Treatment of adult Graves' disease

Ann Endocrinol (Paris). 2018 Dec;79(6):618-635. doi: 10.1016/j.ando.2018.08.003. Epub 2018 Aug 16.

Abstract

Treatment strategy in Graves' disease firstly requires recovery of euthyroid status by antithyroid therapy. Treatment modalities, precautions, advantages and side-effects are to be discussed with the patient. No particular treatment modality has demonstrated superiority. Pregnancy or pregnancy project affects choice of treatment and monitoring. Graves' orbitopathy is liable to be aggravated by iodine-131 treatment and requires pre-treatment assessment. Iodine-131 treatment aims at achieving hypothyroidism. Thyroid surgery for Graves' disease should preferably be performed by an expert team. In case of recurrence of hyperthyroidism, the various treatment options should be discussed with the patient. Empiric treatment of thyroid dermopathy uses local corticosteroids in occlusive dressing.

Keywords: Antithyroid drugs; Antithyroïdien; Chirurgie; Graves’ disease; Grossesse; Maladie de Basedow; Myxœdeme prétibial; Orbitopathie; Orbitopathy; Pregnancy; Radioiode; Radioiodine; Surgery; Thyroid dermopathy.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adult
  • Age of Onset
  • Antithyroid Agents / therapeutic use
  • Female
  • Graves Disease / epidemiology
  • Graves Disease / therapy*
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Pregnancy
  • Pregnancy Complications / therapy
  • Radiotherapy Dosage / standards
  • Thyroidectomy / methods
  • Thyroidectomy / standards

Substances

  • Antithyroid Agents
  • Iodine Radioisotopes