Journal of Yeungnam Medical Science

Review article

Long-term management of Graves disease: a narrative review: Hyo-Jeong Kim; J Yeungnam Med Sci. 2023;40(1):12-22. Published online November 4, 2022; DOI: https://doi.org/10.12701/jyms.2022.00444

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Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient’s drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

Citations

Citations to this article as recorded by

Commentary: Azathioprine as an adjuvant therapy in severe Graves’ disease: a randomized controlled open-label clinical trial
Madhukar Mittal, Azher Rizvi
Frontiers in Endocrinology.2024;[Epub] CrossRef
Total Thyroidectomy – A Cost-effective Alternative to Anti-Thyroid Drugs in the Management of Grave's Disease
Erivelto Volpi, Leonardo M. Volpi
Clinical Thyroidology.2023; 35(5): 183. CrossRef
Evaluation of the Abbott Alinity i Thyroid-Stimulating Hormone Receptor Antibody (TRAb) Chemiluminescent Microparticle Immunoassay (CMIA)
Deborah J. W. Lee, Soon Kieng Phua, Yali Liang, Claire Chen, Tar-Choon Aw
Diagnostics.2023; 13(16): 2707. CrossRef
Mechanisms and Treatment Options for Hyperthyroid-Induced Osteoporosis: A Narrative Review
Robert M Branstetter, Rahib K Islam, Collin A Toups, Amanda N Parra, Zachary Lee, Shahab Ahmadzadeh, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
Cureus.2023;[Epub] CrossRef

Case Report

A Case reports of a Surgical Correctiona of the Mandibular Retrusion.: Nan Hee Im, Jin Ho Park, Byung Rho Chin, Hee Kyung Lee; Yeungnam Univ J Med. 1995;12(2):393-399. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.393

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Abstract PDF: Mandibular retrusion showing the facial problem with a marked maxillarry incisors protrusion and chin deficiency, resulting in a highly convex profile is uncommon in Korea.. The large incisor overjet and deep-bite create functional limitations and unpleasing esthetic result. The majority of theses cases are susceptible to correction by orthodontic therapeutic methods. But severe Class II retrognathic cases in which orthodontic treatment alone has not been capable of achieving good results. Orthognathic surgery offers several approaches. In this case, mandibular advancement by bilateral sagittal split ramus osteotomy and augmentation genioplasty has a special surgical problems. The suprahyoid muscle gorup are lengthened if the body of the mandible is surgically repositioned anteriorly. Instability of results and relapse return to original position shoud predicted during post-surgical muscular readjustment.. To maintain maximum correction with this technique, it is suggested that the mandibular body be well rotated forward at time of surgical intervention and overcorrected anteriory as much as possible. So, the authors report the case with review of concerned literature.

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