Plasma exchange and hemoperfusion in iodine-induced thyrotoxicosis.
Iodine-induced thyrotoxicosis is a life-threatening disease. Plasma exchange and hemoperfusion are the available means of detoxication. Both methods were applied repeatedly to 4 patients with iodine-induced thyrotoxicosis, and the efficacy of these treatment methods was compared. Thyroxine plasma levels were decreased by 33%, while the calculated body stores were reduced by 18% during plasma exchange. Hemoperfusion was less effective. With both methods, a rebound of plasma levels was seen. Improvement of the clinical condition was delayed for 1 week after discontinuation of treatment. One patient died, probably because detoxication was discontinued too soon after the thyroid hormone levels had normalized. Plasma exchange by using albumin (120 g/4,000 ml = 30 g/l) as replacement fluid is superior to that by using fresh-frozen plasma (2,000 ml/4,000 ml), since less thyroxine is administered (19 vs. 160 nmol).
Preuschof
L
L
Abteilung für Allgemeine Inner Medizin und Nephrologie, Freie Universität Berlin, Universitätsklinikum Steglitz, BRD.
Keller
F
F
Bogner
U
U
Reuter
E
E
Offermann
G
G
D000368:Aged; D005260:Female; D006042:Goiter / Q000150:complications*; D006464:Hemoperfusion; D006801:Humans; D007455:Iodine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D013971:Thyrotoxicosis / Q000139:chemically induced / Q000628:therapy*
D007455:Iodine