Therapeutic Plasma Exchange Shows Greater Efficacy Than DFPP in Reducing FT3 and FT4 Levels in Thyrotoxicosis due to Amiodarone-Induced Thyrotoxicosis Type 2.

The American Society for Apheresis (ASFA) recommendations only mention using therapeutic plasma exchange (TPE) to treat drug-resistant thyroid storms. Double filtration plasmapheresis (DFPP) is a therapeutic apheresis procedure with the advantage of being semi-selective, making it possible to limit albumin losses and reduce the volume of replacement fluid. However, there have been no studies comparing the efficacy and tolerability of TPE and DFPP for this specific indication. We hereby report the observation of 2 patients treated for thyroid storms due to amiodarone-induced thyrotoxicosis who were each able to benefit from TPE as well as DFPP sessions, enabling us to compare the purification of free thyroid hormones and tolerance of these two treatments. TPE showed greater efficiency in removing thyroid hormones with the same tolerability as DFPP.