{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:48:00Z","timestamp":1790808480883,"version":"4.1.0"},"reference-count":15,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":2121,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Introduction: Hyperthyroid patients who are unresponsive to medical treatment remain a challenging clinical problem. Objective: The goal of our study was to evaluate the use of therapeutic plasma exchange (TPE) in hyperthyroid patients and their outcome after TPE. Method: We retrospectively reviewed 22 patients who underwent TPE for refractory thyrotoxicosis in our institution: 13 with Graves\u2019 disease, 7 with amiodarone-induced thyrotoxicosis (AIT), 1 with toxic goiter, and 1 pregnant patient with familial nonautoimmune thyrotoxicosis. Results: Before TPE, all patients had severe hyperthyroidism, and antithyroid drugs were either contraindicated or not sufficiently effective to restore euthyroidism promptly. After all the TPEs, free T&amp;lt;sub&amp;gt;4&amp;lt;\/sub&amp;gt; (fT4) decreased significantly by 48% (p = 0.001) and fT3 by 52% (p = 0.0001). The median number of TPE sessions per patient was 4 (range: 1\u201310). There were no complications during the 91 TPE sessions. Total thyroidectomy with no severe side effects was performed on 16\/22 patients and 1 other patient was treated with radioactive iodine. One patient died from severe thyrotoxicosis during medical care. The remaining 4 patients were followed up without any radical treatment. For all 7 patients with AIT, iterative TPE led to a significant clinical improvement, and amiodarone was continued for 1 patient. Available treatments were continued between TPE sessions (cholestyramine for 13 patients [60%] and glucocorticoids for 16 patients [73%]). Conclusion: TPE allowed a safe decrease of 50% in thyroid hormone levels, and it should be considered for refractory hyperthyroid patients when medical treatments are contraindicated or have failed to restore euthyroidism, irrespective of the etiology of the thyrotoxicosis.<\/jats:p>","DOI":"10.1159\/000507019","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T17:00:28Z","timestamp":1588093228000},"page":"86-92","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":11,"title":["Therapeutic Plasma Exchange in Refractory Hyperthyroidism"],"prefix":"10.1530","volume":"10","author":[{"given":"Clotilde","family":"Sa\u00efe","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Ghander","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Saheb","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Jublanc","sequence":"additional","affiliation":[{"name":"3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Lemesle","sequence":"additional","affiliation":[{"name":"4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Lussey-Lepoutre","sequence":"additional","affiliation":[{"name":"5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Leenhardt","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Menegaux","sequence":"additional","affiliation":[{"name":"6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tresallet","sequence":"additional","affiliation":[{"name":"7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Buffet","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2020,4,28]]},"reference":[{"issue":"6","key":"2026070713040674300_ref1","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1089\/thy.2010.0417","article-title":"Hyperthyroidism 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        JL\n            , FaradjiA, DemangeatC, SapinR, ChabrierG, SimonC, et al. [Quantitative evaluation of hormonal extraction performed by continuous plasma exchange in euthyroid patients. Application to the treatment of severe hyperthyroidism]. 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