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Treatment of Hyperthyroid Disease
Abstract
PURPOSE: To evaluate treatments for hyperthyroid disease. DATA SOURCES: Selected studies published during the last 20 years addressing the diagnosis, causes, and treatment of hyperthyroid disease. STUDY SELECTION: Studies were chosen based on their usefulness in addressing specific points in the treatment of hyperthyroid disease. DATA EXTRACTION: Various treatment principles extracted from the references form the basis for the conclusions and recommendations made here. RESULTS: Hyperthyroid disease is a common endocrine disease. Although Graves disease is the most common cause of thyrotoxicosis, other primary and secondary causes exist. With classic signs and symptoms accompanied by confirmatory laboratory measures of thyroid hyperfunction, the diagnosis can be established firmly. Radioiodine is the preferred method to treat Graves disease; however, recent data concerning treatment with a combination of propylthiouracil and thyroxine require further evaluation to establish its efficacy. Radioiodine is also the preferred treatment for the other forms of hyperthyroid disease; however, patient-specific considerations in both may require patient-tailored therapies. CONCLUSIONS: Hyperthyroid disease can be treated definitively for most patients. Palliative therapy with beta-adrenergic blockade is useful in some patients. Further studies are needed to determine whether more recently described treatments have improved efficacy and whether therapy directed specifically at the underlying immunologic cause of Graves disease can be used successfully.
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“Once it has been established that the patient is hyperthyroid and the cause is GD, the patient and physician must choose between three effective and relatively safe initial treatment options: RAI therapy, ATDs, or thyroidectomy (59).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [59]
In the citing paper
“In earlier studies in the United States, about 20%-30% of patients were reported to have a lasting remission after 12-18 months of medication ( 59), but more recent data are not available.”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [59]
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“Once it has been established that the patient is hyperthyroid and the cause is GD, the patient and physician must choose between three effective and relatively safe initial treatment options: RAI therapy, ATDs, or thyroidectomy (59).”
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“In the USA, remissions in 20 to 30% were reported after 12 to 18 months of medication [32].”
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“In the US, remission rates from 20% to 30% were reported after 12 to 18 months of medical treatment [27].”
BackgroundAbou-auda, H. S., & Abou-Shaaban, R. R. A. (2015) · Cited by 1
Topliss, D. J. (1995) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1995.tb126122.x · Cited by 1
Der alte Mensch mit Morbus Bechterew
Halder, W. (2005) · Springer eBooks · doi:10.1007/3-211-26646-1_20 · Cited by 1
Huang, S. A. (2013) · Humana Press eBooks · doi:10.1007/978-1-60761-395-4_16
Metadata
- Authors
- Klein, I., Becker, D. V., & Levey, G. S.
- Affiliations
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- Corresponding author
- Klein, Irwin
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1994-08-15
- Volume
- 121
- Issue
- 4
- Pages
- 281-288
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2090730711
- Cited by
- 120
- References
- 0
- Citations by year
- 2024: 2 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 2 · 2019: 4 · 2018: 5 · 2017: 2 · 2016: 4 · 2015: 5 · 2013: 13 · 2012: 4
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (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 › Ophthalmology › Ophthalmology and Eye Disorders
- Keywords
- hyperthyroidism, Graves' disease, thyrotoxicosis, radioiodine therapy, propylthiouracil, thyroxine, beta-adrenergic blockade, antithyroid drugs
- MeSH terms
- Graves Disease, Humans, Hyperthyroidism, Palliative Care
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