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Hyperthyroidism

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Thyroid Disorders

Abstract

Hyperthyroidism has multiple etiologies, manifestations, and potential therapies and untreated cases may result in significant morbidity and mortality. Appropriate treatment requires an accurate diagnosis and is influenced by age, coexisting medical conditions and patient preference. The proper treatment of hyperthyroidism depends on recognition of the signs and symptoms of the disease and determination of the etiology. The most common cause of hyperthyroidism is Graves’ disease. Other common causes include toxic multinodular goiter, toxic adenomas, thyroiditis and certain medications. The diagnostic workup should begin with a thyroid-stimulating hormone level test, the most sensitive screening test. There are many therapeutic modalities of hyperthyroidism and selection of these modalities depend upon the age, cause, prevailing medical condition and patient’s preference. This chapter will provide an overview of hyperthyroidism in non-pregnant adults.

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References

  1. Singer PA, Cooper DS, Levy EG, et al. (American Thyroid Association Standards of Care Committee). Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA. 1995;273:808–12.

    Google Scholar 

  2. Baskin HJ, Cobin RH, Duick DS, et al. (American Association of Clinical Endocrinologists). American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8:457–69.

    Google Scholar 

  3. Ellis H. Robert Graves: 1796–1852. Br J Hosp Med (Lond). 2006;67:313.

    Article  Google Scholar 

  4. Cruz AA, Akaishi PM, Vargas MA, et al. Association between thyroid autoimmune dysfunction and non-thyroid autoimmune diseases. Ophthal Plast Reconstr Surg. 2007;23:104–8.

    Article  PubMed  Google Scholar 

  5. Weetman AP. Graves’ disease. N Engl J Med. 2000;343:1236–48.

    Article  CAS  PubMed  Google Scholar 

  6. Tunbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf). 1977;7:481–93.

    Article  CAS  Google Scholar 

  7. Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol (Oxf). 1995;43:55–68.

    Article  CAS  Google Scholar 

  8. Davies TF, Larsen PR. Thyrotoxicosis. In: Larsen PR et al., editors. Williams textbook of endocrinology. 10th ed. Philadelphia: Saunders; 2003. p. 374–421.

    Google Scholar 

  9. Jacobson EM, Tomer Y. The CD40, CTLA-4, thyroglobulin, TSH receptor, and PTPN22 gene quintet and its contribution to thyroid autoimmunity: back to the future. J Autoimmun. 2007;28:85–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Iwama S, Ikezaki A, Kikuoka N, et al. Association of HLA-DR, −DQ genotype and CTLA-4 gene polymorphism with Graves’ disease in Japanese children. Horm Res. 2005;63:55–60.

    Article  CAS  PubMed  Google Scholar 

  11. Chu X, Pan CM, Zhao SX, et al. A genome-wide association study identifies two new risk loci for Graves’ disease. Nat Genet. 2011;43:897–901.

    Article  CAS  PubMed  Google Scholar 

  12. Lumbroso S, Paris F, Sultan C. Activating Gsalpha mutations: analysis of 113 patients with signs of McCune-Albright syndrome--an European Collaborative Study. J Clin Endocrinol Metab. 2004;89:2107–13.

    Article  CAS  PubMed  Google Scholar 

  13. Betterle C, Dal Pra C, Mantero F, et al. Autoimmune adrenal insufficiency and autoimmune polyendocrine syndromes: autoantibodies, autoantigens, and their applicability in diagnosis and disease prediction. Endocr Rev. 2002;23:327–64.

    Article  CAS  PubMed  Google Scholar 

  14. Plagnol V, Howson JM, Smyth DJ, et al. Genome-wide association analysis of autoantibody positivity in type 1 diabetes cases. PLoS Genet. 2011;7:e1002216.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Simmonds MJ, Brand OJ, Barrett JC, Newby PR, Franklyn JA, Gough SC. Association of Fc receptor-like 5 (FCRL5) with Graves’ disease is secondary to the effect of FCRL3. Clin Endocrinol (Oxf). 2010;73:654–60.

    Article  CAS  Google Scholar 

  16. Newby PR, Pickles OJ, Mazumdar S, Brand OJ, Carr-Smith JD, Pearce SH, et al. Follow-up of potential novel Graves’ disease susceptibility loci, identified in the UK WTCCC genomewide nonsynonymous SNP study. Eur J Hum Genet. 2010;18:1021–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Nakabayashi K, Shirasawa S. Recent advances in the association studies of autoimmune thyroid disease and the functional characterization of AITD-related transcription factor ZFAT. Nihon Rinsho Meneki Gakkai Kaishi. 2010;33:66–72.

    Article  CAS  PubMed  Google Scholar 

  18. Chu X, Dong Y, Shen M, et al. Polymorphisms in the ADRB2 gene and Graves disease: a case–control study and a meta-analysis of available evidence. BMC Med Genet. 2009;10:26.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Boelaert K, Newby PR, Simmonds MJ, et al. Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med. 2010;123:183.e1–9.

    Article  Google Scholar 

  20. Woeber KA. Update on the management of hyperthyroidism and hypothyroidism. Arch Intern Med. 2000;160:1067–71.

    Article  CAS  PubMed  Google Scholar 

  21. Bahn RS. Mechanisms of disease—Graves’ ophthalmopathy. N Engl J Med. 2010;362:726–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Smith TJ. Pathogenesis of Graves’ orbitopathy: a 2010 update. J Endocrinol Invest. 2010;33:414–21.

    Article  CAS  PubMed  Google Scholar 

  23. Douglas RS, Afifiyan NF, Hwang CJ, et al. Increased generation of fibrocytes in thyroid associated ophthalmopathy. J Clin Endocrinol Metab. 2010;95:430–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Corvilain B, Dumont JF, Vassart G. Toxic adenoma and toxic multinodular goiter. In: Werner SC, Ingbar SH, Braverman LE, Utiger RD, editors. Werner & Ingbar’s the thyroid: a fundamental and clinical text. 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 564–72.

    Google Scholar 

  25. Duprez L, Hermans J, Van Sande J, et al. Two autonomous nodules of a patient with multinodular goiter harbor different activating mutations of the thyrotropin receptor gene. J Clin Endocrinol Metab. 1997;82:306–8.

    CAS  PubMed  Google Scholar 

  26. Holzapfel HP, Fuhrer D, Wonerow P, et al. Identification of constitutively activating somatic thyrotropin receptor mutations in a subset of toxic multinodular goiters. J Clin Endocrinol Metab. 1997;82:4229–33.

    CAS  PubMed  Google Scholar 

  27. Tonacchera M, Chiovato L, Pinchera A, et al. Hyperfunctioning thyroid nodules in toxic multinodular goiter share activating thyrotropin receptor mutations with solitary toxic adenoma. J Clin Endocrinol Metab. 1998;83:492–8.

    CAS  PubMed  Google Scholar 

  28. Kopp P, Kimura ET, Aeschimann S, et al. Polyclonal and monoclonal thyroid nodules coexist within human multinodular goiters. J Clin Endocrinol Metab. 1994;79:134–9.

    CAS  PubMed  Google Scholar 

  29. Gabriel EM, Bergert ER, Grant CS, et al. Germline polymorphism of codon 727 of human thyroid-stimulating hormone receptor is associated with toxic multinodular goiter. Clin Endocrinol Metab. 1999;84:3328–35.

    CAS  Google Scholar 

  30. Nogueira CR, Kopp P, Arseven OK, et al. Thyrotropin receptor mutations in hyperfunctioning thyroid adenomas from Brazil. Thyroid. 1999;9:1063–8.

    Article  CAS  PubMed  Google Scholar 

  31. Muhlberg T, Herrmann K, Joba W, et al. Lack of association of nonautoimmune hyperfunctioning thyroid disorders and a germline polymorphism of codon 727 of the human thyrotropin receptor in a European Caucasian population. J Clin Endocrinol Metab. 2000;85:2640–3.

    CAS  PubMed  Google Scholar 

  32. Hamburger JI. Evolution of toxicity in solitary nontoxic autonomously functioning thyroid nodules. J Clin Endocrinol Metab. 1980;50:1089–93.

    Article  CAS  PubMed  Google Scholar 

  33. Bransom CJ, Talbot CH, Henry L, et al. Solitary toxic adenoma of the thyroid gland. Br J Surg. 1979;66:592–5.

    Article  CAS  PubMed  Google Scholar 

  34. Dumont JE, Lamy F, Roger P, et al. Physiological and pathological regulation of thyroid cell proliferation and differentiation by thyrotropin and other factors. Physiol Rev. 1992;72:667–97.

    CAS  PubMed  Google Scholar 

  35. Parma J, Van Sande J, Swillens S, et al. Somatic mutations causing constitutive activity of the thyrotropin receptor are the major cause of hyperfunctioning thyroid adenomas: identification of additional mutations activating both the cyclic adenosine 3′,5′-monophosphate and inositol phosphate-Ca2+ cascades. Mol Endocrinol. 1995;9:725–33.

    CAS  PubMed  Google Scholar 

  36. Takeshita A, Nagayama Y, Yokoyama N, et al. Rarity of oncogenic mutations in the thyrotropin receptor of autonomously functioning thyroid nodules in Japan. J Clin Endocrinol Metab. 1995;80:2607–11.

    CAS  PubMed  Google Scholar 

  37. Frost L, Vestergaard P, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med. 2004;164:1675–8.

    Article  PubMed  Google Scholar 

  38. Trulzsch B, Krohn K, Wonerow P, et al. Detection of thyroid-stimulating hormone receptor and Gs alpha mutations: in 75 toxic thyroid nodules by denaturing gradient gel electrophoresis. J Mol Med. 2001;78:684–91.

    Article  CAS  PubMed  Google Scholar 

  39. Slatosky J, Shipton B, Wahba H. Thyroiditis: differential diagnosis and management. Am Fam Physician. 2000;61:1047–52.

    CAS  PubMed  Google Scholar 

  40. Roberts CG, Ladenson PW. Hypothyroidism. Lancet. 2004;363:793–803.

    Article  CAS  PubMed  Google Scholar 

  41. Fitzgerald PA. Endocrinology. In: Tierny LM, McPhee SJ, Papadakis MA, editors. Current medical diagnosis and treatment. 44th ed. New York: McGraw-Hill; 2005. p. 1102–10.

    Google Scholar 

  42. Beck-Peccoz P, Persani L, Mannavola D, et al. Pituitary tumours: TSH-secreting adenomas. Best Pract Res Clin Endocrinol Metab. 2009;23:597–606.

    Article  CAS  PubMed  Google Scholar 

  43. Beck-Peccoz P, Brucker-Davis F, Persani L, et al. Thyrotropin-secreting pituitary tumors. Endocr Rev. 1996;17:610–38.

    CAS  PubMed  Google Scholar 

  44. Refetoff S, Weiss RE, Usala SJ. The syndromes of resistance to thyroid hormone. Endocr Rev. 1993;14:348–99.

    CAS  PubMed  Google Scholar 

  45. Refetoff S, Dumitrescu AM. Syndromes of reduced sensitivity to thyroid hormone: genetic defects in hormone receptors, cell transporters and deiodination. Best Pract Res Clin Endocrinol Metab. 2007;21:277–305.

    Article  CAS  PubMed  Google Scholar 

  46. Thomas JS, Leclere J, Hartemann P, et al. Familial hyperthyroidism without evidence of autoimmunity. Acta Endocrinol (Copenh). 1982;100:512–8.

    CAS  Google Scholar 

  47. Gozu HI, Lublinghoff J, Bircan R, et al. Genetics and phenomics of inherited and sporadic non-autoimmune hyperthyroidism. Mol Cell Endocrinol. 2010;322:125–34.

    Article  CAS  PubMed  Google Scholar 

  48. Knudson PB. Hyperthyroidism in adults: variable clinical presentations and approaches to diagnosis. J Am Board Fam Pract. 1995;8:109–13.

    CAS  PubMed  Google Scholar 

  49. Heeringa J, Hoogendoorn EH, van der Deure WM, et al. High-normal thyroid function and risk of atrial fibrillation: the Rotterdam study. Arch Intern Med. 2008;168:2219–24.

    Article  PubMed  Google Scholar 

  50. Ross DS. Syndromes of thyrotoxicosis with low radioactive iodine uptake. Endocrinol Metab Clin North Am. 1998;27:169–85.

    Article  CAS  PubMed  Google Scholar 

  51. Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. Lancet. 2010;376:717–29.

    Article  PubMed  Google Scholar 

  52. Paladini D, Vassallo M, Sglavo G, et al. Struma ovarii associated with hyperthyroidism, elevated CA 125 and pseudo-Meigs syndrome may mimic advanced ovarian cancer. Ultrasound Obstet Gynecol. 2008;32:237–8.

    Article  CAS  PubMed  Google Scholar 

  53. Wong LY, Diamond TH. Severe ophthalmopathy developing after treatment of coexisting malignant struma ovarii and Graves’ disease. Thyroid. 2009;19:1125–7.

    Article  PubMed  Google Scholar 

  54. Griffin MA, Solomon DH. Hyperthyroidism in the elderly. J Am Geriatr Soc. 1986;34:887–92.

    Article  CAS  PubMed  Google Scholar 

  55. Singer PA, Cooper DS, Levy EG, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA. 1995;273:808–12.

    Article  CAS  PubMed  Google Scholar 

  56. Mokshagundum SP, Barzel US. Thyroid disease in the elderly. J Am Geriatr Soc. 1993;41:1361–9.

    Article  Google Scholar 

  57. Isley WL. Thyroid dysfunction in the severely ill and elderly: forget the classic signs and symptoms. Postgrad Med. 1993;94:111–8. 127–8, 139–140.

    CAS  PubMed  Google Scholar 

  58. Henschke PJ. When to suspect thyroid disease in the elderly. Geriatrics. 1982;37:125–9.

    CAS  PubMed  Google Scholar 

  59. Somerville W, Levine SA. Angina pectoris and thyrotoxicosis. Br Heart J. 1950;12:245.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Federman DD. Hyperthyroidism in geriatric population. Hosp Pract. 1991;26:61–76.

    CAS  Google Scholar 

  61. Baloch Z, Carayon P, Conte-Devolx B, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid. 2003;13:3–126.

    Article  PubMed  Google Scholar 

  62. Baskin HJ, Cobin RH, Duick DS, Gharib H, Guttler RB, Kaplan MM, Segal RL, American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocr Pract. 2002;8:457–69.

    PubMed  Google Scholar 

  63. Harper MB, Mayeaux Jr EJ. Thyroid disease. In: Taylor RB, editor. Family medicine: principles and practice. 6th ed. New York: Springer; 2003. p. 1042–52.

    Google Scholar 

  64. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489–99.

    Article  CAS  PubMed  Google Scholar 

  65. Chung JO, Cho DH, Chung DJ, et al. Ultrasonographic features of papillary thyroid carcinoma in patients with Graves’ disease. Korean J Intern Med. 2010;25:71–6.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Cappelli C, Pirola I, De Martino E, et al. The role of imaging in Graves’ disease: a cost-effectiveness analysis. Eur J Radiol. 2008;65:99–103.

    Article  CAS  PubMed  Google Scholar 

  67. Markovic V, Eterovic D. Thyroid echogenicity predicts outcome of radioiodine therapy in patients with graves’ disease. J Clin Endocrinol Metab. 2007;92:3547–52.

    Article  CAS  PubMed  Google Scholar 

  68. Ralls PW, Mayekawa DS, Lee KP, et al. Color-flow Doppler sonography in Graves disease: “thyroid inferno”. AJR Am J Roentgenol. 1988;150:781–4.

    Article  CAS  PubMed  Google Scholar 

  69. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658–65.

    Article  PubMed  Google Scholar 

  70. Riis AL, Jørgensen JO, Gjedde S, et al. Whole body and forearm substrate metabolism in hyperthyroidism: evidence of increased basal muscle protein breakdown. Am J Physiol Endocrinol Metab. 2005;288:E1067–73.

    Article  CAS  PubMed  Google Scholar 

  71. Torring O, Tallstedt L, Wallin G, et al. Graves’ hyperthyroidism: treatment with antithyroid drugs, surgery, or radioiodine—a prospective, randomized study. J Clin Endocrinol Metab. 1996;81:2986–93.

    CAS  PubMed  Google Scholar 

  72. Jansson S, Lie-Karlsen K, Stenqvist O, et al. Oxygen consumption in patients with hyperthyroidism before and after treatment with beta-blockade versus thyrostatic treatment: a prospective randomized study. Ann Surg. 2001;233:60–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Ginsberg J. Diagnosis and management of Graves’ disease. CMAJ. 2003;168:575–85.

    PubMed  PubMed Central  Google Scholar 

  74. Nedrebo BG, Holm PA, Uhlving S, Sorheim JI, Skeie S, Eide GE, et al. Predictors of outcome and comparison of different drug regimens for the prevention of relapse in patients with Graves’ disease. Eur J Endocrinol. 2002;147:583–9.

    Article  CAS  PubMed  Google Scholar 

  75. Porterfield Jr JR, Thompson GB, Farley DR, Grant CS, Richards ML. Evidence-based management of toxic multinodular goiter (Plummer’s disease). World J Surg. 2008;32:1278–84.

    Article  PubMed  Google Scholar 

  76. Cooper DS. Antithyroid drugs. N Engl J Med. 2005;352:905–17.

    Article  CAS  PubMed  Google Scholar 

  77. Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21:593–646.

    Article  PubMed  CAS  Google Scholar 

  78. De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97:2543–65.

    Article  PubMed  CAS  Google Scholar 

  79. Tajiri J, Noguchi S, Murakami T, Murakami N. Antithyroid drug-induced agranulocytosis. The usefulness of routine white blood cell count monitoring. Arch Intern Med. 1990;150:621–4.

    Article  CAS  PubMed  Google Scholar 

  80. The Food and Drug Administration and American Thyroid Association. Propylthiouracil-related liver toxicity: public workshop. April 19, 2009; Washington, D.C.

    Google Scholar 

  81. Stalberg P, Svensson A, Hessman O, et al. Surgical treatment of Graves’ disease: evidence-based approach. World J Surg. 2008;32:1269–77.

    Article  PubMed  Google Scholar 

  82. Wartofsky L, Glinoer D, Solomon B, et al. Differences and similarities in the diagnosis and treatment of Graves’ disease in Europe, Japan, and the United States. Thyroid. 1991;1:129–35.

    Article  CAS  PubMed  Google Scholar 

  83. Erickson D, Gharib H, Li H, van Heerden JA. Treatment of patients with toxic multinodular goiter. Thyroid. 1998;8:277–82.

    Article  CAS  PubMed  Google Scholar 

  84. Kang AS, Grant CS, Thompson GB, et al. Current treatment of nodular goiter with hyperthyroidism (Plummer’s disease): surgery versus radioiodine. Surgery. 2002;132:916–23.

    Article  PubMed  Google Scholar 

  85. Nygaard B, Hegedüs L, Ulriksen P, et al. Radioiodine therapy for multinodular toxic goiter. Arch Intern Med. 1999;159:1364–8.

    Article  CAS  PubMed  Google Scholar 

  86. Read Jr CH, Tansey MJ, Menda Y. A 36 year retrospective analysis of the efficacy and safety of radioactive iodine in treating young Graves’ patients. J Clin Endocrinol Metab. 2004;89:4229–33.

    Article  CAS  PubMed  Google Scholar 

  87. Shore RE. Issues and epidemiological evidence regarding radiation-induced thyroid cancer. Radiat Res. 1992;131:98–111.

    Article  CAS  PubMed  Google Scholar 

  88. Rivkees SA. The use of radioactive iodine in the management of hyperthyroidism in children. In: Current drug targets. Immune, endocrine and metabolic disorders, vol. 1. Boca Raton: Bentham Science Publishers; 2001. p. 255–64.

    Google Scholar 

  89. Bartalena L, Marcocci C, Bogazzi F, Manetti L, Tanda ML, Dell’Unto E, et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy. N Engl J Med. 1998;338:73–8.

    Article  CAS  PubMed  Google Scholar 

  90. Braga M, Walpert N, Burch HB, Solomon BL, Cooper DS. The effect of methimazole on cure rates after radioiodine treatment for Graves’ hyperthyroidism: a randomized clinical trial. Thyroid. 2002;12:135–9.

    Article  CAS  PubMed  Google Scholar 

  91. Andrade VA, Gross JL, Maia AL. The effect of methimazole pretreatment on the efficacy of radioactive iodine therapy in Graves’ hyperthyroidism: one-year follow-up of a prospective, randomized study. J Clin Endocrinol Metab. 2001;86:3488–93.

    CAS  PubMed  Google Scholar 

  92. Burch HB, Solomon BL, Cooper DS, Ferguson P, Walpert N, Howard R. The effect of antithyroid drug pretreatment on acute changes in thyroid hormone levels after (131) I ablation for Graves’ disease. J Clin Endocrinol Metab. 2001;86:3016–21.

    CAS  PubMed  Google Scholar 

  93. Meier DA, Brill DR, Becker DV, Clarke SE, Silberstein EB, Royal HD, et al. Society of Nuclear Medicine procedure guideline for therapy of thyroid disease with iodine-131 (sodium iodide). Accessed online 21 July 2005, at: http://interactive.snm.org/docs/pg_ch26_0403.pdf.

  94. Sisson JC, Freitas J, McDougall IR, Dauer LT, Hurley JR, Brierley JD, et al. Radiation safety in the treatment of patients with thyroid diseases by radioiodine 131i: practice recommendations of the American Thyroid Association. Thyroid. 2011;21(4):335–46.

    Article  PubMed  Google Scholar 

  95. Fontanilla JC, Schneider AB, Sarne DH. The use of oral radiographic contrast agents in the management of hyperthyroidism. Thyroid. 2001;11:561–7.

    Article  CAS  PubMed  Google Scholar 

  96. Shindo M. Surgery for hyperthyroidism. ORL J Otorhinolaryngol Relat Spec. 2008;70:298–304.

    Article  PubMed  Google Scholar 

  97. Worni M, Schudel HH, Seifert E, et al. Randomized controlled trial on single dose steroid before thyroidectomy for benign disease to improve postoperative nausea, pain, and vocal function. Ann Surg. 2008;248:1060–6.

    Article  PubMed  Google Scholar 

  98. Farrar WB. Complications of thyroidectomy. Surg Clin North Am. 1983;63:1353–61.

    CAS  PubMed  Google Scholar 

  99. Schoretsanitis G, Melissas J, Sanidas E. Does draining the neck affect morbidity following thyroid surgery? Am Surg. 1998;64:778–80.

    CAS  PubMed  Google Scholar 

  100. Johnson JT, Wagner RL. Infection following uncontaminated head and neck surgery. Arch Otolaryngol Head Neck Surg. 1987;113:368–9.

    Article  CAS  PubMed  Google Scholar 

  101. Gavilan J, Gavilan C. Recurrent laryngeal nerve. Identification during thyroid and parathyroid surgery. Arch Otolaryngol Head Neck Surg. 1986;112:1286–8.

    Article  CAS  PubMed  Google Scholar 

  102. Chandrasekhar S, Randolph G, Seidman M, et al. Clinical practice guideline: improving voice outcomes after thyroid surgery. Otolaryngol Head Neck Surg. 2013;148(6 Suppl):S1–37.

    Article  PubMed  Google Scholar 

  103. Wong C, Price S, Scott-Coombes D. Hypocalcaemia and parathyroid hormone assay following total thyroidectomy: predicting the future. World J Surg. 2006;30:825–32.

    Article  CAS  PubMed  Google Scholar 

  104. Netterville JL, Aly A, Ossoff RH. Evaluation and treatment of complications of thyroid and parathyroid surgery. Otolaryngol Clin North Am. 1990;23:529–52.

    CAS  PubMed  Google Scholar 

  105. Ezon I, Zilbert N, Pinkney L, et al. A large struma ovarii tumor removed via laparoscopy in a 16-year-old adolescent. J Pediatr Surg. 2007;42:E19–22.

    Article  PubMed  Google Scholar 

  106. Wolff EF, Hughes M, Merino MJ, et al. Expression of benign and malignant thyroid tissue in ovarian teratomas and the importance of multimodal management as illustrated by a BRAF-positive follicular variant of papillary thyroid cancer. Thyroid. 2010;20:981–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  107. Nielsen CH, El Fassi D, Hasselbalch HC, et al. B-cell depletion with rituximab in the treatment of autoimmune diseases. Graves’ ophthalmopathy: the latest addition to an expanding family. Expert Opin Biol Ther. 2007;7:1061–78.

    Article  CAS  PubMed  Google Scholar 

  108. Yamamoto M, Sasaki A, Asahi H, Shimada Y, Sato N, Nakajima J, et al. Endoscopic subtotal thyroidectomy for patients with Graves’ disease. Surg Today. 2001;31:1–4.

    Article  CAS  PubMed  Google Scholar 

  109. Xiao H, Zhuang W, Wang S, Yu B, Chen G, Zhou M, et al. Arterial embolization: a novel approach to thyroid ablative therapy for Graves’ disease. J Clin Endocrinol Metab. 2002;87:3583–9.

    CAS  PubMed  Google Scholar 

  110. Ozdemir S, Buyukbese M, Kadioglu P, Soyasal T, Senturk H, Akin P. Plasmapheresis: an effective therapy for refractory hyperthyroidism in the elderly. Indian J Med Sci. 2002;56:65–8.

    CAS  PubMed  Google Scholar 

  111. Tarantino L, Giorgio A, Mariniello N, de Stefano G, Perrotta A, Aloisio V, et al. Percutaneous ethanol injection of large autonomous hyperfunctioning thyroid nodules. Radiology. 2000;214:143–8.

    Article  CAS  PubMed  Google Scholar 

  112. Shimizu K, Kumita S, Kitamura Y, Nagahama M, Kitagawa W, Akasu H, et al. Trial of autotransplantation of cryopreserved thyroid tissue for postoperative hypothyroidism in patients with Graves’ disease. J Am Coll Surg. 2002;194:14–22.

    Article  PubMed  Google Scholar 

  113. Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001;86:3579–94.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Syed Khalid Imam FCPS, FACE .

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Imam, S.K. (2016). Hyperthyroidism. In: Imam, S., Ahmad, S. (eds) Thyroid Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-25871-3_8

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