Therapeutic plasma exchange with albumin as a valuable method of preparing thyrotoxic patients for a life-saving thyroidectomy.

Autor: Tańska K; Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Leszczyńska D; Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Glinicki P; Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Kapuścińska R; Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Szczepkowski M; Department of Colorectal, General and Oncological Surgery, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Dedecjus M; Department of Endocrine Oncology and Nuclear Medicine, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland., Stachlewska-Nasfeter E; Department of Endocrine Oncology and Nuclear Medicine, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland., Brym I; Department of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Żelek T; Department of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Daniewska D; Department of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland., Gietka-Czernel M; Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw, Poland.
Jazyk: angličtina
Zdroj: Journal of clinical apheresis [J Clin Apher] 2021 Jun; Vol. 36 (3), pp. 496-498. Date of Electronic Publication: 2020 Dec 19.
DOI: 10.1002/jca.21866
Abstrakt: Hyperthyroidism affects approximately 1.2% of the population and its routine treatment includes antithyroid drugs (ATDs), radioiodine and surgery. Management of patients with resistance or contraindications to ATDs who require thyroidectomy may be challenging. We present the experience of our department in preparing thyrotoxic patients for life-saving thyroidectomy by using therapeutic plasma exchange (TPE) with albumin: one patient with Graves' disease and previous history of agranulocytosis and cholestatic jaundice after ATDs and two patients with amiodarone-induced thyrotoxicosis. Five to six TPEs were applied to each patient resulting in a decrease of fT3 by 57% to 83%, fT4 by 21% to 60% and decrease/normalization of total thyroid hormones. All patients underwent surgery successfully. In case of drug-resistant thyrotoxicosis or contraindications to ATDs, TPE can be a valuable tool in preparing patients for surgery. Albumin used as a replacement fluid appears to be effective in ameliorating clinical and laboratory symptoms of thyrotoxicosis.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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