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PubMed · 8814121

Treatment options for hyperthyroidism.

L Wartofsky
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Abstract

Antithyroid drugs induce sustained remission in only 55% of cases. Radioiodine, the overwhelming choice of specialists, may pose risks, including aggravation of ophthalmopathy. Surgical ablation should be considered only if a highly skilled surgeon is available. Thyroid storm requires aggressive management, and definitive treatment is needed for toxic adenoma or toxic multinodular goiter.

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Antithyroid AgentsGraves DiseaseHumansHyperthyroidismIodine RadioisotopesThyroid CrisisThyroid NoduleThyroidectomyTreatment OutcomeJournal ArticleReview

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BibTeXRIS

L Wartofsky. 1996-09-15. Treatment options for hyperthyroidism.. https://doi.org/10.1080/21548331.1996.11443345

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PubMed1999

[Cost-effectiveness analysis: radioiodine or antithyroid medication in primary treatment of immune hyperthyroidism].

AIM: As first-line therapy of hyperthyroidism caused by Graves' disease antithyroid drugs are favoured in Europe, while radioiodine therapy is favoured in the USA. Radioiodine therapy has become more economic in Germany since the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines. METHOD: Sensitivity analyses took into account the long-term relapse rate of conservative or radioiodine therapy, use of diagnostic tests, level of health insurance, drops in productivity and a discount factor. Costing models included the costs of follow-up care over 30 years. The costs of the hospitalisation for radioiodine therapy were calculated for 300 patients, discharged with 250 MBq 1-131 residual activity. RESULT: Antithyroid drugs were considered cost-effective when they achieved relapse rate of 50% or less, a cut in the number of tests needed and reduced working hours. Failure to meet any one of these conditions makes primary radioiodine therapy more cost-effective in 1593 of 1944 calculated costing models. Repeated conservative therapies will increase clearly the overall costs. CONCLUSION: Radioiodine is a cost-effective, first-line therapy in patients with a special risk of relapse after primary conservative therapy (goitre, younger patient, persistent elevated TSH-receptor-antibodies or Tc-uptake).

Antithyroid Agents↗
PubMed1998

Confirmation of residues of thyreostatic drugs in thyroid glands by multiple mass spectrometry after thin-layer chromatographic screening.

A method is described for the confirmation of high-performance thin layer chromatography (HPTLC) suspect results of residues of thyreostatic drugs in thyroid tissue. The method is based on the infusion of the remainder of the extract used for HPTLC via the electrospray interface into a mass spectrometer operating in the multiple stage mass spectrometry (MSn) mode. The clean-up of the samples was performed with a selective extraction procedure, based on a specific complex formation of the drugs with mercury ions, bound in an affinity column. The thyreostatic drugs were derivatised with 7-chloro-4-nitrobenzo-2-oxa-1,3-diazole.

Antithyroid Agents↗