{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T12:24:25Z","timestamp":1786969465009,"version":"build-2736575974"},"reference-count":10,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report 2 young women with severe Graves thyrotoxicosis in whom antithyroid drugs were contraindicated\u2014one due to drug induced moderate neutropenia and the other due to Graves disease\u2013associated hepatic dysfunction and cytopenia. Both patients presented with life-threatening manifestations of thyrotoxicosis and were unsuitable for immediate surgery or radioiodine therapy. Therapeutic plasma exchange (TPE) was used as a bridging strategy to achieve rapid biochemical control. In the first case, a single session of TPE enabled prompt stabilization for total thyroidectomy. In the second, 3 sessions of TPE led to marked clinical improvement, reversal of hepatic dysfunction and cytopenia, and facilitated successful radioiodine ablation. Neither patient experienced TPE-related complications. These 2 cases highlight the utility of TPE as a safe and effective interim therapy in complicated thyrotoxicosis, allowing timely transition to definitive treatment in high-risk clinical settings where conventional antithyroid therapies are contraindicated.<\/jats:p>","DOI":"10.1210\/jcemcr\/luaf240","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:57:10Z","timestamp":1757678230000},"source":"Crossref","is-referenced-by-count":1,"title":["Therapeutic Plasma Exchange in Severe Graves Disease With Hematologic and Hepatic Complications"],"prefix":"10.1210","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-5492","authenticated-orcid":false,"given":"Vivek","family":"Jha","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Shaharyar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavyanjali","family":"Kundu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Madhad","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Medenica","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Internal Clinic of the Clinical Center of Montenegro , Podgorica 81000 ,","place":["Montenegro"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-1611","authenticated-orcid":false,"given":"Pinaki","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"issue":"3","key":"2025103106061940600_luaf240-B1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/jca.21705","article-title":"Guidelines on the use of therapeutic apheresis in clinical practice\u2014evidence-based approach from the Writing Committee of the American Society for Apheresis: the eighth special issue","volume":"34","author":"Padmanabhan","year":"2019","journal-title":"J Clin Apher"},{"issue":"1","key":"2025103106061940600_luaf240-B2","first-page":"e14","article-title":"Therapeutic plasma exchange as a bridge to total thyroidectomy in patients with severe thyrotoxicosis","volume":"6","author":"Tieken","year":"2020","journal-title":"AACE Clin Case Rep"},{"issue":"3","key":"2025103106061940600_luaf240-B3","doi-asserted-by":"crossref","first-page":"517","DOI":"10.3390\/jpm13030517","article-title":"Therapeutic plasma exchange for the treatment of hyperthyroidism: approach to the patient with thyrotoxicosis or antithyroid-drugs induced agranulocytosis","volume":"13","author":"Tizianel","year":"2023","journal-title":"J Pers Med"},{"issue":"1","key":"2025103106061940600_luaf240-B4","first-page":"86","article-title":"Therapeutic plasma exchange in refractory hyperthyroidism","volume":"10","author":"Sa\u00efe","year":"2021","journal-title":"Eur Thyroid 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contraindicated","volume":"58","author":"Ozbey","year":"2004","journal-title":"Int J Clin Pract"},{"issue":"3","key":"2025103106061940600_luaf240-B8","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1620\/tjem.2024.J043","article-title":"Successful combination of fresh frozen plasma and albumin 5% in plasma exchange for a patient with concurrent thyroid storm and Guillain-Barr\u00e9 syndrome: a rare case report","volume":"263","author":"Bui-Thi","year":"2024","journal-title":"Tohoku J Exp Med"},{"issue":"2","key":"2025103106061940600_luaf240-B9","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/jca.20037","article-title":"The Italian Registry for Therapeutic Apheresis. A report from the apheresis study group of the Italian Society of Nephrology","volume":"20","author":"Passalacqua","year":"2005","journal-title":"J Clin Apher"},{"issue":"2","key":"2025103106061940600_luaf240-B10","first-page":"e240150","article-title":"Therapeutic plasma exchange as a bridge to definitive treatment in severe thyrotoxicosis with propylthiouracil-induced neutropenia","volume":"2025","author":"Medenica","year":"2025","journal-title":"Endocrinol Diabetes Metab Case Rep"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/12\/luaf240\/65046511\/luaf240.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/3\/12\/luaf240\/65046511\/luaf240.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:06:31Z","timestamp":1761905191000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luaf240\/8307243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":10,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,10,27]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luaf240","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,10,27]]},"article-number":"luaf240"}}