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. 2023 Jun;16(2):126-129.
doi: 10.1177/1753495X211031328. Epub 2021 Aug 23.

Therapeutic plasma exchange for Graves' disease in pregnancy

Matthew Lumchee  1   2 , Mimi Yue  2   3 , Josephine Laurie  1   2 , Adam Morton  1   2
Affiliations

Therapeutic plasma exchange for Graves' disease in pregnancy

Matthew Lumchee et al. Obstet Med. 2023 Jun.

Abstract

Graves' disease in pregnancy may be associated with maternal, fetal and neonatal complications, which are proportionate to the severity of hyperthyroidism. Optimal management is detailed preconception counselling, achievement of an euthyroid state prior to conception, and close monitoring of thyroid function and thyroid-stimulating antibodies together with judicious use of anti-thyroid medications during pregnancy. A case of Graves' disease in pregnancy, complicated by pancytopenia, with a deterioration in thyroid function following cessation of thionamide therapy is described here. Therapeutic plasma exchange was subsequently used to achieve rapid control prior to thyroidectomy. Therapeutic plasma exchange is an effective treatment for hyperthyroidism where thionamides are ineffective or contraindicated, as a bridge to definitive management.

Keywords: Graves’ disease; Pregnancy complications; endocrine; thyrotoxicosis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Trend of FT4, FT3, TSH receptor antibodies, FBC, WBC and Plt.
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