Department of Endocrinology-Diabetology and Nutrition, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital Center, University of Mohammed 1st, 4806, 60049, Oujda, Morocco.
Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital Center, University of Mohammed 1st, 4806, 60049, Oujda, Morocco.
J Med Case Rep. 2024 Mar 30;18(1):193. doi: 10.1186/s13256-024-04480-9.
Plasmapheresis represent an alternative therapeutic option for hyperthyroidism with thyroid storm or refractory cases. It provides a rapid decrease in plasma thyroid hormones and anti-thyroid antibodies. The aim of this paper was to report our single center's experience in managing particular situations of hyperthyroidism using apheresis.
The following case series describes three young African patients (two females, one male) aged 29, 37, and 25 years old, respectively, with Graves' disease who presented with drug ineffectiveness, drug-induced agranulocytosis, and thyroid storm with multi-organ failure. The three patients underwent plasmapheresis sessions leading to effective decline of thyroid hormone levels and offering a window for processing total thyroidectomy.
DISCUSSION/CONCLUSION: The standard management of thyrotoxicosis and thyroid storm was usually codified by the concomitant use of antithyroid medication, iodine, beta-blockers, and corticosteroids. This medical preparation can be effective in most cases. However, drug toxicity or ineffectiveness can limit the use of such therapeutics. Our paper supports the efficiency and safety of therapeutic plasma exchange in the preoperative management of thyrotoxicosis.
血浆置换是甲状腺危象或难治性甲状腺功能亢进症的一种替代治疗选择。它可迅速降低血浆甲状腺激素和抗甲状腺抗体水平。本文旨在报告我们单中心使用血浆置换治疗特殊甲状腺功能亢进症的经验。
本病例系列描述了 3 名年轻的非洲患者(2 名女性,1 名男性),年龄分别为 29 岁、37 岁和 25 岁,均患有格雷夫斯病,分别表现为药物无效、药物诱导的粒细胞缺乏症和甲状腺危象合并多器官衰竭。这 3 名患者接受了血浆置换治疗,导致甲状腺激素水平有效下降,并为进行甲状腺全切除术提供了机会。
讨论/结论:甲状腺毒症和甲状腺危象的标准治疗通常包括抗甲状腺药物、碘、β受体阻滞剂和皮质类固醇的联合使用。这种药物治疗在大多数情况下是有效的。然而,药物毒性或无效可能会限制这些治疗方法的应用。我们的论文支持在甲状腺功能亢进症的术前管理中使用治疗性血浆置换的有效性和安全性。