Treatment of relapsed hyperthyroidism

Graves disease is the most common disease that causes hyperthyroidism. It is an autoimmune disease characterized by the overproduction of thyroid hormones due to continuous stimulation of the thyroid gland by thyroid-stimulating hormone receptor antibody. Therapeutic modalities for Graves disease include antithyroid drugs (ATDs), radioactive iodine, and thyroidectomy. ATDs are the most preferred therapeutic option by physicians in most countries except North America. However, current treatment strategies are unfortunately aimed at inhibiting thyroid hormone production or ablating the thyroid to induce permanent hypothyroidism, not at inhibiting thyroid-stimulating hormone receptor antibody. ATD therapy has a high relapse rate (more than 50%), and morbidity and mortality increase in cases of relapse. Therefore, the proper and prompt management of relapsed patients is very important.