J Korean Med Sci.  2015 Oct;30(10):1531-1534. 10.3346/jkms.2015.30.10.1531.

Therapeutic Plasmapheresis Enabling Radioactive Iodine Treatment in a Patient with Thyrotoxicosis

• Min SH
• Phung A
• Oh TJ
• Han KS
• Kim MJ
• Kim JM
• Lee JH
• Park YJ

• KMID: 2344190
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1531

Abstract

Therapeutic plasma exchange (TPE) is one possible treatment for patients resistant to conventional antithyroid drugs or requiring urgent attention for thyrotoxicosis. We report a 35-yr-old man with thyrotoxicosis, ultimately attributed to Graves' disease in whom antithyroid drug used initially was soon discontinued, due to abnormal liver function, and replaced by Lugol's solution. Three weeks later, an escape phenomenon (to Lugol's solution) was apparent, so we performed TPE to control the thyrotoxicosis. Two courses of TPE by a centrifugal type machine resulted in diminished levels of thyroid hormone levels, which then rebounded after another two courses of membrane filtration type TPE. However, the patient could be treated with radioactive iodine therapy without any complications at present.

Keyword

Plasmapheresis; Graves Disease; Thyrotoxicosis

MeSH Terms

Adult
Antithyroid Agents/adverse effects/therapeutic use
Cetirizine/adverse effects/therapeutic use
Graves Disease/*radiotherapy
Hepatitis B, Chronic/complications
Humans
Iodides/therapeutic use
Iodine Radioisotopes/*therapeutic use
Male
Methimazole/adverse effects/therapeutic use
Plasmapheresis/*methods
Thyroid Gland/*pathology
Thyrotoxicosis/*therapy
Antithyroid Agents
Cetirizine
Iodides
Iodine Radioisotopes
Methimazole

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