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Therapeutic plasmapheresis in thyrotoxic patients
Ilgin Yildirim Simsir1, Murat Ozdemir2, Soner Duman3
1Ege University Medical Faculty, Division of Endocrinology and Metabolism Disorders, Izmir, Turkey. ilginyildirim@hotmail.com.
Endocrine
|July 4, 2018
Summary
Therapeutic plasma exchange (TPE) effectively lowers thyroid hormone levels in thyrotoxicosis patients when drugs fail. This rapid treatment offers a reliable alternative for managing severe thyroid conditions.
Area of Science:
- Endocrinology
- Internal Medicine
- Hematology
Background:
- Thyrotoxicosis management often requires alternatives to antithyroid drugs due to side effects or ineffectiveness.
- Rapid hormone reduction is crucial in thyroid storm or when urgent intervention is needed.
Purpose of the Study:
- To evaluate therapeutic plasma exchange (TPE) as a rapid, effective, and reliable treatment for thyrotoxicosis.
- To assess TPE's utility when conventional therapies are contraindicated or insufficient.
Main Methods:
- Therapeutic plasma exchange (TPE) was performed on 46 patients with thyrotoxicosis.
- Patient data, including diagnoses and thyroid hormone levels (fT3, fT4), were analyzed before and after TPE.
Main Results:
- The study included 46 thyrotoxic patients, predominantly with Graves' disease (87%).
- TPE significantly reduced elevated free triiodothyronine (fT3) and free thyroxine (fT4) levels (p < 0.000).
- Median fT3 decreased from 9.9 to 4.0 pg/mL, and median fT4 from 2.9 to 1.6 ng/dL post-TPE.
Conclusions:
- Therapeutic plasma exchange (TPE) is a highly effective treatment for reducing thyroid hormone levels in thyrotoxicosis.
- TPE serves as a valuable alternative modality for preparing patients for definitive treatment, especially when antithyroid drugs are not feasible.
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