| Graves' disease with moderate-severe endocrine ophthalmopathy-long term results of a prospective, randomized study of total or subtotal thyroid resection. | |
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MedLine Citation:
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PMID: 16279849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The optimal thyroid surgery to be performed in patients with Graves' disease and concomitant endocrine ophthalmopathy is a matter of debate. We randomly assigned 44 patients with moderate-severe eye signs in a trial of treatment with subtotal, leaving a small (approximately 2 g) thyroid remnant, or total thyroidectomy. At inclusion, the patients had been treated with antithyroid drugs, and corticosteroids been given to 12 (27%). All received postoperative thyroxine supplementation and were followed for 3 years at regular examinations. The eye disease improved in all cases, and throughout the study, the two groups did not differ with regard to subjective and objective eye symptoms and laboratory findings. At the study start, motility disturbances were present in 8 and 11 of the cases in the subtotal and total resection group and proptosis in 16 and 17, respectively. After 3 years, the corresponding data were 3 and 6 cases with motility defects and 16 and 15 cases with proptosis. Thyrotropin (TSH)-receptor antibody levels gradually fell and became nondetectable in 21 (49%). The surgical complication rate (permanent recurrent laryngeal nerve paresis and permanent hypoparathyroidism) was significantly higher in the total thyroidectomy group. The data indicate that in patients with Graves' disease and active endocrine ophthalmopathy, subtotal thyroidectomy, leaving a small thyroid remnant, will reduce the risk of surgical complications but not the beneficial effect of surgery. |
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Authors:
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J Järhult; C Rudberg; E Larsson; H Selvander; K Sjövall; B Winsa; J Rastad; F A Karlsson; |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thyroid : official journal of the American Thyroid Association Volume: 15 ISSN: 1050-7256 ISO Abbreviation: Thyroid Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-11-10 Completed Date: 2006-03-10 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 9104317 Medline TA: Thyroid Country: United States |
Other Details:
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Languages: eng Pagination: 1157-64 Citation Subset: IM |
Affiliation:
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Department of Surgery, Eksjö Hospital, Sweden. johannes.jarhult@lj.se |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Female Follow-Up Studies Graves Ophthalmopathy / surgery* Humans Male Middle Aged Ocular Motility Disorders / etiology Receptors, Thyrotropin / immunology Thyroidectomy* / adverse effects, methods |
| Chemical | |
Reg. No./Substance:
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0/Receptors, Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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