Graves’ Disease: New Management Protocol

Graves’ Disease: New Management Protocol

Graves’ Disease: New Management Protocol

Graves’ Disease: New Management Protocol

 

A mini review

Kahaly G.

JCEM 2020 105 (12)3704-20.

DR.Guttler’s Comments;

  1. Low TSH
  2. Free T4,  TSH-R-Ab, Thyroid Ultrasound
  3. Positive TSH-R-Ab
  4. Dx of GD.
  5. Methimazole MMI Treatment of choice for 18 months for adults and 36 months for children.
  6. Serious adverse effects poor compliance, or patient choice. Surgery for big glands  or nodules included or graves’ eye disease GO.
  7. Radioiodine RAI, no GO no nodules volume <50 ml.
  8. Relapse or recurrence.
  9. Long term low dose MMI is a safe and valuable alternative to destructive surgery or RAI.
  10. GO therapy with anti-insulin like growth factor 1 monoclonal antibody for severe active eye disease is FDA approved.
  11. COVID 19 infection is a risk factor for poor controlled hyperthyroidism.This contributes to infection related mortality.
  12. If GO is not severe postpone steroids with Covid19 infection. Use only local treatment and preventive measures.
  13. Call me for evaluation before having surgery or RAI.
  14. 310-393-8860 or [email protected]
  15. Dr.G.
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