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Minji Kim  (Kim M) 1 Article
Thyroid
Refractory Graves' Disease Successfully Cured by Adjunctive Cholestyramine and Subsequent Total Thyroidectomy
Yeoree Yang, Seawon Hwang, Minji Kim, Yejee Lim, Min-Hee Kim, Sohee Lee, Dong-Jun Lim, Moo-Il Kang, Bong-Yun Cha
Endocrinol Metab. 2015;30(4):620-625.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.620
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  • 79 Download
  • 14 Web of Science
  • 12 Crossref
AbstractAbstract PDFPubReader   

The three major forms of treatment for Graves thyrotoxicosis are antithyroid drugs, radioactive iodine therapy and thyroidectomy. Surgery is the definitive treatment for Graves thyrotoxicosis that is generally recommended when other treatments have failed or are contraindicated. Generally, thyrotoxic patients should be euthyroid before surgery to minimize potential complications which usually requires preoperative management with thionamides or inorganic iodine. But several cases of refractory Graves' disease have shown resistance to conventional treatment. Here we report a 40-year-old female patient with Graves' disease who complained of thyrotoxic symptoms for 7 months. Her thyroid function test and thyroid autoantibody profiles were consistent with Graves' disease. One kind of thionamides and β-blocker were started to control her disease. However, she was resistant to nearly all conventional medical therapies, including β-blockers, inorganic iodine, and two thionamides. She experienced hepatotoxicity from the thionamides. What was worse is her past history of serious allergic reaction to corticosteroids, which are often used to help control symptoms. A 2-week regimen of high-dose cholestyramine improved her uncontrolled thyrotoxicosis and subsequent thyroidectomy was successfully performed. In conclusion, cholestyramine could be administered as an effective and safe adjunctive agent for preoperative preparation in patients with severe hyperthyroid Graves's disease that is resistant to conventional therapies.

Citations

Citations to this article as recorded by  
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    Fateen Ata, Adeel Ahmad Khan, Shuja Tahir, Zaina Al Amer
    International Medical Case Reports Journal.2023; Volume 16: 783.     CrossRef
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    The Quarterly Journal of Nuclear Medicine and Molecular Imaging.2021;[Epub]     CrossRef
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    Maorong Wang, Yerong Yu
    Endocrine Practice.2020; 26(6): 675.     CrossRef
  • Cholestyramine alters bile acid amounts and the expression of cholesterol‐related genes in rabbit intestinal and hepatic tissues
    Dong Ni Qiu, Quan Shang, Da Yu Sun, Wei Qun Ding, Zhong Guang Luo, Jian Chen, Wei Ru Jiang, Jian Ping Huang, Xiao Yun Jiang
    Journal of Digestive Diseases.2017; 18(2): 107.     CrossRef
  • ENDOCRINOLOGY IN PREGNANCY: Pregnancy and the incidence, diagnosing and therapy of Graves’ disease
    Peter Laurberg, Stine Linding Andersen
    European Journal of Endocrinology.2016; 175(5): R219.     CrossRef
  • 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
    Douglas S. Ross, Henry B. Burch, David S. Cooper, M. Carol Greenlee, Peter Laurberg, Ana Luiza Maia, Scott A. Rivkees, Mary Samuels, Julie Ann Sosa, Marius N. Stan, Martin A. Walter
    Thyroid.2016; 26(10): 1343.     CrossRef
  • Cholestyramine Use for Rapid Reversion to Euthyroid States in Patients with Thyrotoxicosis
    Jeonghoon Ha, Kwanhoon Jo, Borami Kang, Min-Hee Kim, Dong-Jun Lim
    Endocrinology and Metabolism.2016; 31(3): 476.     CrossRef
  • The role of bile acids in metabolic regulation
    Libor Vítek, Martin Haluzík
    Journal of Endocrinology.2016; 228(3): R85.     CrossRef
  • Recent Advances in Autoimmune Thyroid Diseases
    Won Sang Yoo, Hyun Kyung Chung
    Endocrinology and Metabolism.2016; 31(3): 379.     CrossRef
  • A Case of Methimazole-Resistant Severe Graves' Disease: Dramatic Response to Cholestyramine
    Seung Byung Chae, Eun Sook Kim, Yun Im Lee, Bo Ram Min
    International Journal of Thyroidology.2016; 9(2): 190.     CrossRef
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