Posttherapeutic myxedema. Relative occurrence after treatment of hyperthyroidism by radioactive iodine (131-I) or subtotal thyroidectomy

Bronsky, David; Kiamko, Rosario T.; Waldstein, Sheldon S.

doi:10.1001/archinte.121.2.113

Cited by 25 publications

(4 citation statements)

References 9 publications

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“…It has generally been accepted that the incidence and severity of hypothyroidism developing after subtotal thyroidectomy are lower and milder than that after radioiodine therapy [6,16,17]. Bronsky et al [16] reported that the cumulative increase in the development of hypothyroidism that follows thyroidectomy is progressive and is qualitatively similar to that that follows 131I therapy. Green and Wilson [18] found that the incidence following surgery rose slowly from less than 2% at 1 year to 6% at 10 years.…”

Section: Discussionmentioning

confidence: 99%

Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis

et al. 1984

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One hundred fifty‐seven patients with hyperthyroidism treated by subtotal thyroidectomy 2–8 years previously were followed up with serum T3, T4, and TSH determinations. There was some difficulty in distinguishing the various groups of patients by thyroid function tests. However, it was determined that the percentages of patients with hyperthyroidism, euthyroidism, and hypothyroidism, based on T3 values, were 3.2%, 89.7%, and 7.1%, respectively, whereas 5.8%, 41.6%, and 53.1% were hyperthyroid, euthyroid, and hypothyroid by TSH criteria. Subclinical hypothyroidism, that is, increased TSH levels but normal T3 and T4 levels, accounted for the major discrepancy in these results. Subclinical hypothyroidism is more sensitive to disclosure by the TRH stimulation test. However, the incidence and severity of hypothyroidism after thyroidectomy are lower and milder than after131I treatment. The recurrence rate is less than that after the administration of antithyroid drugs, and postoperative complications are rare. Surgical treatment, therefore, plays an important role in the treatment of patients with hyperthyroidism. Those patients with sustained subclinical hypothyroidism after subtotal thyroidectomy should receive supplemental thyroid hormone.

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Section: Discussionmentioning

confidence: 99%

Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis

et al. 1984

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“…Dem stehen vor allem entgegen die, insbesondere bei der Radiojodtherapie fehlende, therapiebedingte Morbidit/it. Wie die Radiojodtherapie beinhaltet die operative Behandlung jedoch dariiber hinaus eine unterschiedliche Rate an Schilddriisenfunktionsst6rungen, die allerdings nicht nur Folge der Art und Intensit/it der Schilddriisenablation sind [11,17,37], sondern wahrscheinlich auch durch die aliment/ire Jodversorgung [54] und die Intensit/it des Autoimmunprozesses im Restgewebe [6,19,20,28,32,57] beeinflul3t werden.…”

Section: Surgical Treatment Of Graves' Diseaseunclassified

Operatives Therapiekonzept der Immunthyreopathie

Dralle

Schober

Hesch

1987

Langenbecks Arch Chiv

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73 patients with Graves' disease, surgically treated from 1975-1986, were investigated retrospectively. 43 patients, treated by subtotal thyroidectomy (Enderlen-Hotz) and a bilateral thyroid remnant of a total of about 8-12 g, were compared with 30 patients, treated by a modified subtotal thyroidectomy leaving a unilateral thyroid remnant of about 4-8 g, with respect to preoperative duration of disease, indications for surgical treatment, weight of resected specimens, operative complications and postoperative thyroid function. Surgical complications were similar in both groups. After subtotal thyroidectomy 14/43 patients (33%) displayed either recurrent hyperthyroidism (9/43, 21%) or local recurrence of Graves' goiter (3/43, 7%) or both (2/43, 5%). The modified subtotal resected group showed no recurrences of the disease. After subtotal thyroidectomy 11 patients were euthyroid without thyroid medication (26%) compared to only two patients (7%) after the modified procedure of subtotal thyroid resection. To prevent recurrences of goiter as well as hyperthyroidism and, on the other hand, to achieve euthyroid function postoperatively without need for thyroid replacement therapy, subtotal thyroidectomy with a small thyroid remnant of about 4-8 g is recommended for all patients with large goiter and a chronic recurrent course of the disease or with iodine induced thyrotoxicosis. Patients with non-recurrent Graves' disease but large goiter probably benefit from subtotal thyroidectomy with a larger thyroid remnant of about 8-12 g.

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“…G reen and W ilson found 2% in one year and 6% in 10 years; N ofal, Beierwaltes and Patno [2] found 20% in one year, 45% in ten years, and about 60%, by extrapolation, in 20 years. Bronsky, K iamko and Waldstein [10] imply a similar rise with time. It seems evident that patients treated either by radioiodine or by subtotal thyroidectomy should be followed regularly for life.…”

Section: Discussionmentioning

confidence: 79%

Long-Term Follow-up of Patients Treated for Thyrotoxicosis Using the Achilles’ Reflex Time

Nordyke¹

1970

Horm Res Paediatr

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Hypothyroidism commonly occurs after both radioiodineand surgical treatment of thyrotoxicosis. Since the incidence increases with the passage of time, it is important to follow all such patients for life. A system is presented which makes use of clinical judgement and the measured Achilles’ reflex time. In persons with easily reproducible reflexes this combination may be used to assure the continued euthyroid state after it has been reached, to suggest the presence of hypothyroidism, and to verify the hypothyroidism once suspected. Application of the method may help to reduce the large pool of patients with post-treatment hypothyroidism.

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Posttherapeutic myxedema. Relative occurrence after treatment of hyperthyroidism by radioactive iodine (131-I) or subtotal thyroidectomy

Cited by 25 publications

References 9 publications

Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis

Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis

Operatives Therapiekonzept der Immunthyreopathie

Long-Term Follow-up of Patients Treated for Thyrotoxicosis Using the Achilles’ Reflex Time

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