title: The results of therapeutic plasma exchange in patients with severe hyperthyroidism: a retrospective multicenter study.
abstract: Hyperthyroidism characterized by elevated serum levels of circulating thyroid hormones. The aim of hyperthyroidism treatment is to achieve a euthyroid state as soon as possible and to maintain euthyroid status. However, drug withdrawal and utilization of alternative therapies are needed in cases in which leucopenia or impairment in liver functions is observed during medical therapy. In the present study, we aimed to present our cases which underwent therapeutic plasma exchange (TPE) due to severe hyperthyroidism. The results of 22 patients who underwent therapeutic plasma exchange due to hyperthyroidism in Apheresis Units of Erciyes University and Gaziantep University, between 2006 and 2012, were retrospectively reviewed. These cases had severe thyrotoxic values despite anti-thyroid drug use. After TPE, we observed a significant decrease in free thyroxin (FT4) (p<0.001) and free triiodotyhronin (FT3) (p<0.004) levels. There was statistically significant increase in the mean values of TSH levels after TPE (p<0.001). Clinical improvement was achieved in hyperthyroidism by TPE in 20 cases (91%). Both FT3 and FT4 levels remained above the normal limits in two of 22 patients. TPE should be considered as an effective and safe therapeutic option to achieve euthyroid state before surgery or radioactive iodine treatment. TPE is a useful option in cases with severe hyperthyroidism unresponsive to anti-thyroid agents and in those with clinical manifestations of cardiac failure and in patients with severe adverse events during anti-thyroid therapy.
authors.affiliation: Erciyes University, Department of Hematology and Apheresis Unit, 38039 Kayseri, Turkey. muzafferkeklik@yahoo.com
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Keklik
authors.forename: Leylagul
authors.initials: L
authors.lastname: Kaynar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Serdar
authors.initials: S
authors.lastname: Sivgin
authors.forename: Musa
authors.initials: M
authors.lastname: Solmaz
authors.forename: Cigdem
authors.initials: C
authors.lastname: Pala
authors.forename: Sulbiye
authors.initials: S
authors.lastname: Aribas
authors.forename: Gulsah
authors.initials: G
authors.lastname: Akyol
authors.forename: Kursat
authors.initials: K
authors.lastname: Unluhizarci
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Bulent
authors.initials: B
authors.lastname: Eser
authors.forename: Ali
authors.initials: A
authors.lastname: Unal
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood* / Q000628:therapy*; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D012189:Retrospective Studies; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000503:physiopathology; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D014284:Triiodothyronine; D013974:Thyroxine