Recurrence of hyperthyroidism in multinodular goiter after long-term drug therapy: A comparison with Graves’ disease
Abstract
The chance of permanent remission after prolonged drug therapy was investigated in 41 patients with toxic multinodular goiter. For purposes of comparison a group of 41 patients with Graves' disease was also studied. After euthyroidism was achieved all patients received a combination of thionamide and thyroxine for at least 12 months. The minimum follow-up period was 2 yr. Relapse of thyrotoxicosis occurred in 95.1% of patients with toxic multinodular goiter and 34.1% of patients with Graves' disease (p < 0.001). It is concluded that for patients with toxic multinodular goiter early radioiodine therapy or surgery is preferred since prolonged drug therapy seldom produces permanent remission.
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Permanent hypoparathyroidism occurs in <2.0% and permanent RLN injury in <2.0% following near-total/total thyroidectomy.
“Potential complications following near-total/total thyroidectomy include the risk of permanent hypoparathyroidism (<2.0%) or RLN injury (<2.0%) (261,262).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [262]
Discontinuation of ATD treatment in nodular thyroid disease results in relapse.
“Therefore, discontinuation of treatment results in relapse (262,297).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [262]
ATDs do not induce remission in patients with nodular thyroid disease.
“ATDs do not induce remission in patients with nodular thyroid disease.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [262]
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References 14 · Cited by 53
- Authors
- van Soestbergen, M. J. M., van der Vijver, J. C. M., & Graafland, A. D.
- Venue
- Journal of Endocrinological Investigation
- Published
- 1992-12
- Volume
- 15
- Issue
- 11
- Pages
- 797-800
- ISSN
- 0391-4097 (ISSN-L)
- 1720-8386
- OpenAlex
- W1966975556
- Cited by
- 53
- References
- 14
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 5 · 2022: 8 · 2021: 5 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 2 · 2012: 3
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Endocrinological Investigation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Keywords
- hyperthyroidism recurrence, toxic multinodular goiter, Graves' disease, antithyroid drug therapy, thionamides, thyroxine, remission, radioiodine therapy, thyroid surgery, thyrotoxicosis
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Carbimazole, Drug Therapy, Combination, Female, Goiter, Nodular, Graves Disease, Humans, Hyperthyroidism, Iodine Radioisotopes, Male, Methimazole, Middle Aged, Propylthiouracil, Radionuclide Imaging, Recurrence, Antithyroid Agents, Thyroid Gland, Thyroxine
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