[Plasma exchange and hyperthyroidism. Current indications].

Abstract

Serious thyrotoxicosis must be treated quickly and efficiently. Plasma exchange (PE) takes place when ordinary treatment is not suitable in emergency cases. Several methods of plasma clearing have already been practiced successfully. PE is the best one. It quickly removes a great amount of thyroid hormones and occasionally pathological immunoglobulins. Risks have not to be underestimated. The most serious accidents are particularly linked with the substitution fluids. Hemoperfusion, peritoneal dialysis, transfusion exchanges can be used too. Thyrotoxicosis crisis, as far as life prognosis is concerned, is an appropriate indication of PE, either as a first line treatment or after the classical treatment has failed. Serious hyperthyroidism due to iodine overload is not improved with common treatment. In this case PE might be worthwhile. In malignant exophthalmia, unimproved with an usual treatment PE can be successfully used, every time ocular prognosis is concerned.