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Jonah Robinson Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Max Richardson Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Janis Hickey British Thyroid Foundation, Harrogate, UK

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Andy James Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Simon H. Pearce Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Steve G. Ball Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Richard Quinton Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Margaret Morris Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Margaret Miller Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Petros Perros Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, Harrogate, UK

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Introduction Hyperthyroidism affects approximately 1% of the adult population [ 1 , 2 ]. Antithyroid drugs are commonly used to control hyperthyroidism [ 3 , 4 ]. Assuming an incidence of Graves' disease in Europe of 21/100,000 per year [ 5

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Spiros Karras Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece

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Gerasimos E. Krassas Department of Endocrinology, Diabetes and Metabolism, Panagia General Hospital, Thessaloniki, Greece

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Graves’ disease (GD) can occur during the postpartum period, as a relapse of previous GD or a newly diagnosed case with no apparent thyroid disease background. In this case, antithyroid drugs (ATD) are considered the treatment of choice by most

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Hiroyuki Iwaki Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Kenji Ohba Medical Education Center, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Eisaku Okada Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takeshi Murakoshi Obstetrics and Gynecology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Yumiko Kashiwabara Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Chiga Hayashi Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Akio Matsushita Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Shigekazu Sasaki Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Takafumi Suda Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

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Yutaka Oki Department of Metabolism and Endocrinology, Hamamatsu-Kita Hospital, Hamamatsu, Japan

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Rieko Gemma Division of Endocrinology, Department of Internal Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan

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Introduction Antithyroid drugs (ATDs) are the mainstay of medical treatment for Graves’ hyperthyroidism, occurring in approximately 0.2% during pregnancy [ 1 ]. All ATDs tend to be more potent in the fetus than in the mother [ 2 - 4 ]. ATD

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Meihua Jin Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea

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Ahreum Jang Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Division of Endocrinology and Metabolism, Department Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

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Chae A Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Tae Yong Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Bae Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Young Kee Shong Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Min Ji Jeon Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Won Gu Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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gland ( 1 , 2 ). Current treatment options for patients with Graves’ hyperthyroidism include antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, and surgery ( 1 , 3 , 4 ). Although geographical difference exists, ATD is the preferred first

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Pei-Wen Wang Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

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I-Ya Chen Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

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Suh-Hang Hank Juo Department of Medical Research, Kaohsiung Medical University Hospital and Graduate Institute of Medical Genetics, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC

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Edward Hsi Department of Medical Research, Kaohsiung Medical University Hospital and Graduate Institute of Medical Genetics, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC

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Rue-Tsuan Liu Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

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Ching-Jung Hsieh Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine

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Introduction For patients with Graves’ disease (GD), there are three choices of treatment, none of which is perfect. The primary goal of antithyroid drug therapy is to temporarily restore the patient to the euthyroid state while awaiting a

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Hirotoshi Nakamura Kuma Hospital, Kobe, Japan

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Akane Ide Kuma Hospital, Kobe, Japan

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Takumi Kudo Kuma Hospital, Kobe, Japan

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Eijun Nishihara Kuma Hospital, Kobe, Japan

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Mitsuru Ito Kuma Hospital, Kobe, Japan

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Akira Miyauchi Kuma Hospital, Kobe, Japan

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Introduction Agranulocytosis (AG) is one of the most serious complications of antithyroid drug (ATD) therapy for Graves' disease. It is rare, but if its discovery is delayed and severe infection develops, a lethal outcome can happen [ 1 ]. In

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Suvi Turunen Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Marja Vääräsmäki Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Maarit Leinonen Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland

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Mika Gissler Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden

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Tuija Männistö Northern Finland Laboratory Centre Nordlab, Oulu, Department of Neurobiology, Care Sciences and Society, Finland Karolinska Institute, Stockholm, Sweden

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Eila Suvanto Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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the potential benefits outweigh the potential harms [ 2 ]. Current American and European guidelines recommend treating overt maternal hypothyroidism with levothyroxine (LT4) and overt hyperthyroidism with antithyroid drugs (ATDs) including

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Shakeel Kautbally Divisions of Endocrinology and Nutrition, Université Catholique de Louvain, Brussels, Belgium

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Orsalia Alexopoulou Divisions of Endocrinology and Nutrition, Université Catholique de Louvain, Brussels, Belgium

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Chantal Daumerie Divisions of Endocrinology and Nutrition, Université Catholique de Louvain, Brussels, Belgium

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François Jamar Divisions of Nuclear Medicine, Université Catholique de Louvain, Brussels, Belgium

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Michel Mourad Divisions of Endocrine Surgery, St. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium

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Dominique Maiter Divisions of Endocrinology and Nutrition, Université Catholique de Louvain, Brussels, Belgium

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second-line treatments, at least in Europe, in case of unsuccessful therapy with antithyroid drugs (ATD), disease relapse, or drug intolerance [ 1 ]. Surgery should consist of a near total thyroidectomy (TTx), which leads to a reduced risk of relapse, as

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Sun Mi Park Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Yoon Young Cho Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Ji Young Joung Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Seo Young Sohn Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Sun Wook Kim Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Jae Hoon Chung Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

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Introduction As antithyroid drugs (ATD) still remain the preferred modality of treatment for Graves' disease [ 1 , 2 ], clinical competence and appropriate management taking into account an array of clinical and laboratory features related to

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Claudio Marcocci Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy

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Marenza Leo Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy

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Maria Antonietta Altea Department of Endocrinology and Metabolism, University of Pisa, Pisa, Italy

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have been performed in hyperthyroid patients with GD, either under basal conditions or after restoration of euthyroidism with antithyroid drug (ATD) or radioiodine [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Untreated hyperthyroidism is

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