Changes of Thyroid Hormones and Their Binding Proteins during Plasma Exchange for Polyneuropathy in a Patient with Substituted Hypothyroidism due to Hashimoto's Thyroiditis.

Jenni, Stefan; Adler, Marcel; Lanz, Simone; Taleghani, Behrouz Mansouri; Christ, Emanuel (2016). Changes of Thyroid Hormones and Their Binding Proteins during Plasma Exchange for Polyneuropathy in a Patient with Substituted Hypothyroidism due to Hashimoto's Thyroiditis. Transfusion medicine and hemotherapy, 43(1), pp. 45-49. Karger 10.1159/000440822

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BACKGROUND Pharmacodynamic studies and data concerning adaptation of thyroid substitution in patients with substituted hypothyroidism during plasma exchange (PE) is not available. CASE REPORT We measured TSH, fT3 and fT4, total T4, thyroxin binding globulin (TBG), and albumin before and after 5 PE procedures in a 37-year-old women who underwent PE for a therapy-resistant polyneuropathy. Thyroxin was increased empirically by 8% resulting in a dose of 1.95 µg/kg per day. RESULTS Despite larger reductions of total T4 and TBG over a series of 5 PEs (40-50% from baseline), only small reductions of 8% in fT3 and fT4 concentrations were documented with a concomittant increase in TSH level. Changes of fT4, fT3, and TSH remained within normal range. CONCLUSIONS i) Despite a significant decrease in total thyroid hormone pool following PE, fT4, fT3, and TSH concentrations changed only slightly. ii) Based on this observation, a general increase in thyroid replacement therapy before PE cannot be recommended, but considered in case of a high normal TSH level.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Jenni, Stefan and Christ, Emanuel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1660-3796

Publisher:

Karger

Language:

English

Submitter:

Lia Bally

Date Deposited:

05 Apr 2017 08:46

Last Modified:

07 Apr 2017 08:52

Publisher DOI:

10.1159/000440822

PubMed ID:

27022322

Uncontrolled Keywords:

Hypothyroidism; Plasma exchange; Substitution; Thyroid hormones

BORIS DOI:

10.7892/boris.93449

URI:

https://boris.unibe.ch/id/eprint/93449

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