{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:56:36Z","timestamp":1777366596113,"version":"3.51.4"},"reference-count":18,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a case of double filtration plasmapheresis (DFPP) performed in medication-resistant Graves disease (GD) with a massive goiter. A 19-year-old female was diagnosed with GD and initially demonstrated poor medication compliance. She presented with loss of consciousness from hypoxemia due to goiter-related tracheal narrowing. Despite inpatient drug therapy, the thyroid hormone levels remained high. We performed DFPP to control thyrotoxicosis before proceeding with thyroidectomy. After 4 sessions, thyroid hormone levels improved, enabling total thyroidectomy. GD with a large goiter may be refractory to medical therapy. In such cases, DFPP can improve thyroid hormone levels.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag095","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:55:23Z","timestamp":1777362923000},"source":"Crossref","is-referenced-by-count":0,"title":["Double filtration plasmapheresis in antithyroid drug-refractory Graves disease with a massive goiter"],"prefix":"10.1210","volume":"4","author":[{"given":"Miku","family":"Yamazaki","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, University of Yamanashi Hospital , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8540-2801","authenticated-orcid":false,"given":"Hiroyuki","family":"Uchinuma","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, University of Yamanashi Hospital , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuka","family":"Yokota","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Yamanashi Hospital , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1329-2180","authenticated-orcid":false,"given":"Hiroki","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, University of Yamanashi , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Moriguchi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, University of Yamanashi Hospital , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-4561","authenticated-orcid":false,"given":"Kyoichiro","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, University of Yamanashi Hospital , Yamanashi 409-3898 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026042803551593600_luag095-B1","author":"Guidelines Japan Thyroid Association"},{"issue":"4","key":"2026042803551593600_luag095-B2","doi-asserted-by":"crossref","first-page":"578","DOI":"10.21037\/gs-23-499","article-title":"Silicone stent placement for tracheal stenosis induced by a giant goiter due to Graves\u2019 disease: a case report","volume":"13","author":"Misaki","year":"2024","journal-title":"Gland Surg"},{"issue":"6","key":"2026042803551593600_luag095-B3","doi-asserted-by":"crossref","first-page":"2157","DOI":"10.1210\/jc.2006-2135","article-title":"Comparison of methimazole and propylthiouracil in patients with hyperthyroidism caused by Graves\u2019 disease","volume":"92","author":"Nakamura","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2026042803551593600_luag095-B4","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1056\/NEJMra042972","article-title":"Antithyroid drugs","volume":"352","author":"Cooper","year":"2005","journal-title":"N Engl J Med"},{"issue":"5","key":"2026042803551593600_luag095-B5","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1507\/endocrj.42.697","article-title":"A hyperthyroid patient with Graves\u2019 disease who was strongly resistant to methimazole: investigation on possible mechanisms of the resistance","volume":"42","author":"Li","year":"1995","journal-title":"Endocr J"},{"issue":"3","key":"2026042803551593600_luag095-B6","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1365-2265.1995.tb02030.x","article-title":"Response to methimazole in Graves\u2019 disease. 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