{"title":"血浆置换治疗甲状腺毒症：一项以危重病人为重点的回顾性研究。","authors":"Ummu Mutlu, Fatih Bektas, Senem Dadin, Hulya Hacisahinogullari, Yalin Iscan, Gulsah Yenidunya Yalin, Nurdan Gul, Ozlem Soyluk Selcukbiricik, Sevgi Kalayoglu Besisik, Ayse Kubat Uzum","doi":"10.1007/s12020-025-04314-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Severe thyrotoxicosis is a life-threatening condition. Therapeutic plasma exchange (TPE) can rapidly reduce elevated thyroid hormone levels and serves as an alternative treatment option, particularly in cases like thyroid storm, where achieving euthyroid status is critical. We evaluated our experience regarding the efficacy and safety of TPE in patients with thyrotoxicosis where antithyroid drugs cannot be utilized due to side effects or fail to work.</p><p><strong>Methods: </strong>A retrospective cohort study evaluated adult patients who underwent TPE due to thyrotoxicosis between 2015-2024. Causes of thyrotoxicosis, TPE indications, complications, changes in thyroid hormones, and post-TPE treatments were noted.</p><p><strong>Results: </strong>Twenty-two patients were included. The median age was 50 years (32-60). 51.9% were female. The most common cause of thyrotoxicosis was Graves' disease. Indications for TPE included side effects from ATD, emergency non-thyroid surgery, thyroid storm, and molar pregnancies. The median number of TPE sessions was 2.5 (2-3). Albumin was used as the replacement fluid for most patients. After TPE, free T4 and free T3 decreased by 43 and 64.1%, respectively. Prolongation of prothrombin time was common; however, bleeding occurred in only one patient. After TPE, 10 patients underwent surgery, and 3 received RAI. ATD treatment continued in 9 patients.</p><p><strong>Conclusion: </strong>Our study is among the largest series in the literature. Consistent with existing literature, it has been demonstrated that TPE was reliable and effective in establishing rapid and effective euthyroid state not only in cases of antithyroid drug side effects, ineffectiveness, and thyroid storm but also before non-thyroidal emergency surgeries.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":"157-165"},"PeriodicalIF":2.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Therapeutic plasmapheresis in the management of thyrotoxicosis: a-retrospective study with emphasis on critically ill patients.\",\"authors\":\"Ummu Mutlu, Fatih Bektas, Senem Dadin, Hulya Hacisahinogullari, Yalin Iscan, Gulsah Yenidunya Yalin, Nurdan Gul, Ozlem Soyluk Selcukbiricik, Sevgi Kalayoglu Besisik, Ayse Kubat Uzum\",\"doi\":\"10.1007/s12020-025-04314-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Severe thyrotoxicosis is a life-threatening condition. Therapeutic plasma exchange (TPE) can rapidly reduce elevated thyroid hormone levels and serves as an alternative treatment option, particularly in cases like thyroid storm, where achieving euthyroid status is critical. We evaluated our experience regarding the efficacy and safety of TPE in patients with thyrotoxicosis where antithyroid drugs cannot be utilized due to side effects or fail to work.</p><p><strong>Methods: </strong>A retrospective cohort study evaluated adult patients who underwent TPE due to thyrotoxicosis between 2015-2024. Causes of thyrotoxicosis, TPE indications, complications, changes in thyroid hormones, and post-TPE treatments were noted.</p><p><strong>Results: </strong>Twenty-two patients were included. The median age was 50 years (32-60). 51.9% were female. The most common cause of thyrotoxicosis was Graves' disease. Indications for TPE included side effects from ATD, emergency non-thyroid surgery, thyroid storm, and molar pregnancies. The median number of TPE sessions was 2.5 (2-3). Albumin was used as the replacement fluid for most patients. After TPE, free T4 and free T3 decreased by 43 and 64.1%, respectively. Prolongation of prothrombin time was common; however, bleeding occurred in only one patient. After TPE, 10 patients underwent surgery, and 3 received RAI. ATD treatment continued in 9 patients.</p><p><strong>Conclusion: </strong>Our study is among the largest series in the literature. Consistent with existing literature, it has been demonstrated that TPE was reliable and effective in establishing rapid and effective euthyroid state not only in cases of antithyroid drug side effects, ineffectiveness, and thyroid storm but also before non-thyroidal emergency surgeries.</p>\",\"PeriodicalId\":49211,\"journal\":{\"name\":\"Endocrine\",\"volume\":\" \",\"pages\":\"157-165\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12020-025-04314-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-025-04314-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Therapeutic plasmapheresis in the management of thyrotoxicosis: a-retrospective study with emphasis on critically ill patients.
Purpose: Severe thyrotoxicosis is a life-threatening condition. Therapeutic plasma exchange (TPE) can rapidly reduce elevated thyroid hormone levels and serves as an alternative treatment option, particularly in cases like thyroid storm, where achieving euthyroid status is critical. We evaluated our experience regarding the efficacy and safety of TPE in patients with thyrotoxicosis where antithyroid drugs cannot be utilized due to side effects or fail to work.
Methods: A retrospective cohort study evaluated adult patients who underwent TPE due to thyrotoxicosis between 2015-2024. Causes of thyrotoxicosis, TPE indications, complications, changes in thyroid hormones, and post-TPE treatments were noted.
Results: Twenty-two patients were included. The median age was 50 years (32-60). 51.9% were female. The most common cause of thyrotoxicosis was Graves' disease. Indications for TPE included side effects from ATD, emergency non-thyroid surgery, thyroid storm, and molar pregnancies. The median number of TPE sessions was 2.5 (2-3). Albumin was used as the replacement fluid for most patients. After TPE, free T4 and free T3 decreased by 43 and 64.1%, respectively. Prolongation of prothrombin time was common; however, bleeding occurred in only one patient. After TPE, 10 patients underwent surgery, and 3 received RAI. ATD treatment continued in 9 patients.
Conclusion: Our study is among the largest series in the literature. Consistent with existing literature, it has been demonstrated that TPE was reliable and effective in establishing rapid and effective euthyroid state not only in cases of antithyroid drug side effects, ineffectiveness, and thyroid storm but also before non-thyroidal emergency surgeries.
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
