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Benign Thyroid Disease
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Antithyroid drugs are first-line medical management and are tried for 12–18 months, with a third of patients achieving lasting remission. Poor prognostic factors for relapse in patients treated medically initially are shown in Table 81.2.
Endocrine Disorders, Contraception, and Hormone Therapy during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Treatment of hyperthyroidism during pregnancy is a choice between antithyroid drugs and subtotal thyroidectomy since maternal radioiodine treatment results in fetal thyroid ablation. Ablation should be avoided after 10–12 weeks of gestation, if possible, to avoid fetal thyroid ablation. Antithyroid drugs are commonly employed to control hyperthyroidism in pregnancy to avoid surgical intervention, whereas most instances of exposure to 131I are inadvertent exposures before pregnancy is recognized. Proper assessment of gestational timing is important during embryo-fetal development because early exposure (before 10–12 weeks) to 131I exposure pose little to no risk.
Drugs in pregnancy and lactation
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Hyperthyroidism during pregnancy is usually attributable to Grave’s disease, an autoimmune disease caused by the presence of thyroid-stimulating immunoglobulin (TSI). TSI crosses the placenta and may cause intrauterine hyperthyroidism. The treatment of hyperthyroidism during pregnancy is based on maternal administration of antithyroid drugs that easily cross the placenta. Propylthiouracil is the drug of choice, but carbimazole and thiamiazole are also prescribed during pregnancy. Careful titration of the dose should be continued throughout pregnancy [34].
2022 Expert consensus on the use of laser ablation for papillary thyroid microcarcinoma
Published in International Journal of Hyperthermia, 2022
Lu Zhang, Wei Zhou, Jian Qiao Zhou, Qian Shi, Teresa Rago, Giovanni Gambelunghe, Da Zhong Zou, Jun Gu, Man Lu, Fen Chen, Jie Ren, Wen Cheng, Ping Zhou, Stefano Spiezia, Enrico Papini, Wei Wei Zhan
Expert Recommendation 19: In the event of local hemorrhage, local pressure should be applied until the bleeding stops. Surgical consultation is needed in case of severe bleeding. Recommendation strength: strong recommendation; low quality evidence.3. Abnormal thyroid function is a minor complication after PLA. A transient increase of serum anti-thyroid antibodies and thyroglobulin levels may be observed. Delayed transient hyperthyroidism or hypothyroidism is rare and generally self-limiting [28]. If hyperthyroidism occurs, the majority of patients will spontaneously recover by avoiding iodine in their diet. Severe hyperthyroidism is treated using oral antithyroid drugs. If thyroid hormone surge occurs, levothyroxine tablets can be taken orally. Thyroid function should be monitored regularly in these patients, with dosage adjusted accordingly.
Assessment of subclinical left ventricular dysfunction with speckle-tracking echocardiography in hyperthyroid and euthyroid Graves’ disease and its correlation with serum TIMP-1
Published in Acta Cardiologica, 2021
Irfan Veysel Duzen, Suzan Tabur, Sadettin Ozturk, Mert Deniz Savcilioglu, Enes Alıc, Mustafa Yetisen, Sıddık Sanli, Huseyin Goksuluk, Ertan Vuruskan, Gokhan Altunbas, Fatma Yılmaz Coskun, Mehmet Kaplan, Seyithan Taysi, Murat Sucu
The study enrolled 40 hyperthyroid patients with newly diagnosed Graves’ disease, 40 patients with Graves’ disease who were euthyroid for at least 6 months and 40 control subjects with no known illness and normal thyroid function tests (T3, T4 and TSH). Graves’ disease was diagnosed on the basis of thyroid function tests (high/normal serum free triiodothyronine (sT3) and free thyroxine (sT4) and low thyroid stimulating hormone (TSH) levels), increased thyroid-stimulating hormone receptor antibodies (TRAB) and the heterogeneous appearance of the thyroid parenchyma as demonstrated by ultrasound and medical history. Antithyroid drug (only methimazole) was used for treatment of the patients. Eighteen (18) of 40 patients have taken methimazole therapy in the euthyroid Graves’ group. Patients who were treated with radioactive iodine therapy, surgery or immunsupressive drugs were excluded from the study. In the hyperthyroid Graves’ patient group, echocardiography was performed in two days after diagnosis of Graves’ disease. Patients with known coronary artery disease, diabetes mellitus or hypertension, patients with segmental wall motion abnormality on echocardiography, patients with valvular heart disease, pregnant women, patients with known autoimmune disease, pulmonary disease, chronic renal disease or cancer were excluded. Patients with extrathyroidal manifestations of Graves' disease, Graves' orbitopathy, thyroid dermopathy and acropachy were also excluded from the study.
Pitfalls in the assessment of gestational transient thyrotoxicosis
Published in Gynecological Endocrinology, 2020
Patients with HG complicated by GTT usually complain of nausea, vomiting, and weight loss by 4–9 weeks of gestation, and they present with tachycardia, fine tremors, and mild proximal weakness. Patients with high serum FT3 levels present with shortness of breath, heat intolerance, and palpitations. Hyponatremia, hypokalemia, mild hyperbilirubinemia, and mild-to-moderate liver enzyme elevations are also described [35]. The most appropriate treatment for HG with GTT includes fasting and intravenous hydration to maintain the water and electrolyte balance, and thyroid function elevations should be conducted. Antithyroid drugs might be warranted for patients with severe clinical symptoms; treatment usually lasts for a few weeks, because thyroid function normalizes by the second trimester [6,7].