Graves' hyperthyroidism treated with potassium iodide: early response and after 2 years of follow-up.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2024-11-08 Print Date: 2024-12-01 DOI:10.1530/ETJ-24-0085

Megumi Fujikawa, Ken Okamura

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引用次数: 0

Abstract

Objective: As thionamide is associated with various adverse effects, we re-evaluated the practical efficacy of potassium iodide (KI) therapy for Graves' hyperthyroidism (GD).

Methods: We administered KI (mainly 100 mg/day) to 324 untreated GD patients and added methimazole (MMI) only to those remaining thyrotoxic even at 200 mg/day. When the patient became hypothyroid, MMI, if taken was stopped, then levothyroxine (LT4) was added without reducing the KI dose. Radioactive iodine (RI) therapy or thyroidectomy was performed whenever required. We evaluated the early effects of KI at 2-4 weeks and followed patients for 2 years.

Results: At 2 weeks, serum thyroid hormone levels decreased in all 324 patients. At 4 weeks, fT4, fT3, and both fT4 and fT3 levels became normal or low in 74.7%, 50.6%, and 50.6% of patients, respectively. In a cross-sectional survey over 2 years, GD was well-controlled with KI or KI + LT4 (KI-effective) in >50% of patients at all time points. Among 288 patients followed for 2 years, 42.7% remained 'KI-effective' throughout the 2 years (KI Group), 30.9% were well-controlled with additional MMI given for 1-24 months, and 26.4% were successfully treated with ablative therapy (mainly RI). Among 'KI-effective' patients at 4 weeks, 76.5% were classified into the KI Group. No patients experienced adverse effects from KI.

Conclusion: KI therapy was useful in the treatment of GD. A sufficient dose of KI was effective in >50% of GD patients from 4 weeks to 2 years, and 42.7% (76.5% of 'KI-effective' patients at 4 weeks) remained 'KI-effective' throughout the 2 years.

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用碘化钾治疗巴塞杜氏甲状腺功能亢进症：早期反应和两年随访。

目的由于硫酰胺与各种不良反应相关，我们重新评估了碘化钾（KI）治疗巴塞杜氏甲状腺功能亢进症（GD）的实际疗效：方法：我们对324名未经治疗的GD患者进行了碘化钾治疗（主要是100毫克/天），仅对那些即使服用200毫克/天仍有甲状腺毒性的患者添加了甲巯咪唑（MMI）。当患者出现甲状腺功能减退时，停用甲巯咪唑，然后在不减少 KI 剂量的情况下添加左甲状腺素（LT4）。必要时还会进行放射性碘（RI）治疗或甲状腺切除术。我们在 2-4 周时评估了 KI 的早期效果，并对患者进行了为期 2 年的随访：结果：2周时，所有324名患者的血清甲状腺激素都有所下降。4 周时，分别有 74.7%、50.6% 和 50.6% 的患者 fT4、fT3 以及 fT4 和 fT3 水平变得正常或偏低。在一项为期 2 年的横断面调查中，在所有时间点，均有超过 50% 的患者在使用 KI 或 KI+LT4（KI 有效）后，GD 得到了很好的控制。在随访 2 年的 288 名患者中，42.7% 的患者在 2 年中一直保持 "KI 有效"（KI 组），30.9% 的患者在额外服用 MMI 1-24 个月后病情得到良好控制，26.4% 的患者成功接受了消融治疗（主要是 RI）。在 4 周的 "KI 有效 "患者中，76.5% 被归入 KI 组。没有患者出现 KI 不良反应：结论：KI疗法对治疗GD很有帮助。结论：KI疗法对治疗GD很有帮助。从4周到2年，足够剂量的KI对50%以上的GD患者有效，42.7%（4周时 "KI有效 "患者的76.5%）在2年中保持 "KI有效"。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.