Endocrine Abstracts

Introduction: Hyperthyroidism is the condition that occurs due to excessive release of thyroid hormone by the thyroid gland. Anti-thyroid drugs are usually the first choice of the treatment but surgery and radioactive iodine can also be used in treatment of hyperthyroidism. Plasmapheresis is a rapid and effective treatment option in cases where immediate euthyroidism is needed to be obtained due to complications of thyrotoxicosis and major side effects of antithyroid drugs.

Material and method: Between January 2012 and December 2016, we evaluated patients who received plasmapheresis to provide immediate euthyroidism due to severe hyperthyroidism or side effects of anti-thyroid drugs or urgent non-thyroid surgery were included to the study.

Results: Eighteen patients were included the study, of whom 11 were female and seven were male. The mean age was 52.44 years. Seven patients had TDG (%38.9), two patients had TDMNG (%11.1), two patients had TA (%11.1), four patients had TMNG (%22.2) and one patient had amiodarona induced thyrotoxikosis (%5.6). Additionally, plasmapheresis was performed to achieve euthyrodism before non-thyroid surgery in two patients (11.1%). The mean plasmapheresis sessions was 5.22. The mean sessions was 3.62 for patients with TDG and TDMNG, whereas it was 6.43 for patients with TA and TMNG (P:0.029). The decrease of mean fT₄ and fT₃ were 48% and 65%, respectively (P<0.0001). Anaphylaxis was seen only in one patient due to fresh frozen plasma. So treatment was changed to albumin.

Conclusions: Although plasmapheresis is not commonly used for the treatment of the hypertyroidism, it is a reliable and effective treatment option for patients who can not use antithyroid drugs or hyperthyroidism can not resolve with these drugs before total thyroidectomy, RAI or non thyroid emergency surgery.