Fighting thyrotoxicosis with therapeutic plasma exchange: A case report

4区医学 Q3 Nursing

Endocrinologia, Diabetes y Nutricion Pub Date : 2024-04-01 DOI:10.1016/j.endinu.2024.01.009

Álvaro Valverde Márquez, María Teresa Mories Álvarez, Heather Stacey Villanueva Alvarado, Ximena Carolina Vivas Vaca, Manuel Delgado Gómez

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Abstract

Thyrotoxicosis is the clinical condition resulting from an excess of thyroid hormones for any reason. The main causes are Graves–Basedow disease, toxic multinodular goitre and toxic adenoma. The medical treatment to control thyroid function includes antithyroid drugs, beta blockers, iodine solutions, corticosteroids and cholestyramine. Although therapeutic plasma exchange is not generally part of the therapy, it is an alternative as a preliminary stage before the definitive treatment.

This procedure makes it possible to eliminate T4, T3, TSI, cytokines and amiodarone. In most cases, more than one cycle is necessary, either daily or every three days, until clinical improvement is observed. The effect on thyrotoxicosis is temporary, with an approximate duration of 24–48 h.

This approach has been proposed as a safe and effective alternative when the medical treatment is contraindicated or not effective, and when there is multiple organ failure or emergency surgery is required.

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用治疗性血浆置换对抗甲亢：病例报告

甲状腺毒症是指由于任何原因导致甲状腺激素过量而引起的临床症状。主要病因是巴塞杜氏病、毒性多结节性甲状腺肿和毒性腺瘤。控制甲状腺功能的药物治疗包括抗甲状腺药物、β受体阻滞剂、碘溶液、皮质类固醇和胆碱。虽然治疗性血浆置换通常不属于治疗的一部分，但它是最终治疗前的一个初步阶段。在大多数情况下，需要一个以上的周期，每天或每三天一次，直到观察到临床改善为止。对甲状腺毒症的影响是暂时的，持续时间大约为 24-48 小时。当药物治疗被禁用或无效，以及出现多器官衰竭或需要紧急手术时，这种方法被认为是一种安全有效的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia, Diabetes y Nutricion Nursing-Nutrition and Dietetics

CiteScore

2.10

自引率

0.00%

发文量

169

审稿时长

35 days

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.