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Autoimmune Thyroid Disease (Flajani-Parry-Graves-von Basedow Disease): An Overview of Treatment

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Thyroid Disorders

Abstract

The ideal treatment for Graves-Basedow disease should restore normal thyroid function, avoid recurrence of hyperthyroidism, prevent development of hypothyroidism and prevent the occurrence or progression of ophthalmopathy. There are basically three approaches for the treatment of GD: anti-thyroid medical treatment, I-131 therapy and surgery. Antithyroid drugs act principally by interfering with the organification of iodine, thereby suppressing thyroid hormone levels. I-131 is transported into thyroid follicular cells resulting in cell necrosis over weeks to months. Sometimes Antithyroid drugs are used before the administration of radioactive iodine to promptly achieve euthyroidism and to attenuate exacerbation of thyrotoxicosis. Surgery (thyroidectomy) results in rapid control of thyrotoxicosis and has minimal risk of recurrence when a total thyroidectomy is performed. Antithyroid drugs should be initiated before surgery to reduce the risk of thyroid storm. With experienced surgeons, the risk of permanent complications is very low. Surgery is clearly indicated in certain patients: Patients who have not responded to prolonged antithyroid drug therapy, or who develop toxic reactions to the drug and for whatever reason are unsuitable for 131-I therapy; patients with huge glands, which frequently do not regress adequately after 131-I therapy; patients who prefer surgery, and patients with thyroid nodules that raise a suspicion of carcinoma.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Internal Medicine Department, University of Cauca, Popayán-Cauca, Colombia

    Hernando Vargas-Uricoechea MD, MSc, Ph.Dc

  2. Division of Basic Immunology and Biomedical Sciences, University of Valle, Cali-Valle, Colombia

    Anilza Bonelo-Perdomo BSc, MSc, Ph.D

  3. Division of Genetic and Molecular Epidemiology, University of Cauca, Popayán-Cauca, Colombia

    Carlos Hernán Sierra-Torres Ph.D

  4. Laboratory of Pathology, Hospital Universitario San José, Popayán-Cauca, Colombia

    Ivonne Meza-Cabrera MD

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  1. Hernando Vargas-Uricoechea MD, MSc, Ph.Dc
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  2. Anilza Bonelo-Perdomo BSc, MSc, Ph.D
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  3. Carlos Hernán Sierra-Torres Ph.D
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  4. Ivonne Meza-Cabrera MD
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Correspondence to Hernando Vargas-Uricoechea MD, MSc, Ph.Dc .

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Editors and Affiliations

  1. Internal Medicine, Al-Mouwasat Hospital, Jubail, Saudi Arabia

    Syed Khalid Imam

  2. School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom

    Shamim I. Ahmad

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Vargas-Uricoechea, H., Bonelo-Perdomo, A., Sierra-Torres, C.H., Meza-Cabrera, I. (2016). Autoimmune Thyroid Disease (Flajani-Parry-Graves-von Basedow Disease): An Overview of Treatment. In: Imam, S., Ahmad, S. (eds) Thyroid Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-25871-3_9

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  • DOI: https://doi.org/10.1007/978-3-319-25871-3_9

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