Clinical and immunological studies on patients with Graves' disease preoperatively treated with corticosteroids and iodides |
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Authors: | Yoshio Kasuga MD Akira Sugenoya Shinya Kobayashi Gengo Kaneko Hiroyuki Masuda Minoru Fujimori Shozo Takahashi Futoshi Iida |
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Institution: | (1) The Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, 390 Matsumoto, Japan |
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Abstract: | The purpose of this study was to evaluate the acute effects of corticosteroid and iodide preoperative therapy in patients
with Graves' disease in terms of thyroid function and immunological parameters. The above combination was prescribed for 4
patients who had experienced severe side effects from antithyroid drugs (ATD) in order to reduce the possibility of post-thyroidectomy
thyroid storm. Corticosteroids were employed daily for four days, and iodides were given daily for two weeks prior to thyroidectomy.
The free T3 values decreased rapidly to euthyroid levels following the administration of both drugs, although the free T4 values were still much higher than normal in 3 of the 4 patients at the time of surgery. By comparison, 3 of 8 patients treated
with ATD also had thyroid hormone levels above normal. Studies of lymphocyte subsets revealed that the percentage of helper
T cells was significantly less in the corticosteroidiodide treatment group than in the control and ATD groups. It is thus
possible that postoperative thyroid storm might be prevented through corticosteroid-iodide therapy by virtue of the reduction
of free T3 values to within the normal range by the time of surgery. The acute suppression of helper T cells was another result of this
form of therapy observed. |
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Keywords: | Graves' disease thyroid storm preoperative treatment corticosteroids iodides |
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