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Thyrotoxicosis HELP
Based on 1,032 articles published since 2008
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These are the 1032 published articles about Thyrotoxicosis that originated from Worldwide during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline 2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition). 2016

Satoh, Tetsurou / Isozaki, Osamu / Suzuki, Atsushi / Wakino, Shu / Iburi, Tadao / Tsuboi, Kumiko / Kanamoto, Naotetsu / Otani, Hajime / Furukawa, Yasushi / Teramukai, Satoshi / Akamizu, Takashi. ·Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan. ·Endocr J · Pubmed #27746415.

ABSTRACT: Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan. Detailed analyses of clinical data from 356 patients revealed that the mortality in Japan was still high (∼11%) and that multiple organ failure and acute heart failure were common causes of death. In addition, multimodal treatment with antithyroid drugs, inorganic iodide, corticosteroids and beta-adrenergic antagonists has been suggested to improve mortality of these patients. Based on the evidence obtained by nationwide surveys and additional literature searches, we herein established clinical guidelines for the management of thyroid storm. The present guideline includes 15 recommendations for the treatment of thyrotoxicosis and organ failure in the central nervous system, cardiovascular system, and hepato-gastrointestinal tract, admission criteria for the intensive care unit, and prognostic evaluation. We also proposed preventive approaches to thyroid storm, roles of definitive therapy, and future prospective trial plans for the treatment of thyroid storm. We hope that this guideline will be useful for many physicians all over the world as well as in Japan in the management of thyroid storm and the improvement of its outcome.

2 Guideline 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. 2016

Ross, Douglas S / Burch, Henry B / Cooper, David S / Greenlee, M Carol / Laurberg, Peter / Maia, Ana Luiza / Rivkees, Scott A / Samuels, Mary / Sosa, Julie Ann / Stan, Marius N / Walter, Martin A. ·1 Massachusetts General Hospital , Boston, Massachusetts. · 2 Endocrinology - Metabolic Service, Walter Reed National Military Medical Center , Bethesda, Maryland. · 3 Division of Endocrinology, Diabetes, and Metabolism, The Johns Hopkins University School of Medicine , Baltimore, Maryland. · 4 Western Slope Endocrinology , Grand Junction, Colorado. · 5 Departments of Clinical Medicine and Endocrinology, Aalborg University and Aalborg University Hospital , Aalborg, Denmark . · 6 Thyroid Section, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul , Porto Alegre, Brazil . · 7 Pediatrics - Chairman's Office, University of Florida College of Medicine , Gainesville, Florida. · 8 Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University , Portland, Oregon. · 9 Section of Endocrine Surgery, Duke University School of Medicine , Durham, North Carolina. · 10 Division of Endocrinology, Mayo Clinic , Rochester, Minnesota. · 11 Institute of Nuclear Medicine, University Hospital Bern , Switzerland . ·Thyroid · Pubmed #27521067.

ABSTRACT: BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. METHODS: The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. RESULTS: Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves' hyperthyroidism with antithyroid drugs, the management of pregnant hyperthyroid patients, and the preparation of patients for thyroid surgery. The sections on less common causes of thyrotoxicosis have been expanded. CONCLUSIONS: One hundred twenty-four evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

3 Guideline Practice Bulletin No. 148: Thyroid disease in pregnancy. 2015

Anonymous4310824. · ·Obstet Gynecol · Pubmed #25798985.

ABSTRACT: -- No abstract --

4 Guideline The Brazilian consensus for the diagnosis and treatment of hyperthyroidism: recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism. 2013

Maia, Ana Luiza / Scheffel, Rafael S / Meyer, Erika Laurini Souza / Mazeto, Glaucia M F S / Carvalho, Gisah Amaral de / Graf, Hans / Vaisman, Mario / Maciel, Lea M Z / Ramos, Helton E / Tincani, Alfio José / Andrada, Nathalia Carvalho de / Ward, Laura S / Anonymous4160758. ·Unidade de Tireoide, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. almaia@ufrgs.br ·Arq Bras Endocrinol Metabol · Pubmed #23681266.

ABSTRACT: INTRODUCTION: Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis. OBJECTIVE: This consensus, developed by Brazilian experts and sponsored by the Department of Thyroid Brazilian Society of Endocrinology and Metabolism, aims to address the management, diagnosis and treatment of patients with thyrotoxicosis, according to the most recent evidence from the literature and appropriate for the clinical reality of Brazil. MATERIALS AND METHODS: After structuring clinical questions, search for evidence was made available in the literature, initially in the database MedLine, PubMed and Embase databases and subsequently in SciELO - Lilacs. The strength of evidence was evaluated by Oxford classification system was established from the study design used, considering the best available evidence for each question. RESULTS: We have defined 13 questions about the initial clinical approach for the diagnosis and treatment that resulted in 53 recommendations, including the etiology, treatment with antithyroid drugs, radioactive iodine and surgery. We also addressed hyperthyroidism in children, teenagers or pregnant patients, and management of hyperthyroidism in patients with Graves' ophthalmopathy and various other causes of thyrotoxicosis. CONCLUSIONS: The clinical diagnosis of hyperthyroidism usually offers no difficulty and should be made with measurements of serum TSH and thyroid hormones. The treatment can be performed with antithyroid drugs, surgery or administration of radioactive iodine according to the etiology of thyrotoxicosis, local availability of methods and preferences of the attending physician and patient.

5 Guideline Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. 2011

Bahn, Rebecca S / Burch, Henry B / Cooper, David S / Garber, Jeffrey R / Greenlee, M Carol / Klein, Irwin / Laurberg, Peter / McDougall, I Ross / Montori, Victor M / Rivkees, Scott A / Ross, Douglas S / Sosa, Julie Ann / Stan, Marius N / Anonymous3420698 / Anonymous3430698. ·Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA. ·Endocr Pract · Pubmed #21700562.

ABSTRACT: OBJECTIVE: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. METHODS: The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. RESULTS: Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. CONCLUSIONS: One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

6 Guideline Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. 2011

Bahn Chair, Rebecca S / Burch, Henry B / Cooper, David S / Garber, Jeffrey R / Greenlee, M Carol / Klein, Irwin / Laurberg, Peter / McDougall, I Ross / Montori, Victor M / Rivkees, Scott A / Ross, Douglas S / Sosa, Julie Ann / Stan, Marius N / Anonymous4760692 / Anonymous4770692. ·Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota 55905, USA. bahn.rebecca@mayo.edu ·Thyroid · Pubmed #21510801.

ABSTRACT: BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. METHODS: The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. RESULTS: Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. CONCLUSIONS: One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

7 Guideline Thyroid function disorders--Guidelines of the Netherlands Association of Internal Medicine. 2008

Muller, A F / Berghout, A / Wiersinga, W M / Kooy, A / Smits, J W A / Hermus, A R M M / Anonymous210595. ·Diakonessenhuis Utrecht, Utrecht, the Netherlands. amuller@diakhuis.nl ·Neth J Med · Pubmed #18349473.

ABSTRACT: Thyroid function disorders are common with a female to male ratio of 4 to 1. In adult women primary hypothyroidism and thyrotoxicosis have a prevalence of 3.5/1000 and 0.8/1000, respectively. This guideline is aimed at secondary care providers especially internists, but also contains relevant information for interested general practitioners and gynaecologists. A multidisciplinary working group, containing delegates of professional and patient organisations, prepared the guideline. According to principles of 'evidence-based medicine' available literature was studied and discussed. Considering the availability and quality of published studies a practical advice was formulated. For a full overview of the literature and considerations the reader is referred to the original version of the guideline (accessible through NIV-net). In this manuscript we have aimed to provide the practicing internist with practical and 'as evidence-based as possible' treatment guidelines with respect to thyroid function disorders.

8 Editorial Perinatal Endocrine Challenges. 2018

Muir, Andrew B / Rose, Susan R. ·Pediatric Endocrinology, Emory University, Atlanta, GA 30322, USA. Electronic address: abmuir@emory.edu. · Pediatrics and Pediatric Endocrinology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, MLC 7012, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Electronic address: Mslrose4@gmail.com. ·Clin Perinatol · Pubmed #29406016.

ABSTRACT: -- No abstract --

9 Editorial Coronary artery spasm and thyrotoxicosis: the best index is that of suspicion. 2014

Goldstein, James A. ·Department of Cardiovascular Medicine, Beaumont Health System, William Beaumont Hospital, Royal Oak, Michigan, USA. ·Coron Artery Dis · Pubmed #24326784.

ABSTRACT: -- No abstract --

10 Editorial How long should we check thyroid function after amiodarone withdrawal? 2013

Shinohara, Tetsuji / Takahashi, Naohiko. ·Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University. ·Circ J · Pubmed #24152756.

ABSTRACT: -- No abstract --

11 Editorial [Amiodarone treatment and thyroid disorders]. 2013

Łacka, Katarzyna / Fraczek, Magdalena Maria. ·Uniwersytet Medyczny im. Katedra Endokrynologii, Przemiany Materii i Chorób Wewnetrznych. kktlacka@gmail.com ·Pol Merkur Lekarski · Pubmed #23984597.

ABSTRACT: Amiodarone is a benzofuranic iodine-rich antiarrhythmic drug used in the treatment of severe tachyarrhythmias, especially ventricular. Drug causes many adverse effects including thyroid disorders in 14-18% of patients: amiodarone induced thyrotoxicosis type I and type II (AIT I, AIT II) and amiodarone induced hypothyroidism (AIH). AIT occurs more frequently in geographical areas with low iodine intake, whereas AIH is more frequent in iodine-sufficient areas. AIH may appear both in normal thyroid gland and Hashimoto's disease. AIT I occurs most often on the basis of Greave's disease or goiter. In contrast to AIT, AIH does not cause difficulties with diagnosis and treatment. In order to differentiate between AIT I and AIT II such methods as USG, CFDS, RAIU, MIBI and IL-6 are used. Increased vascularization showed in CFDS, increased MIBI uptake in scintigraphy, increased 131I uptake in RAIU in some cases are typical for AIT I. In opposition to AIT I, all this parameters are decreased in AIT II and it is possible that the level of serum IL-6 is increased. However, the usefulness of IL-6 is controversial. After diagnosis discontinuation of amiodarone should be taken into consideration. In addition, AIT I is preferably treated with methimazole and potassium perchlorate. AIT II is treated with glucocorticoids. In the case of unclear diagnosis and mixed types of AIT the combination of all foregoing drugs should be instituted. If the case is refractory, thyreidectomy should be taken into consideration, especially if a patient suffers from left ventricular systolic dysfunction. RIT--radioiodine therapy is also possible.

12 Editorial Clinical criteria for the diagnosis of thyroid storm. 2012

Wartofsky, Leonard. · ·Thyroid · Pubmed #22746147.

ABSTRACT: -- No abstract --

13 Editorial The American Thyroid Association and American Association of Clinical Endocrinologists guidelines for hyperthyroidism and other causes of thyrotoxicosis: an appraisal. 2011

Daniels, Gilbert H. · ·Endocr Pract · Pubmed #21700559.

ABSTRACT: -- No abstract --

14 Editorial The American Thyroid Association/American Association of Clinical Endocrinologists guidelines for hyperthyroidism and other causes of thyrotoxicosis: a European perspective. 2011

Kahaly, George J / Bartalena, Luigi / Hegedüs, Laszlo. · ·Thyroid · Pubmed #21663420.

ABSTRACT: -- No abstract --

15 Editorial Highlights of the guidelines on the management of hyperthyroidism and other causes of thyrotoxicosis. 2011

Medeiros-Neto, Geraldo / Romaldini, João H / Abalovich, Marcos. · ·Thyroid · Pubmed #21663419.

ABSTRACT: -- No abstract --

16 Editorial The American Thyroid Association and American Association of Clinical Endocrinologists hyperthyroidism and other causes of thyrotoxicosis guidelines: viewpoints from Japan and Korea. 2011

Yamashita, Shunichi / Amino, Nobuyuki / Shong, Young Kee. · ·Thyroid · Pubmed #21663418.

ABSTRACT: -- No abstract --

17 Editorial New American Thyroid Association and American Association of Clinical Endocrinologists guidelines for thyrotoxicosis and other forms of hyperthyroidism: significant progress for the clinician and a guide to future research. 2011

Pearce, Elizabeth N / Hennessey, James V / McDermott, Michael T. · ·Thyroid · Pubmed #21663417.

ABSTRACT: -- No abstract --

18 Editorial Thyroid dysfunction and the coagulation system: the often ignored link. 2009

Boppidi, Hima / Daram, Sumanth R. · ·South Med J · Pubmed #19139704.

ABSTRACT: -- No abstract --

19 Review Issues in amiodarone-induced thyrotoxicosis: Update and review of the literature. 2019

Maqdasy, Salwan / Benichou, Thomas / Dallel, Sarah / Roche, Béatrice / Desbiez, Françoise / Montanier, Nathanaëlle / Batisse-Lignier, Marie / Tauveron, Igor. ·Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Laboratoire GReD, UMR Université Clermont Auvergne-CNRS 6293, Inserm U1103, BP 10448, 63177 Aubière, France. Electronic address: smaqdasy@chu-clermontferrand.fr. · Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France. · Service d'endocrinologie, diabétologie et maladies métaboliques, CHU Clermont-Ferrand, 63003 Clermont-Ferrand, France; Laboratoire GReD, UMR Université Clermont Auvergne-CNRS 6293, Inserm U1103, BP 10448, 63177 Aubière, France. ·Ann Endocrinol (Paris) · Pubmed #30236455.

ABSTRACT: Amiodarone, a benzofuranic iodine-rich pan-anti-arrhythmic drug, induces amiodarone-induced thyrotoxicosis (AIT) in 7-15% of patients. AIT is a major issue due to its typical severity and resistance to anti-thyroid measures, and to its negative impact on cardiac status. Classically, AIT is either an iodine-induced thyrotoxicosis in patients with abnormal thyroid (type 1), or due to acute thyroiditis in a "healthy" thyroid (type 2). Determination of the type of AIT is a diagnostic dilemma, as characteristics of both types may be present in some patients. As it is the main etiological factor in AIT, it is recommended that amiodarone treatment should be stopped; however, it may be the only anti-arrhythmic option, needing to be either continued or re-introduced to improve cardiovascular survival. Recently, a few studies demonstrated that amiodarone could be continued or re-introduced in patients with history of type-2 AIT. However, in the other patients, it is recommended that amiodarone treatment be interrupted, to improve response to thioamides and to alleviate the risk of AIT recurrence. In such patients, thyroidectomy is recommended once AIT is under control, allowing safe re-introduction of amiodarone.

20 Review Thyroid storm: a case of haemodynamic failure promptly reversed by aggressive medical therapy with antithyroid agents and steroid pulse. 2018

Andrade Luz, Ivan / Pereira, Tiago / Catorze, Nuno. ·Nephrology, Centro Hospitalar do Médio Tejo EPE, Unidade de Torres Novas, Torres Novas, Santarém, Portugal. · Intensive Care Unit, Centro Hospitalar do Médio Tejo EPE, Unidade de Abrantes, Abrantes, Santarém, Portugal. ·BMJ Case Rep · Pubmed #30567262.

ABSTRACT: Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. The present case clearly shows the beneficial impact of initial clinical suspicion resulting in an early diagnosis and intensive therapy. Moreover, it supports the additional role of steroids to aggressive antithyroid strategy in order to control associated deleterious systemic inflammatory reactions.

21 Review Controversies in the pharmacological treatment of Graves' disease in children. 2018

De Luca, Filippo / Valenzise, Mariella. ·a UOC Pediatria, Department of Human Pathology of Adulthood and Childhood , University of Messina , Messina , Italy. ·Expert Rev Clin Pharmacol · Pubmed #30417713.

ABSTRACT: INTRODUCTION: Graves' disease (GD) is a disorder, in which auto-immunity against the thyroid- stimulating hormone (TSH) receptor is the pivotal pathogenetic element. This disease may have different clinical manifestations, the most common being thyrotoxicosis. Treatment of this condition differs according to its etiology, but there is currently no evidence-based therapeutic strategy which is universally adopted in all countries. Areas covered: a systematic review of the updates on the management of pediatric GD was performed using the Pubmed data base until March 2018. Systematic reviews with or without meta-analysis were analyzed using the following terms: Antithyroid drugs, Childhood, Hyperthyroidism, Radioactive iodine, Thyroidectomy. Expert commentary: As the best way to manage children with GD remains a matter of debate among pediatric endocrinologists, and there is currently no evidence-based therapeutic strategy which is universally adopted, we confirm that the original and prolonged treatment with anti-thyroid drugs (ATDs) remains the mainstay of treatment for juvenile hyperthyroidism. Alternative treatments include radioiodine (RAI) therapy or surgery (total thyroidectomy). We recommend individualizing the therapeutic approach, without prejudices toward radical therapies that become necessary in case of relapse, adverse effects or poor compliance to ATDs. The optimal approach depends on patient or family preference, and specific patient clinical features.

22 Review [CME: Thyrotoxicosis and Thyroiditis]. 2018

Slahor, Lea. ·1 Endokrinologie/Diabetologie, Luzerner Kantonsspital, Luzern. ·Praxis (Bern 1994) · Pubmed #30376773.

ABSTRACT: Hyperthyroidism is caused by an increased synthesis of thyroid hormones or release of preformed thyroid hormones due to destruction of thyroid tissue, or there is an exogenous extrathyroidal source. The term thyroiditis describes a heterogeneous group of disorders, which result in destruction of thyroid tissue and release of preformed thyroid hormones. Although a less common condition, a thyroiditis remains an important differential diagnosis for thyrotoxicosis, and a symptomatic therapy is the cornerstone of treatment. Because of the classical triphasic clinical course a 'wait and see strategy' is reasonable, especially during the first and self-limited hyperthyroid phase. Usually a transient hypothyroid phase follows, before the euthyroid function is restored within a year. However, as permanent hypothyroidism may result, regular follow-up and in that case treatment with levothyroxine is mandatory.

23 Review Investigational drugs in early stage clinical trials for thyrotoxicosis with hyperthyroidism. 2018

Gómez-Sáez, José-Manuel. ·a Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Endocrinology Department , Hospital Universitario de Bellvitge , Barcelona , Spain. ·Expert Opin Investig Drugs · Pubmed #30354697.

ABSTRACT: INTRODUCTION: Thyrotoxicosis with hyperthyroidism is treated with these classical approaches (i) antithyroid drugs to blockade thyroid hormone release and normalize thyroid hormone production and (ii) destruction of the thyroid using radioiodine or surgical removal of the thyroid. The optimal medical therapy, especially for Graves´ disease, remains a subject of debate and there has been little progress in Graves' disease therapeutics over the last decade. AREAS COVERED: Novel treatments of thyrotoxicosis with hyperthyroidism. This includes (i) small molecules such as synthetic thyroid hormone receptor antagonists and environmental molecules and (ii) molecules with interaction between thyroid stimulating hormone (TSH) receptor and TSH receptor antibodies such as M22, ANTAG3, org274179-0, 5C9, and K1-70. Other approaches to Graves´ disease treatment includes immunosuppressive treatment, glucocorticosteroids, rituximab, and intrathyroid injection of dexamethasone. Optimal iodine and selenium supplementation can also be considered. EXPERT OPINION: Clinical trials results suggest that novel thyroid treatments involving small molecule therapy, may predict a good future in Graves' disease treatment; however, a greater understanding of these antagonists is needed. Other treatments comprising immunosuppressives have demonstrated a significant reduction of relapse of the disease, but are not recommended by international guidelines.

24 Review [Challenges in the management of amiodarone-induced thyrotoxicosis]. 2018

Tauveron, Igor / Batisse-Lignier, Marie / Maqdasy, Salwan. ·CHU Clermont-Ferrand, service d'endocrinologie, diabétologie et maladies métaboliques, 63003 Clermont-Ferrand, France; Laboratoire GReD : UMR université Clermont Auvergne-CNRS 6293, Inserm U1103, BP 10448, 63177 Aubiere, France. ·Presse Med · Pubmed #30274916.

ABSTRACT: Amiodarone, a benzofuranic iodine-rich pan antiarrhythmic drug, is frequently associated with thyroid dysfunction. This side effect is heterogeneous and unpredicted, motivating regular evaluation of thyroid function tests. In contrary to hypothyroidism, amiodarone-induced thyrotoxicosis (AIT) is a challenging situation owing to the risk of deterioration of the general and cardiac status of such debilitating patients. Classically, AIT is either an iodine-induced thyrotoxicosis in patients with an abnormal thyroid (type I), or due to a subacute thyroiditis on a "healthy" thyroid (type II). Even if many studies tried to better identify the types of AIT, the diagnostic dilemma of type of AIT could be present, and many patients are treated by an association of antithyroid drugs (useful for type I AIT) with corticoids (useful for type II AIT). Being the main etiological factor in AIT, amiodarone is supposed to be stopped, but it could remain the only anti-arrhythmic option that is needed to be either continued or reintroduced to improve the cardiovascular survival. Recently, many studies demonstrated that amiodarone could be continued or reintroduced in patients with history of type II AIT. Nevertheless, in the other patients, amiodarone maintenance complicates the therapeutic response to the antithyroid drugs and increases the risk of AIT recurrence. Thus, amiodarone therapy is preferred to be interrupted. In such patients, thyroid ablation is recommended once AIT is under control.

25 Review Bilateral Keratoconus Induced by Secondary Hypothyroidism After Radioactive Iodine Therapy. 2018

Lee, Ramon / Hafezi, Farhad / Randleman, J Bradley. · ·J Refract Surg · Pubmed #29738593.

ABSTRACT: PURPOSE: To present a case of new-onset, bilateral, rapidly progressive keratoconus induced by secondary hypothyroidism after radioactive iodine therapy during the sixth decade of life that was successfully treated with corneal cross-linking. METHODS: Case report and literature review. RESULTS: A 53-year-old woman with no ocular complaints but with a history of Graves' disease and thyrotoxicosis was treated with radioactive iodine therapy and oral levothyroxine for secondary acquired hypothyroidism 3 years prior. Initially, uncorrected distance visual acuity (UDVA) was 20/40 and corrected distance visual acuity (CDVA) was 20/25 in both eyes. Over the following 3 years, the patient developed worsening UDVA and CDVA, with increasing manifest astigmatism of greater than 7.00 diopters (D) in the right eye and 4.75 D in the left eye, with corneal thinning and focal steepening and was diagnosed as having bilateral progressive keratoconus. The patient underwent sequential corneal cross-linking with resultant postoperative CDVA of 20/20 and reduced maximum keratometry and manifest astigmatism in both eyes. The patient's thyroid levels were within normal limits throughout the clinical course. CONCLUSIONS: This case provides evidence of the relationship between keratoconus development and thyroid gland dysfunction. The pathophysiology of this relationship has yet to be completely elucidated, but elevated levels of thyroxine in the aqueous humor and tear film and thyroxine receptors in the cornea likely play a role. Screening topographies for patients with thyroid gland dysfunction may be of value for these higher risk patients. [J Refract Surg. 2018;34(5):351-353.].

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