Pm. Schummdraeger, HYPERTHYROIDISM IN GRAVES-DISEASE - DOES A THERAPEUTIC STANDARD EXIST- ANTITHYROID DRUG-TREATMENT, Zentralblatt fur Chirurgie, 122(4), 1997, pp. 224-226
In patients with the first manifestation of hyperthyroidism of Graves'
disease, antithyroid drug treatment is the therapy of first choice. T
reatment has to be carried out depending on iodine supply of the indiv
idual patient with the lowest possible drug dose. Controls of treatmen
t have to be done in short intervals (every 2 weeks) until euthyroidis
m is reached, afterwards controls of thyroid function have to be done
every three months. After euthyroidism is established, the combination
of antithyroid drug therapy with thyroid hormones may be useful to av
oid hypothyroidism or goiter development during treatment in contrast
to a monotherapy with antithyroid drugs. Antithyroid drug treatment ha
s to be carried out for one year. The remission rate of patients does
not increase with higher doses of antithyroid drugs or a longer treatm
ent duration. The determination of TSH receptor antibodies does not he
lp predicting a relapse of hyperthyroidism of Graves' disease in the i
ndividual patient at the end of treatment. Regular follow-up controls
after antithyroid drug treatment are necessary to recognize relapse of
Graves' disease in time.