Treatment for Graves’ Disease and its Recurrence

Title: Treatment for Graves’ Disease and its Recurrence

Authors: Dr S. Zahir Hussain, Dr M.P. Kumaran

DOI: https://dx.doi.org/10.18535/jmscr/v5i7.100

Abstract

INTRODUCTION

The most common cause of hyperthyroidism worldwide is Graves’ disease (GD). Therapeutic options for GD include anti thyroid drugs (ATD), radioactive iodine, and thyroidectomy. ATD treatment is generally well accepted by patients because it normalize thyroid function in a short time, rarely causing hypothyroidism, and ameliorating immune disorder while avoiding radiation exposure and invasive procedures. However, the relapse rate is a major concern for ATD treatment, the rate of relapse depends on the factors like clinical characteristics, treatment strategies, and genetic and environmental factors. Of these influencing factors, some are modifiable but some are non modifiable. The recurrence risk can be reduced by adjusting the modifiable factors as much as possible. The titration regimen for 12–18 months is the optimal strategy of ATD. Levothyroxine administration after successful ATD treatment was not recommended. The addition of immunosuppressive drugs might be helpful to decrease the recurrence rate of GD patients after ATD withdrawal, whereas further studies are needed to address the safety and eﬃcacy

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Corresponding Author

Dr. M.P. Kumaran

Department of Endocrine Surgery, Madras Medical College, Chennai