[Reflections on the therapeutic goal in Basedow hyperthyroidism]

The present state of knowledge of the patho-etiology of autoimmune-hyperthyroidism (Graves' disease) enables us to design a therapeutic strategy basing on causal events of the autoimmune disease and aiming at complete restoration, considering the pros and cons of conservative (antithyroid drug) and destructive (surgery and/or radioactive iodine) therapy. Summarizing the arguments it is stated that antithyroid drugs are the therapy of first choice in Graves' disease, there are, however, no parameters available to predict firmly relapse in hyperthyroid Graves' disease and to establish duration of antithyroid drug treatment. For patients with hyperthyroid Graves' disease recurring after long term antithyroid drug treatment ablation of the thyroid gland as target organ of the autoimmune disease is advocated; requirements for this decision are discussed.