PubMed · 4109876
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H Janukowicz, C Janukowicz. 1971-12-27. [Dark adaptation in hyperthyroidism].. https://pubmed.ncbi.nlm.nih.gov/4109876/
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Hyperthyroidism is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormone. The most common cause of this syndrome is Graves' disease, followed by toxic multinodular goitre, and solitary hyperfunctioning nodules. Autoimmune postpartum and subacute thyroiditis, tumours that secrete thyrotropin, and drug-induced thyroid dysfunction, are also important causes. The diagnosis of hyperthyroidism is generally straightforward, with raised serum thyroid hormones and suppressed serum thyrotropin in almost all cases. Appropriate treatment of hyperthyroidism relies on identification of the underlying cause. Antithyroid drugs, radioactive iodine, and surgery are the traditional treatments for the three common forms of hyperthyroidism. Beta-adrenergic blocking agents are used in most patients for symptomatic relief, and might be the only treatment needed for thyroiditis, which is transient. The more unusual causes of hyperthyroidism, including struma ovarii, thyrotropin-secreting tumours, choriocarcinoma, and amiodarone-induced thyrotoxicosis are, more often than not, a challenge to diagnose and treat.
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Treatment options for benign diseases of the thyroid include medication, radioiodine therapy and surgery. Patients with hyperthyroidism initially receive antithyroid drugs, with further treatment determined by the relapse risk. In the case of Graves' disease this is determined by a number of risk factors, including the volume of the thyroid gland or the presence of endocrinal ophthalmopathy. In such cases with a high relapse risk, radioiodine therapy is the recommended first-line treatment. Further indications--if surgery is not necessary--are autonomous goiter, recurrent (autonomous) goiter and latent hyperthyroidism. A single radioiodine treatment suffices to control the situation in more than 90% of the cases, and the goiter clearly diminishes in size. Radiation-induced malignancies or malformations have not been seen, but iodine treatment is contraindicated in pregnancy. In view of the short hospital stay of only four to five days, and the ready availability of treatment units, the authors consider radioiodine therapy a suitable first-line option in patients with Graves' hyperthyroidism.