Evidence map›Paper›PMID 32953456›Full record

ArticleJournal of clinical & translational endocrinology2020

Impact of first-line treatment choice on long-term outcomes of hyperthyroid Graves' disease patients with thyrotoxic periodic paralysis.

Krittadhee Karndumri, Yotsapon Thewjitcharoen, Waralee Chatchomchuan, Sriurai Porramatikul, Sirinate Krittiyawong, Ekgaluck Wanothayaroj, Siriwan Butadej, Soontaree Nakasatien, Rajata Rajatanavin, Thep Himathongkam

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical & translational endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 46% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Approach to the patient with severe hyperthyroidism-related complications.The Journal of clinical endocrinology and metabolism · 2026
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Krittadhee KarndumriDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Yotsapon ThewjitcharoenDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Waralee ChatchomchuanDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Sriurai PorramatikulDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Sirinate KrittiyawongDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Ekgaluck WanothayarojDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Siriwan ButadejDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Soontaree NakasatienDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Rajata RajatanavinDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Thep HimathongkamDiabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Bangkok Hospital · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThyrotoxic periodic paralysis (TPP) is a unique manifestation of Graves' disease. While it is uncommon in Asian, it is extremely rare in Caucasian patients (0.1-0.2%). Previous studies suggested that TPP indicate more severity of Graves' disease and definitive treatments should be used to prevent relapses.

aimTo describe clinical features and impact of first-line treatment on long-term outcomes of TPP patients.

methodA retrospective cohort study over 35 years (1985-2019) of TPP from Graves' disease patients was conducted. All cases were analyzed and their clinical courses were compared between those who received anti-thyroid drugs (ATD) versus radioactive iodine (RAI) as a primary treatment. None of them underwent surgery.

resultsA total of 2964 hyperthyroid Graves' disease patients were treated and followed-up at least 3 months over the study period. TPP was identified in 63 cases (2.1%) of all patients. There were 60 males and only 3 females with age at presentation of 35.0 ± 8.2 years. TPP was the first presentation of hyperthyroid Graves' disease in 82.5% of them. During the acute attack of TPP, all patients presented with bilateral lower limb flaccid weaknesses with median serum potassium of 2.1 mmol/L. No fatal TPP cases were found. RAI was selected as primary treatment in 27 patients (42.9%). Nearly all RAI-treated patients rendered hypothyroidism with the median RAI dose at 15 mCi. No patients who were in remission after RAI treatment developed recurrent attack of TPP. In the remaining 36 ATD-treated patients with mean follow-up time at 9.1 years, relapse was found in 10 patients (27.8%) after the drug discontinuation and 6 patients suffered recurrent TPP. Only 8 ATD-treated TPP patients (22.2%) went into remission.

conclusionsTPP is a rare complication of hyperthyroid Graves' disease. Definitive treatment with RAI or thyroidectomy should be employed to prevent relapse and further attacks of TPP.

Indexed as

Graves' diseaseThaiThyrotoxic Periodic ParalysisTreatment choice

Identifiers

PMID32953456
PMCPMC7486682
OpenAlexW3082742714

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.