Cholestyramine Use for Rapid Reversion to Euthyroid States in Patients with Thyrotoxicosis
نویسندگان
چکیده
Cholestyramine (CS) is an ion exchange resin, which binds to iodothyronines and would lower serum thyroid hormone level. The use of CS added to conventional antithyroid drugs to control thyrotoxicosis has been applied since 1980's, and several studies indicate that using CS in combination with methimazole (MZ) produces a more rapid decline in serum thyroid hormones than with only MZ treatment. Our recent retrospective review of five patients taking high dose MZ and CS, compared to age-, gender-, initial free thyroxine (T4) level-, and MZ dose-matched 12 patients with MZ use only, showed more rapid decline of both free T4 and triiodothyronine levels without more adverse events. CS could be safely applicable short-term adjunctive therapy when first-line antithyroid medications are not enough to adequately control severe thyrotoxicosis or side effects of antithyroid drug would be of great concern.
منابع مشابه
Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy
The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually r...
متن کاملDrug-induced thyrotoxicosis: the surgical option.
BACKGROUND Drug-induced thyrotoxicosis is not uncommon. It may worsen life-threatening arrhythmias and may be refractory to medical treatment. Near-total thyroidectomy presents a valid alternative to medical therapy and should be considered early in the management of the disease. OBJECTIVES To assess whether near-total thyroidectomy was a viable approach for our patients. METHODS Twelve pat...
متن کاملPlasma TSH and serum T-4 levels in long-term follow-up of patients treated with 131-I for thyrotoxicosis.
In February 1972 58% of patients euthyroid after iodine-131 therapy given for thyrotoxicosis between 1954 and 1966 had a high plasma TSH (>7.4 muU/ml) and 42% a normal plasma TSH level. A group of 69 of the euthyroid patients with high plasma TSH levels (25.0+/-2.0 muU/ml) in 1972 were re-examined 15 and 24 months later. The mean plasma TSH in the 66 patients remaining euthyroid at 15 months wa...
متن کاملEvaluation of Radioiodine Therapy in the Refractory Hyperthyroidism
Background: Thyrotoxicosis is a clinical state with potentially multiple etiologies, clinical presentations, and treatments. Thyrotoxicosis is a clinical condition that results from inappropriate function of thyroid hormone in the body tissues. During the early 1950s, radioactive iodine was used as a definitive treatment method. During the last two decades, radioactive iodine has been recognize...
متن کاملThyrotoxicosis and thyroid storm.
Thyroid storm represents the extreme manifestation of thyrotoxicosis as a true endocrine emergency. Although Grave's disease is the most common underlying disorder in thyroid storm, there is usually a precipitating event or condition that transform the patient into life-threatening thyrotoxicosis. Treatment of thyroid storm involves decreasing new hormone synthesis, inhibiting the release of th...
متن کامل