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Title of Journal: J Endocrinol Invest

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Abbravation: Journal of Endocrinological Investigation

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Springer International Publishing

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1720-8386

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Management of recurrent hyperthyroidism in patient

Authors: Kiminori Sugino T Mimura O Ozaki H Iwasaki N Wada A Matsumoto K Ito
Publish Date: 2014/04/09
Volume: 18, Issue: 6, Pages: 415-419
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Abstract

If the aim of surgical treatment for Graves’ disease is not permanent hypothyroidism it is difficult to avoid recurrent hyperthyroidism completely The management of recurrent hyperthyroidism however is neither easy nor obvious Improvement in the sensitivity of TSH assay has allowed the diagnosis of latent hyperthyroidism Little is known about the clinical course of latent hyperthyroidism We studied the management and outcome of recurrent hyperthyroidism in patients with Graves’ disease treated by subtotal thyroidectomy Between January 1988 and August 1991 1115 patients with Graves’ disease were treated by surgery Postoperative thyroid function was evaluated by free T3 free T4 and TSH measurements One hundred sever tyfive patients with suppressed TSH secretion for at least 6 months were categorized as having recurrent hyperthyroidism Eighty patients 451 also had elevated thyroid hormone levels group 1 The remaining 95 patients 549 had normal thyroid hormone levels with suppressed TSH values group 2 In group 1 58 patients were treated with antithyroid drug ATD 12 with iodine and 10 with radioiodine Rl Remission of Graves’ disease was obtained in 22 patients 11 by ATD 1 by iodine and 10 by Ri On the other hand patients in group 2 were followed up without medication and spontaneous remission was observed in 21 of theln 221 It was difficult to induce remission of overt recurrent Graves’ disease by ATD or iodine In contrast spontaneous remission could be obtained in some patients with postoperative latent hyperthyroidism

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