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Endocrinol Metab : Endocrinology and Metabolism


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Moo-Il Kang  (Kang MI) 4 Articles
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
  • 3,927 View
  • 76 Download
  • 12 Citations
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 to this article as recorded by  
  • Non-thionamide antithyroid drug options in Graves’ hyperthyroidism
    Aliya Ruslan, Onyebuchi E Okosieme
    Expert Review of Endocrinology & Metabolism.2023; 18(1): 67.     CrossRef
  • Gestione clinica dell’ipertiroidismo refrattario
    Daniela Gallo, Federica Martina Bianchi, Francesca Manzella La Barbera, Ilaria Clementi, Adriana Lai, Eliana Piantanida, Maria Laura Tanda
    L'Endocrinologo.2023; 24(2): 167.     CrossRef
  • Carbimazole-Resistant Grave’s Thyrotoxicosis is a Diagnostic and Therapeutic Dilemma, Case Report with Literature Review
    Fateen Ata, Adeel Ahmad Khan, Shuja Tahir, Zaina Al Amer
    International Medical Case Reports Journal.2023; Volume 16: 783.     CrossRef
  • Medical treatment of thyrotoxicosis
    The Quarterly Journal of Nuclear Medicine and Molecular Imaging.2021;[Epub]     CrossRef
    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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Bone Metabolism
Efficacy of a Once-Monthly Pill Containing Ibandronate and Cholecalciferol on the Levels of 25-Hydroxyvitamin D and Bone Markers in Postmenopausal Women with Osteoporosis
In-Jin Cho, Ho-Yeon Chung, Sung-Woon Kim, Jae-Won Lee, Tae-Won Lee, Hye-Soon Kim, Sin-Gon Kim, Han Seok Choi, Sung-Hee Choi, Chan Soo Shin, Ki-Won Oh, Yong-Ki Min, Jung-Min Koh, Yumie Rhee, Dong-Won Byun, Yoon-Sok Chung, Jeong Hyun Park, Dong Jin Chung, Minho Shong, Eun-Gyoung Hong, Chang Beom Lee, Ki Hyun Baek, Moo-Il Kang
Endocrinol Metab. 2015;30(3):272-279.   Published online December 9, 2014
  • 4,050 View
  • 43 Download
  • 4 Citations
AbstractAbstract PDFPubReader   

The present study evaluated the efficacy of a combination of ibandronate and cholecalciferol on the restoration of the levels of 25-hydroxyvitamin D (25[OH]D) and various bone markers in postmenopausal women with osteoporosis.


This was a randomized, double-blind, active-controlled, prospective 16-week clinical trial conducted in 20 different hospitals. A total of 201 postmenopausal women with osteoporosis were assigned randomly to one of two groups: the IBN group, which received a once-monthly pill containing 150 mg ibandronate (n=99), or the IBN+ group, which received a once-monthly pill containing 150 mg ibandronate and 24,000 IU cholecalciferol (n=102). Serum levels of 25(OH)D, parathyroid hormone (PTH), and various bone markers were assessed at baseline and at the end of a 16-week treatment period.


After 16 weeks of treatment, the mean serum levels of 25(OH)D significantly increased from 21.0 to 25.3 ng/mL in the IBN+ group but significantly decreased from 20.6 to 17.4 ng/mL in the IBN group. Additionally, both groups exhibited significant increases in mean serum levels of PTH but significant decreases in serum levels of bone-specific alkaline phosphatase and C-telopeptide of type 1 collagen (CTX) at 16 weeks; no significant differences were observed between the groups. However, in subjects with a vitamin D deficiency, IBN+ treatment resulted in a significant decrease in serum CTX levels compared with IBN treatment.


The present findings demonstrate that a once-monthly pill containing ibandronate and cholecalciferol may be useful for the amelioration of vitamin D deficiency in patients with postmenopausal osteoporosis. Moreover, this treatment combination effectively decreased serum levels of resorption markers, especially in subjects with a vitamin D deficiency, over the 16-week treatment period.


Citations to this article as recorded by  
  • Quality of life and patient satisfaction with raloxifene/cholecalciferol combination therapy in postmenopausal women
    Dong-Yun Lee, Yoon-Sok Chung
    Scientific Reports.2022;[Epub]     CrossRef
  • Efficacy of risedronate with cholecalciferol on bone mineral density in Korean patients with osteoporosis
    So Young Park, Moo-Il Kang, Hyung Moo Park, Yumie Rhee, Seong Hwan Moon, Hyun Koo Yoon, Jung-Min Koh, Jae Suk Chang, In Joo Kim, Ye Yeon Won, Ye Soo Park, Hoon Choi, Chan Soo Shin, Taek Rim Yoon, Sung-Cheol Yun, Ho-Yeon Chung
    Archives of Osteoporosis.2020;[Epub]     CrossRef
  • Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency
    Han Seok Choi, Yoon-Sok Chung, Yong Jun Choi, Da Hea Seo, Sung-Kil Lim
    Osteoporosis and Sarcopenia.2016; 2(4): 228.     CrossRef
  • Pharmacologic treatment of osteoporosis
    Yong-Ki Min
    Journal of the Korean Medical Association.2016; 59(11): 847.     CrossRef
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Accelerated Disease Progression after Discontinuation of Sorafenib in a Patient with Metastatic Papillary Thyroid Cancer
Kyung-Jin Yun, Woohyeon Kim, Eun Hee Kim, Min-Hee Kim, Dong-Jun Lim, Moo-Il Kang, Bong-Yun Cha
Endocrinol Metab. 2014;29(3):388-393.   Published online September 25, 2014
  • 3,182 View
  • 30 Download
  • 22 Citations
AbstractAbstract PDFPubReader   

Distant metastases from papillary thyroid carcinoma (PTC) are rare and are associated with a poor prognosis. Here, we describe a patient with metastatic PTC who was treated with a tyrosine kinase inhibitor (TKI, sorafenib) for several months that was acutely exacerbated by discontinuation. A 43-year-old male was diagnosed with PTC in February 2004 and underwent total thyroidectomy followed by two courses of high-dose radioactive iodine (RAI) therapy. Despite two additional courses of high-dose RAI therapy, lung and muscle metastases were developed. Treatment with sorafenib was begun in September 2010. After 11 months treatment of sorafenib, newly developed metastatic lesions were found in mediastinal lymph nodes, liver, and bones. Considered as treatment failure, the administration of sorafenib was discontinued. Two weeks after sorafenib treatment was stopped, the disease progressed abruptly and caused death of the patient by respiratory failure. In our patient, PTC progressed rapidly after the cessation of sorafenib treatment. Patients with several other types of cancer have also experienced such rapid disease progression, termed "flare-ups." Physicians should be aware that flare-ups may occur in advanced PTC patients following the cessation of TKI therapy.


Citations to this article as recorded by  
  • Lenvatinib: an investigational agent for the treatment of differentiated thyroid cancer
    Silvia Martina Ferrari, Giusy Elia, Francesca Ragusa, Sabrina Rosaria Paparo, Valeria Mazzi, Mario Miccoli, Maria Rosaria Galdiero, Gilda Varricchi, Rudy Foddis, Giovanni Guglielmi, Claudio Spinelli, Concettina La Motta, Salvatore Benvenga, Alessandro Ant
    Expert Opinion on Investigational Drugs.2021; 30(9): 913.     CrossRef
  • Low Dose of Lenvatinib Treatment for Patients of Radioiodine-Refractory Differentiated Thyroid Carcinoma – A Real-World Experience
    He-Jiun Jiang, Yen-Hsiang Chang, Yen-Hao Chen, Che-Wei Wu, Pei-Wen Wang, Pi-Jung Hsiao
    Cancer Management and Research.2021; Volume 13: 7139.     CrossRef
  • Rapid disease progression after discontinuation of lenvatinib in thyroid cancer
    Haruhiko Yamazaki, Kiminori Sugino, Kenichi Matsuzu, Chie Masaki, Junko Akaishi, Kiyomi Hames, Chisato Tomoda, Akifumi Suzuki, Takashi Uruno, Keiko Ohkuwa, Wataru Kitagawa, Mitsuji Nagahama, Munetaka Masuda, Koichi Ito
    Medicine.2020; 99(11): e19408.     CrossRef
  • Lenvatinib for thyroid cancer treatment: discovery, pre-clinical development and clinical application
    Rosa Maria Paragliola, Andrea Corsello, Valeria Del Gatto, Giampaolo Papi, Alfredo Pontecorvi, Salvatore Maria Corsello
    Expert Opinion on Drug Discovery.2020; 15(1): 11.     CrossRef
  • Efficacy and Limitations of Lenvatinib Therapy for Radioiodine-Refractory Differentiated Thyroid Cancer: Real-World Experiences
    Chie Masaki, Kiminori Sugino, Naoko Saito, Junko Akaishi, Kiyomi Y. Hames, Chisato Tomoda, Akifumi Suzuki, Kenichi Matsuzu, Takashi Uruno, Keiko Ohkuwa, Wataru Kitagawa, Mitsuji Nagahama, Koichi Ito
    Thyroid.2020; 30(2): 214.     CrossRef
  • Papillary thyroid carcinoma with hyperthyroidism and multiple metastases
    Li-li Zhang, Bin Liu, Fang-fang Sun, Hong-yu Li, Shuang Li, Li-rong Zhao
    Medicine.2020; 99(30): e21346.     CrossRef
  • Missing Skeletal Muscle Metastases of Papillary Thyroid Carcinoma
    Leszek Herbowski
    Diagnostics.2020; 10(7): 457.     CrossRef
  • Reply to “Missing Skeletal Muscle Metastases of Papillary Thyroid Carcinoma”
    Liviu Hitu, Calin Cainap, Dragos Apostu, Katalin Gabora, Eduard-Alexandru Bonci, Marius Badan, Alexandru Mester, Andra Piciu
    Diagnostics.2020; 10(7): 458.     CrossRef
  • Hif-1α Inhibitors Could Successfully Inhibit the Progression of Differentiated Thyroid Cancer in Vitro
    Min-Hee Kim, Tae Hyeong Lee, Jin Soo Lee, Dong-Jun Lim, Peter Chang-Whan Lee
    Pharmaceuticals.2020; 13(9): 208.     CrossRef
  • Extended Real-World Observation of Patients Treated with Sorafenib for Radioactive Iodine-Refractory Differentiated Thyroid Carcinoma and Impact of Lenvatinib Salvage Treatment: A Korean Multicenter Study
    Hye-Seon Oh, Dong Yeob Shin, Mijin Kim, So Young Park, Tae Hyuk Kim, Bo Hyun Kim, Eui Young Kim, Won Bae Kim, Jae Hoon Chung, Young Kee Shong, Dong Jun Lim, Won Gu Kim
    Thyroid.2019; 29(12): 1804.     CrossRef
  • Rapid pleural effusion after discontinuation of lenvatinib in a patient with pleural metastasis from thyroid cancer
    Taisuke Uchida, Hideki Yamaguchi, Kazuhiro Nagamine, Tadato Yonekawa, Eriko Nakamura, Nobuhiro Shibata, Fumiaki Kawano, Yujiro Asada, Masamitsu Nakazato
    Endocrinology, Diabetes & Metabolism Case Reports.2019;[Epub]     CrossRef
  • Thyroid Disorders in the Elderly
    Kevin Higgins
    Clinics in Geriatric Medicine.2018; 34(2): 259.     CrossRef
  • Treatment of refractory thyroid cancer
    Amandine Berdelou, Livia Lamartina, Michele Klain, Sophie Leboulleux, Martin Schlumberger, _ _
    Endocrine-Related Cancer.2018; 25(4): R209.     CrossRef
  • Clinical guidance for radioiodine refractory differentiated thyroid cancer
    Matti L. Gild, Duncan J. Topliss, Diana Learoyd, Francis Parnis, Jeanne Tie, Brett Hughes, John P. Walsh, Donald S.A. McLeod, Roderick J. Clifton‐Bligh, Bruce G. Robinson
    Clinical Endocrinology.2018; 88(4): 529.     CrossRef
  • Case for Stopping Targeted Therapy When Lung Cancer Progresses on Treatment in Hospice-Eligible Patients
    Thomas J. Smith, Nasser Hanna, David Johnson, Sherman Baker, William A. Biermann, Julie Brahmer, Peter M. Ellis, Giuseppe Giaccone, Paul J. Hesketh, Ishmael Jaiyesimi, Natasha B. Leighl, Gregory J. Riely, Joan H. Schiller, Bryan J. Schneider, Joan Tashbar
    Journal of Oncology Practice.2017; 13(12): 780.     CrossRef
  • Intermittent Dosing of Dabrafenib and Trametinib in Metastatic BRAFV600E Mutated Papillary Thyroid Cancer: Two Case Reports
    Paul S. White, Anita Pudusseri, Stephanie L. Lee, Omar Eton
    Thyroid.2017; 27(9): 1201.     CrossRef
  • Aggressive differentiated thyroid cancer with multiple metastases and NRAS and TERT promoter mutations: A case report
    Fabiana Pani, Elisabetta Macerola, Fulvio Basolo, Francesco Boi, Mario Scartozzi, Stefano Mariotti
    Oncology Letters.2017; 14(2): 2186.     CrossRef
  • Tumors Sharply Increased after Ceasing Pazopanib Therapy for a Patient with Advanced Uterine Leiomyosarcoma: Experience of Tumor Flare
    Terumi Tanigawa, Shintaro Morisaki, Hisanobu Fukuda, Shuichiro Yoshimura, Hisayoshi Nakajima, Kohei Kotera
    Case Reports in Obstetrics and Gynecology.2017; 2017: 1.     CrossRef
  • Initial Size of Metastatic Lesions Is Best Prognostic Factor in Patients with Metastatic Differentiated Thyroid Carcinoma Confined to the Lung
    Mijin Kim, Won Gu Kim, Suyeon Park, Hyemi Kwon, Min Ji Jeon, Jong Jin Lee, Jin-Sook Ryu, Tae Yong Kim, Young Kee Shong, Won Bae Kim
    Thyroid.2017; 27(1): 49.     CrossRef
  • Articles in 'Endocrinology and Metabolism' in 2014
    Won-Young Lee
    Endocrinology and Metabolism.2015; 30(1): 47.     CrossRef
  • Pharmacodynamic study of axitinib in patients with advanced malignancies assessed with 18F-3′deoxy-3′fluoro-l-thymidine positron emission tomography/computed tomography
    Justine Yang Bruce, Peter Colin Scully, Lakeesha L. Carmichael, Jens C. Eickhoff, Scott B. Perlman, Jill Marie Kolesar, Jennifer L. Heideman, Robert Jeraj, Glenn Liu
    Cancer Chemotherapy and Pharmacology.2015; 76(1): 187.     CrossRef
  • Optimal Differentiated Thyroid Cancer Management in the Elderly
    Donald S. A. McLeod, Kelly Carruthers, Dev A. S. Kevat
    Drugs & Aging.2015; 32(4): 283.     CrossRef
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2013 Preface: On the Occasion of Publishing the Endocrinology and Metabolism in English
Kyungjin Kim, Moo-Il Kang
Endocrinol Metab. 2013;28(1):1-2.   Published online March 25, 2013
  • 2,416 View
  • 27 Download
  • 1 Citations


Citations to this article as recorded by  
  • Contribution of subcutaneous abdominal fat on ultrasonography to carotid atherosclerosis in patients with type 2 diabetes mellitus
    Chan-Hee Jung, Bo-Yeon Kim, Kyu-Jin Kim, Sang-Hee Jung, Chul-Hee Kim, Sung-Koo Kang, Ji-Oh Mok
    Cardiovascular Diabetology.2014;[Epub]     CrossRef
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