Amiodarone induced thyrotoxicosis may not respond to therapeutic plasma exchange like patients with graves' disease: A report of two cases and literature review
Yükleniyor...
Dosyalar
Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
The achievement of euthyroid state has been suggested in patients with thyrotoxicosis undergoing surgery to reduce the risk of thyroid storm. However, euthyroid state could not always be achieved by antithyroid drugs. Therefore, therapeutic plasma exchange (TPE) is an option in this condition. A 58-year-old male patient with a history of type-2 diabetes using 200 mg amiodarone per day, admitted for diabetic ketoacidosis (DKA), induced by thyrotoxicosis. with palpitation, sweating, polyuria, and polydipsia. Euthyroid state could not be achieved, despite all apropriate treatments for thyrotoxicosis. Therefore, preparation with TPE followed by total thyroidectomy was planned. A 35% decrease in fT3 (free T3) and fT4 (free T4) levels were achieved, after two sessions of TPE. A 74-year-old male patient, admitted for acute anterior myocardial infarction (AMI) induced by thyrotoxicosis due to Graves’ disease. Multiple vessel disease was detected on primer percutanous coronary angiography, and an emergency coronary artery bypass grafting (CABG) was planned. Therefore, preperation with TPE was planned before surgery. A substential decrease in fT4 and fT3 levels (45% and 72%, respectively) levels were achieved, after one session of TPE. Most of the studies evaluating the efficacy of TPE in patients with thyrotoxicosis are including patients with Graves’ disease and toxic multinodular goiter, and TPE was indicated as an effective option for preparation of these patients for surgery. However, as presented in case 1, TPE may not be effective in amiodarone induced thyrotoxicosis (AIT) as in cases with thyrotoxicosis due to Graves’ disease.
Açıklama
Anahtar Kelimeler
Biyoloji, Alerji, Anatomi ve Morfoloji, Androloji, Anestezi, Odyoloji ve Konuşma-Dil Patolojisi, Biyokimya ve Moleküler Biyoloji, Biyofizik, Biyoteknoloji ve Uygulamalı Mikrobiyoloji, Kalp ve Kalp Damar Sistemi, Hücre Biyolojisi, Klinik Nöroloji, Yoğun Bakım, Tıp, Dermatoloji, Acil Tıp, Endokrinoloji ve Metabolizma, Gastroenteroloji ve Hepatoloji, Geriatri ve Gerontoloji, Sağlık Bilimleri ve Hizmetleri, Hematoloji, İmmünoloji, Enfeksiyon Hastalıkları, Tamamlayıcı ve Entegre Tıp, Tıbbi Etik, Tıbbi İnformatik, Tıbbi Laboratuar Teknolojisi, Genel ve Dahili Tıp, Adli Tıp, Tıbbi Araştırmalar Deneysel, Mikrobiyoloji, Nörolojik Bilimler, Kadın Hastalıkları ve Doğum, Onkoloji, Göz Hastalıkları, Ortopedi, Kulak, Burun, Boğaz, Patoloji, Pediatri, Periferik Damar Hastalıkları, Fizyoloji, Temel Sağlık Hizmetleri, Psikiyatri, Halk ve Çevre Sağlığı, Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme, Rehabilitasyon, Solunum Sistemi, Romatoloji, Spor Bilimleri, Cerrahi, Transplantasyon, Tropik Tıp, Üroloji ve Nefroloji
Kaynak
Medicine Science
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
1
