A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients
Graves’ disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I131 iodine ablation are the most commonly prescribed trea...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Greater Baltimore Medical Center
2016-09-01
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| Series: | Journal of Community Hospital Internal Medicine Perspectives |
| Subjects: | |
| Online Access: | http://www.jchimp.net/index.php/jchimp/article/view/32369/pdf_200 |
| _version_ | 1797967740892348416 |
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| author | Vinuta Mohan Robert Lind |
| author_facet | Vinuta Mohan Robert Lind |
| author_sort | Vinuta Mohan |
| collection | DOAJ |
| description | Graves’ disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I131 iodine ablation are the most commonly prescribed treatment for Graves’ disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves’ disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I131iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves’ disease. |
| first_indexed | 2024-04-11T02:35:58Z |
| format | Article |
| id | doaj.art-b7b4a48cfd744ccc802fa7840aee9443 |
| institution | Directory Open Access Journal |
| issn | 2000-9666 |
| language | English |
| last_indexed | 2024-04-11T02:35:58Z |
| publishDate | 2016-09-01 |
| publisher | Greater Baltimore Medical Center |
| record_format | Article |
| series | Journal of Community Hospital Internal Medicine Perspectives |
| spelling | doaj.art-b7b4a48cfd744ccc802fa7840aee94432023-01-02T20:14:36ZengGreater Baltimore Medical CenterJournal of Community Hospital Internal Medicine Perspectives2000-96662016-09-01641410.3402/jchimp.v6.3236932369A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patientsVinuta Mohan0Robert Lind1 Department of Medicine, Saint Francis Medical Center, Seton Hall University, Trenton, NJ, USA Department of Medicine, Hunterdon Medical Center, Flemington, NJ, USAGraves’ disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I131 iodine ablation are the most commonly prescribed treatment for Graves’ disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves’ disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I131iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves’ disease.http://www.jchimp.net/index.php/jchimp/article/view/32369/pdf_200hyperthyroidismthionamidesmethimazolepropylthiuraciliodine ablationthyroid surgery |
| spellingShingle | Vinuta Mohan Robert Lind A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients Journal of Community Hospital Internal Medicine Perspectives hyperthyroidism thionamides methimazole propylthiuracil iodine ablation thyroid surgery |
| title | A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients |
| title_full | A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients |
| title_fullStr | A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients |
| title_full_unstemmed | A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients |
| title_short | A review of treatment options for Graves’ disease: why total thyroidectomy is a viable option in selected patients |
| title_sort | review of treatment options for graves disease why total thyroidectomy is a viable option in selected patients |
| topic | hyperthyroidism thionamides methimazole propylthiuracil iodine ablation thyroid surgery |
| url | http://www.jchimp.net/index.php/jchimp/article/view/32369/pdf_200 |
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