title: Therapeutic Plasmapheresis Enabling Radioactive Iodine Treatment in a Patient with Thyrotoxicosis.
abstract: Therapeutic plasma exchange (TPE) is one possible treatment for patients resistant to conventional antithyroid drugs or requiring urgent attention for thyrotoxicosis. We report a 35-yr-old man with thyrotoxicosis, ultimately attributed to Graves' disease in whom antithyroid drug used initially was soon discontinued, due to abnormal liver function, and replaced by Lugol's solution. Three weeks later, an escape phenomenon (to Lugol's solution) was apparent, so we performed TPE to control the thyrotoxicosis. Two courses of TPE by a centrifugal type machine resulted in diminished levels of thyroid hormone levels, which then rebounded after another two courses of membrane filtration type TPE. However, the patient could be treated with radioactive iodine therapy without any complications at present.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Se Hee
authors.initials: SH
authors.lastname: Min
authors.affiliation: King's College London School of Medicine, London, UK.
authors.forename: Anita
authors.initials: A
authors.lastname: Phung
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Oh
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Kyou-Sup
authors.initials: KS
authors.lastname: Han
authors.affiliation: Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Man Jin
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jee Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
mesh_terms: D000328:Adult; D013956:Antithyroid Agents / Q000009:adverse effects / Q000627:therapeutic use; D017332:Cetirizine / Q000009:adverse effects / Q000627:therapeutic use; D006111:Graves Disease / Q000532:radiotherapy*; D019694:Hepatitis B, Chronic / Q000150:complications; D006801:Humans; D007454:Iodides / Q000627:therapeutic use; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008713:Methimazole / Q000009:adverse effects / Q000627:therapeutic use; D010956:Plasmapheresis / Q000379:methods*; D013961:Thyroid Gland / Q000473:pathology*; D013971:Thyrotoxicosis / Q000628:therapy*
chemical_list: D013956:Antithyroid Agents; D007454:Iodides; D007457:Iodine Radioisotopes; D008713:Methimazole; C472067:levocetirizine; C010389:Lugol's solution; D017332:Cetirizine
keywords: Graves Disease; Plasmapheresis; Thyrotoxicosis