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Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.

Abstract

BACKGROUND

Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition.

METHODS

The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group.

RESULTS

Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis.

CONCLUSIONS

One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

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  • Authors+Show Affiliations

    ,

    Division of Endocrinology, Metabolism, and Nutrition, Mayo Clinic , Rochester, Minnesota 55905, USA. bahn.rebecca@mayo.edu

    , , , , , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Adrenergic beta-Antagonists
    Antithyroid Agents
    Child
    Evidence-Based Medicine
    Female
    Graves Disease
    Humans
    Hyperthyroidism
    Iodine Radioisotopes
    Pregnancy
    Thyroid Crisis
    Thyroid Hormones
    Thyroidectomy
    Thyrotoxicosis

    Pub Type(s)

    Journal Article
    Practice Guideline

    Language

    eng

    PubMed ID

    21510801

    Citation

    Bahn Chair, Rebecca S., et al. "Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists." Thyroid : Official Journal of the American Thyroid Association, vol. 21, no. 6, 2011, pp. 593-646.
    Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593-646.
    Bahn Chair, R. S., Burch, H. B., Cooper, D. S., Garber, J. R., Greenlee, M. C., Klein, I., ... Stan, M. N. (2011). Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid : Official Journal of the American Thyroid Association, 21(6), pp. 593-646. doi:10.1089/thy.2010.0417.
    Bahn Chair RS, et al. Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593-646. PubMed PMID: 21510801.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. AU - Bahn Chair,Rebecca S, AU - Burch,Henry B, AU - Cooper,David S, AU - Garber,Jeffrey R, AU - Greenlee,M Carol, AU - Klein,Irwin, AU - Laurberg,Peter, AU - McDougall,I Ross, AU - Montori,Victor M, AU - Rivkees,Scott A, AU - Ross,Douglas S, AU - Sosa,Julie Ann, AU - Stan,Marius N, AU - ,, AU - ,, Y1 - 2011/04/21/ PY - 2011/4/23/entrez PY - 2011/4/23/pubmed PY - 2011/9/29/medline SP - 593 EP - 646 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 21 IS - 6 N2 - BACKGROUND: Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. METHODS: The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. RESULTS: Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. CONCLUSIONS: One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/21510801/full_citation L2 - https://www.liebertpub.com/doi/full/10.1089/thy.2010.0417?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -