scholarly journals Do we really Need Lugol Solution in the Era of Energy Devices for the Preoperative Management of Patients with Graves’ Disease?

2019 ◽  
Vol 10 (4) ◽  
pp. em00730
Author(s):  
Kalin Nicolaev Vidinov ◽  
Yulian Stoinov
Keyword(s):  
Graves Disease ◽  
Preoperative Management ◽  
Energy Devices ◽  
Lugol Solution

scholarly journals Effect of Lugol Solution on Thyroid Gland Blood Flow and Microvessel Density in the Patients with Graves’ Disease

2007 ◽  
Vol 92 (6) ◽  
pp. 2182-2189 ◽  
Author(s):  
Yeşim Erbil ◽  
Yasemin Ozluk ◽  
Murat Giriş ◽  
Artur Salmaslıoglu ◽  
Halim Issever ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Blood Flow ◽  
Thyroid Gland ◽  
Blood Loss ◽  
Microvessel Density ◽  
Solution Treatment ◽  
Graves Disease ◽  
Preoperative Treatment ◽  
Cd 34 ◽  
Lugol Solution

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.

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 ◽  
...  
Keyword(s):  
Graves Disease ◽  
Preoperative Treatment ◽  
Lugol Solution

scholarly journals Preoperative management in patients with Graves’ disease

Gland Surgery ◽  
2017 ◽  
Vol 6 (5) ◽  
pp. 476-481 ◽  
Author(s):  
Eliana Piantanida
Keyword(s):  
Graves Disease ◽  
Preoperative Management

Effectiveness and Mechanism of Preoperative Lugol Solution for Reducing Thyroid Blood Flow in Patients with Euthyroid Graves’ Disease

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

scholarly journals Propylthiouracil-induced agranulocytosis as a rare complication of antithyroid drugs in a patient with Graves’ disease

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 ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Beta Blockers ◽  
Rare Complication ◽  
Young Male ◽  
Autoimmune Disorder ◽  
Lithium Carbonate ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Lugol Solution ◽  
Therapeutic Alternatives

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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