Therapeutic plasmapheresis for the treatment of thyrotoxicosis: A retrospective multi-center study.

Autor: Builes-Montaño CE; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia.; Endocrinology Department, Hospital Pablo Tobón Uribe, Medellin, Colombia., Rodriguez-Arrieta LA; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia., Román-González A; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia.; Endocrinology Department, Hospital Pablo Tobón Uribe, Medellin, Colombia.; Endocrinology Department, Hospital San Vicente Fundación, Medellin, Colombia., Prieto-Saldarriaga C; Endocrinology Department, Hospital Pablo Tobón Uribe, Medellin, Colombia., Alvarez-Payares JC; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia., Builes-Barrera CA; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia.; Endocrinology Department, Hospital Pablo Tobón Uribe, Medellin, Colombia.; Endocrinology Department, Hospital San Vicente Fundación, Medellin, Colombia., Arango-Toro CM; Internal Medicine Department, Endocrinology and Metabolism Section, School of Medicine, Universidad de Antioquia, Medellin, Colombia.; Endocrinology Department, Hospital Pablo Tobón Uribe, Medellin, Colombia.
Jazyk: angličtina
Zdroj: Journal of clinical apheresis [J Clin Apher] 2021 Oct; Vol. 36 (5), pp. 759-765. Date of Electronic Publication: 2021 Jul 17.
DOI: 10.1002/jca.21927
Abstrakt: Background and Aims: Thyroid storm and severe thyrotoxicosis remain among the most frequent endocrine emergencies, and first-line hyperthyroidism treatment is not always an option. Since the first report in 1970, plasmapheresis is a second-line treatment for severe or otherwise untreatable thyrotoxicosis when rapid euthyroidism is desired.
Methods: We present a retrospective study of the experience in treating thyrotoxicosis with plasmapheresis between 2012 and 2020 in two specialized centers in Colombia. We register the demographic and clinical characteristic and compare the thyroid hormones and other biochemical measurements before and after treatment.
Results: Data from 19 patients was obtained, 58% female with a median age of 35 years (IQR 23.5), and most of them with Graves' disease. The most frequent indication for plasmapheresis was thyroid storm. A median of 4 (IQR 2) sessions lead to a significant reduction in FT4 (P .0001) and TT3 (P < .0003) with a nonsignificant decrease in beta-blocker (P .7353) dose, no change in hepatic enzymes, and no adverse events. After plasmapheresis, thyroidectomy was performed in 10 patients.
Conclusions: Plasmapheresis is an effective and safe treatment option for reducing circulating thyroid hormones in severe thyrotoxicosis when other forms of treatment are contraindicated or in case of urgent thyroid and non-thyroid surgery. It is limited by its cost and the need for highly specialized resources.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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