Therapeutic plasmapheresis in patients with severe hyperthyroidism in whom antithyroid drugs are contraindicated

摘要: Four patients with Graves' disease in whom antithyroid drugs could not be used were treated by plasmapheresis preoperatively. On admission all had severe hyperthyroidism. All beta blockers, cholestyramine and inorganic iodine before plasmapheresis. Plasmapheresis course consisted of three sessions. Removed plasma was replaced a synthetic colloid solution human albumin other than fresh-frozen plasma. led to decreases serum T3 concentrations >78-40% free T4 >69%. Near-total thyroidectomy performed patients. Although screening coagulation tests within normal limits, 1 4 experienced more blood loss usual during the operative procedure. as an alternative therapeutic option preoperative management hyperthyroid contraindications drugs. However, this is invasive procedure should followed carefully for prolonged clinic/subclinic coagulopathy due exchange.