyroid hormones might work better in Japan than in the USA and Europe (36,39). Not all studies from Japan (11), however, have shown a beneficial effect of combination therapy which has been related to the lack of suppression on the TRAb production of not-detected serum TSH concentrations induced by exogenous thyroid hormone.…”

Section: Discussionmentioning

confidence: 99%

Medical therapy of Graves' disease: effect on remission rates of methimazole alone and in combination with triiodothyronine

Raber¹,

Kmen²,

Waldhäusl³

et al. 2000

European Journal of Endocrinology

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In a prospective, randomized study of 135 newly diagnosed patients with hyperthyroidism due to Graves' disease we compared the effect on remission rates of additional triiodothyronine (T3) with conventional antithyroid drug therapy. To this end 114 patients were followed for at least 12 months (15.7+/-4.9, mean+/-s.d.) after the discontinuation of any therapy. After return of thyroid function to normal (8.5+/-7.4 weeks, mean+/-s.d.) patients were maintained on antithyroid medication for 9.0+/-2.5 months. They were then randomly assigned to one of three groups: group 1 (n=44) stopped methimazole, groups 2 (n=39) and 3 (n=31) continued with exogenous T3 (not exceeding 75 microgram/day in any patient) for a further 6 months either with (group 2) or without (group 3) a fixed dose of 10mg methimazole daily. The T3 dose was kept variable to keep TSH suppressed (<0. 1mU/l), which could be achieved in 82% of patients on 100% of their monthly visits. No serious side-effect requiring the discontinuation of the study occurred in any patient. Total T3, TSH-receptor antibodies and some previously suggested potential predictors of relapse including thyroid size by ultrasound, 24h urinary iodine excretion, history of cigarette smoking and ophthalmopathy were determined at the outset of the study and subsequently every 6 months (and total T3 every 4 weeks). No significant difference (P>0.05, Chi square) was seen in relapse of hyperthyroidism after a mean follow-up of 16 months (range: 12-31 months; groups 1:52%, 2:44% and 3:42%) in an area of low-to-moderate iodine intake (prevalence of 24h urinary iodine excretion <100 microgram/24h: 17 and 25% at two different measurements respectively). Concomitantly, no predictor of recurrence of disease could be identified, irrespective of treatment modality.

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Section: Discussionmentioning

confidence: 99%

Medical therapy of Graves' disease: effect on remission rates of methimazole alone and in combination with triiodothyronine

Raber¹,

Kmen²,

Waldhäusl³

et al. 2000

European Journal of Endocrinology

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“…There has been much speculation as to why T4 treatment might work better in Japan than in Europe. Differences in the genetic background and the obvious differences in dietary iodine supply have been implicated (13,14), but the exact reasons remain unclear. We should, however, point out that because of the limited number of patients, our study is not able to exclude a less than 50% reduction in the recurrence rate by TSH suppressive treatment.…”

Section: Discussionmentioning

confidence: 99%

Suppression of serum thyrotropin with thyroxine in patients with Graves' disease: effects on recurrence of hyperthyroidism and thyroid volume

Pfeilschifter

Ziegler²

1997

European Journal of Endocrinology

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Based on findings that thyroxine may have a beneficial effect on the recurrence of Graves' hyperthyroidism, we prospectively studied the effects of a TSH suppressive treatment with thyroxine on the course of Graves' disease in fifty patients with recent onset of hyperthyroidism. After the normalization of serum tri-iodothyronine (T3) and thyroxine (T4) concentrations, one group of patients was randomly assigned to a combined treatment with carbimazole and a TSH suppressive dose of T4 for 12 months, followed by another 12 months of TSH suppressive therapy alone. The other group of patients also received carbimazole for one year, but T4 was only added as indicated to normalize elevated TSH serum concentrations, and patients received no therapy during the second year. By the end of the second year, a relapse of hyperthyroidism had occurred in 43% of the patients with and in 45% of the patients without suppressive T4 treatment. In those patients without a relapse of hyperthyroidism, initial thyroid size significantly (P = 0.01) decreased with time in both treatment groups. However, patients on suppressive T4 treatment tended to have a greater reduction in thyroid volume than patients with normal TSH serum concentrations (P = 0.05). In conclusion, we were unable to detect a preventive effect of exogenous TSH suppression on the recurrence of hyperthyroidism. However, our data suggest that TSH suppressive treatment may have a beneficial effect on thyroid enlargement in Graves' disease.

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Evaluation and management of common thyroid disorders in women

Mazzaferri¹

1997

American Journal of Obstetrics and Gynecology

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Will postpartum recurrence of Graves' hyperthyroidism become a thing of the past?

Cited by 4 publications

References 0 publications

Medical therapy of Graves' disease: effect on remission rates of methimazole alone and in combination with triiodothyronine

Medical therapy of Graves' disease: effect on remission rates of methimazole alone and in combination with triiodothyronine

Suppression of serum thyrotropin with thyroxine in patients with Graves' disease: effects on recurrence of hyperthyroidism and thyroid volume

Evaluation and management of common thyroid disorders in women

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