Thyrotoxicosis

Franklyn, Jayne A; Boelaert, Kristien

doi:10.1016/s0140-6736(11)60782-4

Cited by 262Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryOphthalmology and Eye Disorders

Thyrotoxicosis

Franklyn, Jayne A, Boelaert, Kristien·2012·The Lancet

DOI 10.1016/s0140-6736(11)60782-4

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Abstract

Thyrotoxicosis is a common disorder, especially in women. The most frequent cause is Graves' disease (autoimmune hyperthyroidism). Other important causes include toxic nodular hyperthyroidism, due to the presence of one or more autonomously functioning thyroid nodules, and thyroiditis caused by inflammation, which results in release of stored hormones. Antithyroid drugs are the usual initial treatment (thionamides such as carbimazole or its active metabolite methimazole are the drugs of choice). A prolonged course leads to remission of Graves' hyperthyroidism in about a third of cases. Because of the low remission rate in Graves' disease and the inability to cure toxic nodular hyperthyroidism with antithyroid drugs alone, radioiodine is increasingly used as first line therapy, and is the preferred choice for relapsed Graves' hyperthyroidism. Total thyroidectomy is an option in selected cases. Future efforts are likely to concentrate on novel and safe ways to modulate the underlying disease process rather than stopping excess thyroid hormone production.

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Some patients may develop a transient increase in thyroid hormones after RAI.
“Some patients may develop a transient increase in thyroid hormones after RAI [115, 117] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [117]
The side effects of methimazole are dose-related, whereas those of propylthiouracil are less clearly dose related.
“The side effects of methimazole (MMI) are dose-related, whereas those of propylthiouracil are less clearly dose related [117] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [117]
Hepatocellular disease is rarely reported during MMI treatment.
“Hepatocellular disease is rarely reported during MMI treatment [115, 117] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [117]

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Authors: Franklyn, J. A., & Boelaert, K.
Affiliations: University of Birmingham (GB)
Corresponding author: Franklyn, Jayne A
ORCID: Boelaert, Kristien
Venue: The Lancet
Publisher: Elsevier BV
Published: 2012-03
Volume: 379
Issue: 9821
Pages: 1155-1166
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(11)60782-4
OpenAlex: W4210957724
Cited by: 262
References: 139
Citations by year: 2026: 9 · 2025: 6 · 2024: 37 · 2023: 14 · 2022: 10 · 2021: 10 · 2020: 19 · 2019: 23 · 2018: 16 · 2017: 21 · 2016: 15 · 2015: 24 · 2014: 26 · 2013: 25 · 2012: 7
FWCI: 3.64
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
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: thyrotoxicosis, Graves' disease, autoimmune hyperthyroidism, thyroiditis, antithyroid drugs, methimazole, carbimazole, radioiodine therapy, total thyroidectomy, remission
MeSH terms: Agranulocytosis, Amiodarone, Atrial Fibrillation, Autoimmune Diseases, Child, Female, Goiter, Nodular, Graves Disease, Humans, Hyperthyroidism, Iodine Radioisotopes, Pregnancy, Recurrence, Risk Factors, Antithyroid Agents, Thyroid Hormones, Thyroidectomy, Thyroiditis, Thyrotoxicosis, Thyrotropin, Exercise Tolerance, Graves Ophthalmopathy

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