scholarly journals Preoperative Treatment with Lugol Solution for Graves' Disease

2019 ◽  
Vol 19 (4) ◽  
pp. 157
Author(s):  
Özer Makay ◽  
Hui Sun ◽  
Ettore Caruso ◽  
Antonella Pino ◽  
Alessandro Pontin ◽  
...  
2007 ◽  
Vol 92 (6) ◽  
pp. 2182-2189 ◽  
Author(s):  
Yeşim Erbil ◽  
Yasemin Ozluk ◽  
Murat Giriş ◽  
Artur Salmaslıoglu ◽  
Halim Issever ◽  
...  

Abstract Context: Although some endocrine surgeons administer Lugol solution to decrease thyroid gland vascularity, there is still not an agreement on its effectiveness. Objective: The aims of this clinical trial are to evaluate thyroid blood flow and microvessel density in patients with Graves’ disease who received Lugol solution treatment preoperatively. Design: This was a prospective clinical trial. Setting: This clinical trial took place at a tertiary referral center. Method: Thirty-six patients were randomly assigned to receive either preoperative treatment with Lugol solution (group 1, n = 17) or no preoperative treatment with Lugol solution (group 2, n = 19). Main Outcome Measures: Blood flow through the thyroid arteries of patients with Graves’ disease was measured by color flow Doppler ultrasonography. The microvessel density (MVD) was assessed by immunohistochemical and Western blot analysis of the level of expression of CD-34 in thyroid tissue. The weight and blood loss of the thyroid gland were measured in all patients. Results: The mean blood flow, MVD, CD-34 expression, and blood loss in group 1 patients were significantly lower than those in group 2 patients. There was a negative correlation between Lugol solution treatment and blood flow (rs = −0.629; P = 0.0001), blood loss (rs = −0.621; P = 0.0001), MVD (rs = −0.865; P = 0.0001), and CD-34 expression (rs = −0.865; P = 0.0001). According to logistic regression analysis, Lugol solution treatment resulted in a 9.33-fold decreased rate of intraoperative blood loss. Conclusion: Preoperative Lugol solution treatment decreased the rate of blood flow, thyroid vascularity, and intraoperative blood loss during thyroidectomy.


1926 ◽  
Vol 22 (12) ◽  
pp. 1390-1390
Author(s):  
L. Ratner

The author is disappointed in the usual methods of preoperative treatment of Graves' disease. He rejects both resting position, preoperative vascular ligation, and radiotherapy, advising preoperative and postoperative iodine treatment instead.


2015 ◽  
Vol 40 (3) ◽  
pp. 505-509 ◽  
Author(s):  
Shih-Ming Huang ◽  
Wei-Ting Liao ◽  
Chiou-Feng Lin ◽  
H. Sunny Sun ◽  
Nan-Haw Chow

2011 ◽  
Vol 26 (3) ◽  
pp. 159-161 ◽  
Author(s):  
Wei Han Lew ◽  
Chun-Jen Chang ◽  
Jiunn-Diann Lin ◽  
Chung-Yi Cheng ◽  
Yin-Kai Chen ◽  
...  

2019 ◽  
Vol 65 (6) ◽  
pp. 755-760 ◽  
Author(s):  
Patrícia Novais Rabelo ◽  
Paula Novais Rabelo ◽  
Allyne Fernanda de Paula ◽  
Samuel Amanso da Conceição ◽  
Daniela Pultrini Pereira de Oliveira Viggiano ◽  
...  

SUMMARY INTRODUCTION: Graves’ disease (GD) is an autoimmune disorder characterized by hyperthyroidism. Antithyroid drugs (ATDs) are available as therapy. Agranulocytosis is a rare but potentially fatal complication of this therapy. In this study, we report agranulocytosis induced by propylthiouracil (PTU) in a patient with GD and the difficulties of clinical management. CASE: RNBA, male, 30 years old, with GD, treated with propylthiouracil (PTU). He progressed with pharyngotonsillitis. Then, PTU was suspended and antibiotic, filgrastim, propranolol, and prednisone were initiated. Due to the decompensation of hyperthyroidism, lithium carbonate, dexamethasone, and Lugol's solution were introduced. Total thyroidectomy (TT) was performed with satisfactory postoperative progression. DISCUSSION: We describe here the case of a young male patient with GD. For the treatment of hyperthyroidism, thioamides are effective options. Agranulocytosis induced by ATDs is a rare complication defined as the occurrence of a granulocyte count <500/mm3 after the use of ATDs. PTU was suspended, and filgrastim and antibiotics were prescribed. Radioiodine (RAI) or surgery are therapeutic alternatives. Due to problems with ATD use, a total thyroidectomy was proposed. The preoperative preparation was performed with beta-blocker, glucocorticoid, lithium carbonate, and Lugol solution. Cholestyramine is also an option for controlling hyperthyroidism. TT was performed without postoperative complications. CONCLUSION: Thionamide-induced agranulocytosis is a rare complication. With a contraindication to ATDs, RAI and surgery are definitive therapeutic options in GD. Beta-blockers, glucocorticoids, lithium carbonate, iodine, and cholestyramine may be an adjunctive therapy for hyperthyroidism.


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