Advertisement

Graves’ Disease

  • Simon H.S. Pearce
Part of the Contemporary Endocrinology book series (COE)

Summary

Hyperthyroid Graves’ disease is one of the commonest autoimmune disorders, affecting about 1% of women. It is most frequent in the 4th decade of life. There is a genetic predisposition to Graves’ disease, determined by alleles at the major histocompatibility complex (MHC), cytotoxic T-lymphocyte-associated antigen (CTLA-4), protein tyrosine phosphatase non-receptor 22 (PTPN22), and other less well-defined chromosomal loci. Additional, non-genetic, factors that have an influence are cigarette use, pregnancy, estrogen use, and stressful life events. The hyperthyroidism is caused by thyroid-stimulating hormone (TSH) receptor stimulating autoantibodies that lead to excess thyroid hormone production and thyroid growth. Thyroid peroxidase autoantibodies are also frequently found and may be important in thyrocyte destruction and perpetuation of autoimmunity. Graves’ disease may be treated with thionamide antithyroid drugs, radioiodine or thyroid surgery. No treatment is perfect and each has its pros and cons. The recent isolation of monoclonal human TSH receptor antibodies may lead to more sensitive tests for thyroid-stimulating autoantibodies. A key challenge is to define novel therapies that lead to more certain and safe remission of hyperthyroidism without ablation of thyroid function.

Keywords

autoimmune hyperthyroidism thionamide radioiodine TSH receptor thyroid peroxidase autoantibody goiter 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Tunbridge WM, Evered DC, Hall R, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol 1977; 7: 481–493.Google Scholar
  2. 2.
    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: 489–499.PubMedCrossRefGoogle Scholar
  3. 3.
    Holm IA, Manson JE, Michels KB, Alexander EK, Willett WC, Utiger RD. Smoking and other lifestyle factors and the risk of Graves’ hyperthyroidism. Arch Int Med 2005; 165: 1606–1611.CrossRefGoogle Scholar
  4. 4.
    Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community; a twenty year follow up. Clin Endocrinol 1995; 43: 55–68.Google Scholar
  5. 5.
    Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med 1991; 229: 415–420.PubMedGoogle Scholar
  6. 6.
    Perros P, Crombie AL, Matthews JN, Kendall-Taylor P. Age and gender influence the severity of thyroid-associated ophthalmopathy: a study of 101 patients attending a combined thyroid-eye clinic. Clin Endocrinol 1993; 38: 367–372.Google Scholar
  7. 7.
    Vaidya B, Kendall-Taylor P, Pearce SHS. The genetics of autoimmune thyroid disease. J Clin Endocrinol Metab 2002; 87: 5385–5397.PubMedCrossRefGoogle Scholar
  8. 8.
    Brix TH, Kyvik KO, Christensen K, Hegedus L. Evidence for a major role of heredity in Graves’ disease: a population-based study of two Danish twin cohorts. J Clin Endocrinol Metab 2001; 86: 930–934.PubMedCrossRefGoogle Scholar
  9. 9.
    Criswell LA, Pfeiffer KA, Lum RF, et al. Analysis of families in the multiple autoimmune disease genetics consortium (MADGC) collection: the PTPN22 620W allele associates with multiple autoimmune phenotypes. Am J Hum Genet 2005; 76: 561–571.PubMedCrossRefGoogle Scholar
  10. 10.
    Grumet FC, Payne RO, Konishi J, Kriss JP. HL-A antigens as markers for disease susceptibility and autoimmunity in Graves’ disease. J Clin Endocrinol Metab 1974; 39: 1115–1119.PubMedGoogle Scholar
  11. 11.
    Farid NR, Sampson L, Noel EP, et al. A study of human leukocyte D locus related antigens in Graves’ disease. J Clin Invest 1979; 63: 108–113.PubMedGoogle Scholar
  12. 12.
    Yanagawa T, Mangklabruks A, Chang YB, et al. Human histocompatability leukocyte antigen-DQA1*0501 allele associated with genetic susceptibility to Graves’ disease in a Caucasian population. J Clin Endocrinol Metab 1993; 76: 1569–1574.PubMedCrossRefGoogle Scholar
  13. 13.
    Heward JM, Allahabadia A, Daykin J, et al. Linkage disequilibrium between the human leukocyte antigen class II region of the major histocompatibility complex and Graves’ disease: replication using a population case control and family-based study. J Clin Endocrinol Metab 1998; 83: 3394–3397.PubMedCrossRefGoogle Scholar
  14. 14.
    Ban Y, Davies TF, Greenberg DA, et al. Arginine at position 74 of the HLA-DR beta 1 chain is associated with Graves’ disease. Genes Immun 2004; 5: 203–208.PubMedCrossRefGoogle Scholar
  15. 15.
    Simmonds MJ, Howson JM, Heward JM, et al. Regression mapping of association between the human leukocyte antigen region and Graves’ disease. Am J Hum Genet 2005; 76: 157–163.PubMedCrossRefGoogle Scholar
  16. 16.
    Tomer Y, Barbesino G, Greenberg DA, Concepcion ES, Davies TF. Mapping the major susceptibility loci for familial Graves’ and Hashimoto’s diseases: evidence for genetic heterogeneity and gene interactions. J Clin Endocrinol Metab 1999; 84: 4656–4664.PubMedCrossRefGoogle Scholar
  17. 17.
    Sakai K, Shirasawa S, Ishikawa N, et al. Identification of susceptibility loci for autoimmune thyroid disease to 5q31-q33 and Hashimoto’s thyroiditis to 8q23-q24 by multipoint affected sib-pair linkage analysis in Japanese. Hum Mol Genet 2001; 10: 1379–1386.PubMedCrossRefGoogle Scholar
  18. 18.
    Vaidya B, Imrie H, Perros P, et al. The cytotoxic T lymphocyte antigen-4 is a major Graves’ disease locus. Hum Mol Genet 1999; 8: 1195–1199.PubMedCrossRefGoogle Scholar
  19. 19.
    Yanagawa T, Hidaka Y, Guimaraes V, Soliman M, DeGroot LJ. CTLA-4 gene polymorphism associated with Graves’ disease in a Caucasian population. J Clin Endocrinol Metab 1995; 80: 41–45.PubMedCrossRefGoogle Scholar
  20. 20.
    Vaidya B, Pearce SHS. The emerging role of the CTLA4 gene in autoimmune endocrinopathies. Eur J Endocrinol 2004; 150: 619–626.PubMedCrossRefGoogle Scholar
  21. 21.
    Ueda H, Howson JM, Heward JM, et al. Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune disease. Nature 2003; 423: 506–511.PubMedCrossRefGoogle Scholar
  22. 22.
    Atabani SF, Thio CL, Divanovic S, et al. Association of CTLA4 polymorphism with regulatory T cell frequency. Eur. J. Immunol 2005; 35: 2157–2162.PubMedCrossRefGoogle Scholar
  23. 23.
    Vang T, Congia M, Macis MD, et al. Autoimmune-associated lymphoid tyrosine phosphatase is a gain of function variant. Nat Genet 2005; 37: 1300–1302; doi:10.1038/ng1673.CrossRefGoogle Scholar
  24. 24.
    Velaga MR, Wilson V, Jennings CE, et al. The codon 620 tryptophan allele of the lymphoid tyrosine phosphatase (LYP) gene is a major determinant of Graves’ Disease. J Clin Endocrinol Metab 2004; 89, 5862–5865.PubMedCrossRefGoogle Scholar
  25. 25.
    Smyth D, Cooper JD, Collins JE, et al. Replication of an association between the lymphoid tyrosine phosphatase locus (LYP/PTPN22) with type 1 diabetes, and evidence for its role as a general autoimmunity locus. Diabetes 2004; 53: 3020–3023.PubMedCrossRefGoogle Scholar
  26. 26.
    Hiratani H, Bowden DW, Ikegami S, et al. Multiple SNPs in intron 7 of thyrotropin receptor are associated with Graves’ disease. J Clin Endocrinol Metab 2005; 90: 2898–2903.PubMedCrossRefGoogle Scholar
  27. 27.
    Dechairo BM, Zabaneh D, Collins J, et al. Association of the TSHR gene with Graves’ disease: the first disease-specific locus. Eur J Hum Genet 2005; 13: 1223–1230.PubMedCrossRefGoogle Scholar
  28. 28.
    Ban Y, Greenberg DA, Concepcion E, Skrabanek L, Villanueva R, Tomer Y. Amino acid substitutions in the thyroglobulin gene are associated with susceptibility to human and murine autoimmune thyroid disease. Proc Natl Acad Sci USA 2003; 100: 15119–15124.PubMedCrossRefGoogle Scholar
  29. 29.
    Collins JE, Heward JM, Carr-Smith J, Daykin J, Franklyn JA, Gough SC. Association of rare thyroglobulin gene microsatellite variants with autoimmune thyroid disease. J Clin Endocrinol Metab 2003; 88: 5039–5042.PubMedCrossRefGoogle Scholar
  30. 30.
    Collins JE, Heward JM, Howson JM, et al. Common allelic variants of exons 10, 12, and 33 of the thyroglobulin gene are not associated with autoimmune thyroid disease in the United Kingdom. J Clin Endocrinol Metab 2004; 89: 6336–6339.PubMedCrossRefGoogle Scholar
  31. 31.
    Prummel MF, Strieder T, Wiersinga WM. The environment and autoimmune thyroid disease. Eur J Endocrinol 2004; 150: 605–618.PubMedCrossRefGoogle Scholar
  32. 32.
    Vestergaard P. Smoking and thyroid disorders - a meta-analysis. Eur J Endocrinol 2002; 146: 153–161.PubMedCrossRefGoogle Scholar
  33. 33.
    Strieder TG, Prummel MF, Tijssen JG, Endert E, Wiersinga WM. Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease. Clin Endocrinol 2003; 59: 396–401.CrossRefGoogle Scholar
  34. 34.
    Belin RM, Astor BC, Powe NR, Ladenson PW. Smoke exposure is associated with a lower prevalence of serum thyroid autoantibodies and thyrotropin concentration elevation and a higher prevalence of mild thyrotropin concentration suppression in the third National Health and Nutrition Examination (NHANESIII). J Clin Endocrinol Metab 2004; 89: 6077–6086.PubMedCrossRefGoogle Scholar
  35. 35.
    Grelland R. Thyrotoxicosis at Ullevål hospital in the years 1934-44 with a special view of frequency of the disease. Acta Med Scand 1946; 125: 108–138.CrossRefGoogle Scholar
  36. 36.
    Paunkovic N, Paunkovic J, Pavlovic O, Paunovic Z. The significant increase in incidence of Graves’ disease in eastern Serbia during the civil war in the former Yugoslavia. Thyroid 1998; 8: 37–41.PubMedGoogle Scholar
  37. 37.
    Mizokami T, Wu LA, El-Kaissi S, Wall JR. Stress and thyroid autoimmunity. Thyroid 2004; 14: 1047–1055.PubMedCrossRefGoogle Scholar
  38. 38.
    Winsa B, Adami HO, Bergstrom R, et al. Stressful life events and Graves’ disease. Lancet 1991; 338: 1475–1479.PubMedCrossRefGoogle Scholar
  39. 39.
    Yoshiuchi K, Kumano H, Nomura S, et al. Stressful life events and smoking were associated with Graves’ disease in women, but not in men. Psychosomat Med 1998; 60: 182–185.Google Scholar
  40. 40.
    Matos-Santos A, Nobre EL, Costa JG, et al. Relationship between the number and impact of stressful life events and the onset of Graves’ disease and toxic nodular goitre. Clin Endocrinol 2001; 55: 15–19.CrossRefGoogle Scholar
  41. 41.
    Strieder TG, Prummel MF, Tijssen JG, Brosschot JF, Wiersinga WM. Stress is not associated with thyroid peroxidase autoantibodies in euthyroid women. Brain Behav Immun 2005; 19: 203–206.PubMedCrossRefGoogle Scholar
  42. 42.
    Coles AJ, Wing M, Smith S, et al. Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis. Lancet 1999; 354: 1691–1695.PubMedCrossRefGoogle Scholar
  43. 43.
    Chen F, Day SL, Metcalfe RA, et al. Characteristics of autoimmune thyroid disease occurring as a late complication of immune reconstitution in patients with advanced human immunodeficiency virus (HIV) disease. Medicine (Baltimore) 2005; 84: 98–106.CrossRefGoogle Scholar
  44. 44.
    Hidaka Y, Amino N, Iwatani Y, et al. Recurrence of thyrotoxicosis after attack of allergic rhinitis in patients with Graves’ disease. J Clin Endocrinol Metab 1993; 77: 1667–1670.PubMedCrossRefGoogle Scholar
  45. 45.
    Sato A, Takemura Y, Yamada T, et al. A possible role of immunoglobulin E in patients with hyperthyroid Graves’ disease. J Clin Endocrinol Metab 1999; 84: 3602–3605.PubMedCrossRefGoogle Scholar
  46. 46.
    Strieder TG, Wenzel BE, Prummel MF, Tijssen JG, Wiersinga WM. Increased prevalence of antibodies to enteropathogenic Yersinia enterocolitica virulence proteins in relatives of patients with autoimmune thyroid disease. Clin Exp Immunol 2003; 132: 278–282.PubMedCrossRefGoogle Scholar
  47. 47.
    Munakata Y, Kodera T, Saito T, Sasaki T. Rheumatoid arthritis, type 1 diabetes and Graves’ disease after acute parvovirus B19 infection. Lancet 2005; 366: 780.PubMedCrossRefGoogle Scholar
  48. 48.
    Tomer Y, Davies TF. Infection, thyroid disease and autoimmunity. Endocrin Rev 1993; 14: 107–120.CrossRefGoogle Scholar
  49. 49.
    Arscott PA, Rosen ED, Koenig RJ, et al. Immunoreactivity to Yersinia enterocolitica antigens in patients with autoimmune thyroid disease. J Clin Endocrinol Metab 1992; 75: 295–300.PubMedCrossRefGoogle Scholar
  50. 50.
    Adams DD, Fastier FN, Howie JB, Kennedy TH, Kilpatrick JA, Stewart RD. Stimulation of the human thyroid by infusion of plasma containing LATS protector. J Clin Endocrinol Metab 1974; 39: 826–832.PubMedGoogle Scholar
  51. 51.
    Smith BR, Bolton J, Young S, et al. A new assay for thyrotropin receptor autoantibodies. Thyroid 2004; 14: 830–835.PubMedGoogle Scholar
  52. 52.
    Costagliola S, Bonomi M, Morgenthaler NG, et al. Delineation of the discontinuous-conformational epitope of a monoclonal antibody displaying full in vitro and in vivo thyrotropin activity. Mol Endocrinol 2004; 18: 3020–3034.PubMedCrossRefGoogle Scholar
  53. 53.
    Chazenbalk GD, Pichurin P, Chen CR, et al. Thyroid-stimulating autoantibodies in Graves’ disease preferentially recognize the free A subunit, not the thyrotropin holoreceptor. J Clin Invest 2002; 110: 209–217.PubMedCrossRefGoogle Scholar
  54. 54.
    Chen CR, Pichurin P, Nagayama Y, Latrofa F, Rapoport B, McLachlan SM. The thyrotropin receptor autoantigen in Graves’ disease is the culprit as well as the victim. J Clin Invest 2003; 111: 1897–1904.PubMedCrossRefGoogle Scholar
  55. 55.
    Beever K, Bradbury J, Phillips D, et al. Highly sensitive assays of autoantibodies to thyroglobulin and thyroid peroxidase. Clin Chem 1989; 35: 1949–1954.PubMedGoogle Scholar
  56. 56.
    Weetman AP, Cohen S. The IgG subclass distribution of thyroid autoantibodies. Immunol Lett 1986; 13: 335–341.PubMedCrossRefGoogle Scholar
  57. 57.
    Khoury EL, Hammond L, Bottazzo GF, Doniach D. Presence of organ-specific “microsomal” autoantigen on the surface of human thyroid cells in culture: its involvement in complement-mediated cytotoxicity. Clin Exp Immunol 1981; 45: 319–328.Google Scholar
  58. 58.
    Chazenbalk GD, Portolano S, Russo D, Hutchinson JS, Rapoport B, McLachlan S. Human organ-specific autoimmune disease. Molecular cloning and expression of an autoantibody gene repertoire for a major autoantigen reveals an antigenic immunodominant region and restricted immunoglobulin gene usage in the target organ. J Clin Invest 1993; 92: 62–74.PubMedCrossRefGoogle Scholar
  59. 59.
    Arscott PL, Koenig RJ, Kaplan MM, Glick GD, Baker JR Jr. Unique autoantibody epitopes in an immunodominant region of thyroid peroxidase. J Biol Chem 1996: 271: 4966–4973.PubMedCrossRefGoogle Scholar
  60. 60.
    Jaume JC, Guo J, Pauls DL, et al. Evidence for genetic transmission of thyroid peroxidase autoantibody epitopic “fingerprints”. J Clin Endocrinol Metab 1999; 84(4): 1424–1431.PubMedCrossRefGoogle Scholar
  61. 61.
    Weetman AP, McGregor AM, Lazarus JH, Hall R. Thyroid antibodies are produced by thyroid derived lymphocytes. Clin Exp Immunol 1982; 48: 196–200.PubMedGoogle Scholar
  62. 62.
    Nakashima M, Martin A, Davies TF. Intrathyroidal T cell accumulation in Graves’ disease? delineation of mechanisms based on in situ T cell receptor analysis. J Clin Endocrinol Metab 1996; 81: 3346–51.PubMedCrossRefGoogle Scholar
  63. 63.
    Surks M, Ortiz E, Daniels GH, et al. Subclinical thyroid disease; scientific review and guidelines for diagnosis and management. JAMA 2004; 291: 228–238.PubMedCrossRefGoogle Scholar
  64. 64.
    Biondi B, Palmieri EA, Klain M, Schlumberger M, Filetti S, Lombardi G. Subclinical hyperthyroidism: clinical features and treatment options. Eur J Endocrinol 2005; 152: 1–9.PubMedCrossRefGoogle Scholar
  65. 65.
    McDermott MT, Woodmansee WW, Haugen BR, Smart A, Ridgway EC. The management of subclinical hyperthyroidism by thyroid specialists. Thyroid 2003; 13: 1133–1139.PubMedCrossRefGoogle Scholar
  66. 66.
    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: 2986–2993.PubMedCrossRefGoogle Scholar
  67. 67.
    Solomon DH, Beck JC, Vanderlaan WP. Prognosis of hyperthyroidism treated by antithyroid drugs. J Am Med Assoc 1953; 152: 201–205.PubMedGoogle Scholar
  68. 68.
    Reinwein D, Benker G, Lazarus JH, Alexander WD. A prospective randomised trial of antithyroid drug dose in Graves’ disease therapy. J Clin Endocrinol Metab 1993; 76: 1516–1521.PubMedCrossRefGoogle Scholar
  69. 69.
    Engler H, Taurog A, Luthy C, Dorris ML. Reversible and irreversible inhibition of thyroid peroxidase catalysed iodination by thioureylene antithyroid drugs. Endocrinology 1983; 112: 86–95.PubMedGoogle Scholar
  70. 70.
    Marchant B, Lees JF, Alexander WD. Antithyroid drugs. Pharmacol Ther B 1978; 3: 305–348.PubMedGoogle Scholar
  71. 71.
    Okamura K, Ikenoue H, Shiroozu A, Sato K, Yoshinari M, Fujishima M. Reevaluation of the effects of methylmercaptoimidazole and propylthiouracil in patients with Graves’ hyperthyroidism. J Clin Endocrinol Metab 1987; 65: 719–723.PubMedCrossRefGoogle Scholar
  72. 72.
    Cooper DS. Antithyroid drugs. N Engl J Med 2005; 352: 905–917.PubMedCrossRefGoogle Scholar
  73. 73.
    Abraham P, Avenell A, Watson WA, Park CM, Bevan JS. Antithyroid drug regimen for treating Graves’ hyperthyroidism. Cochrane Database Syst Rev 2004; (2): CD003420. pub2; doi: 10.1002/14651858.CD003420.pub2.PubMedGoogle Scholar
  74. 74.
    Bartalena L, Bogazzi F, Martino E. Adverse effects of thyroid hormone preparations and antithyroid drugs. Drug Saf 1996; 15: 53–63.PubMedCrossRefGoogle Scholar
  75. 75.
    Pearce SHS. Spontaneous reporting of adverse reaction to carbimazole and propylthiouracil in the United Kingdom. Clin Endocrinol 2004: 61; 589–594.CrossRefGoogle Scholar
  76. 76.
    Young ET, Steel NR, Taylor JJ, et al. Prediction of remission after antithyroid drug treatment of Graves’ disease. Quart J Med 1988; 66: 175–189.PubMedGoogle Scholar
  77. 77.
    Allahabadia A, Daykin J, Holder RL, et al. Age and gender predict the outcome of treatment for Graves’ hyperthyroidism. J Clin Endocrinol Metab 2000; 85: 1038–1042.PubMedCrossRefGoogle Scholar
  78. 78.
    Wartofsky L. Radioiodine therapy for Graves’ disease: case selection and restrictions recommended to patients in North America. Thyroid 1997; 7: 213–216.PubMedGoogle Scholar
  79. 79.
    Catargi B, Leprat F, Guyot M, Valli N, Ducassou D, Tabarin A. Optimized radioiodine therapy of Graves’ disease: analysis of the delivered dose and of other possible factors affecting outcome. Eur J Endocrinol 1999; 141: 117–121.PubMedCrossRefGoogle Scholar
  80. 80.
    Imseis RE, Vanmiddlesworth L, Massie JD, Bush AJ, Vanmiddlesworth NR. Pretreatment with propylthiouracil but not methimazole reduces the therapeutic efficacy of iodine-131 in hyperthyroidism. J Clin Endocrinol Metab 1998; 83: 685–687.PubMedCrossRefGoogle Scholar
  81. 81.
    Lazarus JH. Guidelines for the use of radioiodine in the management of hyperthyroidism: a summary. J R Coll Physicians Lond 1995; 29: 464–469.PubMedGoogle Scholar
  82. 82.
    Ron E, Doody MM, Becker DV, et al. Cancer mortality following treatment for adult hyperthyroidism. JAMA 1998; 280: 347–355.PubMedCrossRefGoogle Scholar
  83. 83.
    Franklyn JA, Maisonneuve P, Sheppard M, Betteridge J, Boyle P. Cancer incidence and mortality after radioidine treatment for hyperthyroidism: a population-based cohort study. Lancet 1999; 353: 2111–2115.PubMedCrossRefGoogle Scholar
  84. 84.
    Read 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: 4229–4233.PubMedCrossRefGoogle Scholar
  85. 85.
    Tallstedt L, Lundell G, Torring O et al. Occurrence of ophthalmopathy after treatment for Graves’ hyperthyroidism. The Thyroid Study Group. N Engl J Med 1992; 326: 1733–1738.PubMedCrossRefGoogle Scholar
  86. 86.
    Perros P, Kendall-Taylor P, Neoh C, Frewin S, Dickinson J. A prospective study of the effects of radioiodine therapy for hyperthyroidism in patients with minimally active Graves’ ophthalmopathy. J Clin Endocrinol Metab 2005; 90: 5321–5323.PubMedCrossRefGoogle Scholar
  87. 87.
    Allahabadia A, Daykin J, Sheppard MC, Gough SC, Franklyn JA. Radioiodine treatment of hyperthyroidism-prognostic factors for outcome. J Clin Endocrinol Metab 2001; 86: 3611–3617.PubMedCrossRefGoogle Scholar
  88. 88.
    Scholz GH, Hagemann E, Arkenau C, et al. Is there a place for thyroidectomy in older patients with thyrotoxic storm and cardiorespiratory failure? Thyroid 2003; 13: 933–940.PubMedCrossRefGoogle Scholar
  89. 89.
    Lal G, Ituarte P, Kebebew E, Siperstein A, Duh QY, Clark OH. Should total thyroidectomy become the preferred procedure for surgical management of Graves’ disease? Thyroid 2005; 15: 569–574.PubMedCrossRefGoogle Scholar
  90. 90.
    Ku CF, Lo CY, Chan WF, Kung AW, Lam KS. Total thyroidectomy replaces subtotal thyroidectomy as the preferred surgical treatment for Graves’ disease. ANZ J Surg 2005; 75: 528–531.PubMedCrossRefGoogle Scholar
  91. 91.
    Miccoli P, Berti P, Materazzi G, Minuto M, Barellini L. Minimally invasive video-assisted thyroidectomy: five years of experience. J Am Coll Surg 2004; 199: 243–248.PubMedCrossRefGoogle Scholar
  92. 92.
    Panzer C, Beazley R, Braverman L. Rapid preoperative preparation for severe hyperthyroid Graves’ disease. J Clin Endocrinol Metab 2004; 89: 2142–2144.PubMedCrossRefGoogle Scholar
  93. 93.
    Glinoer D. Thyroid hyperfunction during pregnancy. Thyroid 1998; 8: 859–864.PubMedGoogle Scholar
  94. 94.
    Clementi M, Di Gianantonio E, Pelo E, Mammi I, Basile RT, Tenconi R. Methimazole embryopathy: delineation of the phenotype. Am J Med Genet 1999; 83: 43–46.PubMedCrossRefGoogle Scholar
  95. 95.
    Barbero P, Ricagni C, Mercado G, Bronberg R, Torrado M. Choanal atresia associated with prenatal methimazole exposure: three new patients. Am J Med Genet A 2004; 129: 83–86.PubMedCrossRefGoogle Scholar
  96. 96.
    Gora M, Gardas A, Wiktorowicz W, et al. Evaluation of conformational epitopes on thyroid peroxidase by antipeptide antibody binding and mutagenesis. Clin Exp Immunol 2004; 136: 137–144.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2007

Authors and Affiliations

  • Simon H.S. Pearce

There are no affiliations available

Personalised recommendations