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An update on the medical treatment of Graves’ hyperthyroidism

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Abstract

Medical treatment of Graves’ hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves’ hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves’ hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Michele Marinò, Francesco Latrofa, Francesca Menconi & Paolo Vitti

  2. Endocrinology Unit, University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy

    Michele Marinò, Francesco Latrofa, Francesca Menconi & Paolo Vitti

  3. Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy

    Luca Chiovato

  4. Unit of Endocrinology, Fondazione Salvatore Maugeri IRCCS, Pavia, Italy

    Luca Chiovato

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  1. Michele Marinò
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  2. Francesco Latrofa
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  4. Luca Chiovato
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Correspondence to Michele Marinò.

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Marinò, M., Latrofa, F., Menconi, F. et al. An update on the medical treatment of Graves’ hyperthyroidism. J Endocrinol Invest 37, 1041–1048 (2014). https://doi.org/10.1007/s40618-014-0136-z

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  • DOI: https://doi.org/10.1007/s40618-014-0136-z

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