Table6(continued) Number Recommendation evidence Asoution containing potasium odidecan be given for 10dayprotosry 2,0000 ts with GO. lled by ATD.an 1,0000 and scte COpetre 1,0000 0 aadhaoyamdnneGo,tratmcaofGooahbetepmiai,Etrot恤mtouempy 1,0000 Patients with sight-threatenin GO should be treated with ATD 1,0000 Treatment for hyperthyroidism in patients with inactive GO can be selected independently of GO 1,0000 1.0000 pregnancy 1,0000 ing preg 1,0000 1,0000 During pregnancy the lowest possible dose of ATD should be given and the block-and-replace ATD regimen is discouraged 1,0000 Maternal FT4(TT)and TSH should be measured every 2 weeks after initiation of therapy,and every 4 weeks after achieving 1.0000 he target valu A change from PTU to MMI should be considered if ATD are required after 16 weeks gestation 1,0000 2,0000 Lactating women with GD should be offered the same treatments as non-lactating women 1,0000 1,0000 Long-term MMI(CBZ)should be considered asasatisfactory treatment for oder individuals with mild GD 2,0000 PTU should be avoided in children and adolescents 1,0000 Long-term MMI(CBZ)should be the mainstay of treatment with GD 0000 Thyroidectomy is the primary definitive therapy in childhood.but in post-pubertal children RAl can be considered 2.0000 1,0000 2.0000 2018 ETA Guideline for the Management 181 of Graves'Hyperthyroidism 医通 http://guide.medlive.cn/2018 ETA Guideline for the Management of Graves’ Hyperthyroidism Eur Thyroid J 2018;7:167–186 181 DOI: 10.1159/000490384 Number Recommendation Strength and level of evidence 27 A solution containing potassium iodide can be given for 10 days prior to surgery 2, ØØØO 28 In patients with GO, hyperthyroidism should be promptly controlled by ATD, and euthyroidism stably maintained 1, ØØØØ 29 Patients treated with RAI should receive steroid prophylaxis if mild and active GO preexists or there are risk factors for RAI￾associated GO occurrence or progression 1, ØØØØ 30 In patients with moderate-to-severe and active GO, treatment of GO should be the priority. Euthyroidism should be promptly restored with ATD and stably maintained 1, ØØØØ 31 Patients with sight-threatening GO should be treated with ATD 1, ØØOO 32 Treatment for hyperthyroidism in patients with inactive GO can be selected independently of GO 1, ØØOO 33 Women with GD of reproductive age should be offered preconception counseling and be stably euthyroid before attempting pregnancy 1, ØØOO 34 Women with GD should be instructed to immediately confirm pregnancy and contact their physician 1, ØØØØ 35 Women treated with MMI should be switched to PTU when planning pregnancy and/or during the first trimester of pregnancy 1, ØØØØ 36 All patients with a history of autoimmune thyroid disease should have their TSH-R-Ab serum levels measured at the first presentation of pregnancy using either a sensitive binding or a functional cell-based bioassay and, if they are elevated, again at 18–22 weeks of gestation 1, ØØØØ 37 If the maternal TSH-R-Ab concentration remains high (>3 times the cut-off), monitoring of the fetus for thyroid dysfunction throughout pregnancy is recommended 1, ØØØØ 38 During pregnancy the lowest possible dose of ATD should be given and the block-and-replace ATD regimen is discouraged 1, ØØØØ 39 Maternal FT4 (TT4) and TSH should be measured every 2 weeks after initiation of therapy, and every 4 weeks after achieving the target value 1, ØØOO 40 A change from PTU to MMI should be considered if ATD are required after 16 weeks gestation 1, ØOOO 41 In women on a low dose of MMI (<5–10 mg/day) or PTU (<50–100 mg/day), ATD may be stopped during gestation prior to weeks 6–10 2, ØOOO 42 Lactating women with GD should be offered the same treatments as non-lactating women 1, ØØOO 43 MMI is recommended during lactation, given the concerns about PTU-mediated hepatotoxicity 1, ØØOO 44 Older patients who have had atrial fibrillation, cardiac failure, or cardiac ischemic symptoms precipitated by hyperthyroidism should undergo definitive therapy, usually RAI 1, ØØØO 45 Long-term MMI (CBZ) should be considered as a satisfactory treatment for older individuals with mild GD 2, ØOOO 46 PTU should be avoided in children and adolescents 1, ØØØØ 47 Long-term MMI (CBZ) should be the mainstay of treatment in children with GD 1, ØØØO 48 Thyroidectomy is the primary definitive therapy in childhood, but in post-pubertal children RAI can be considered 2, ØØOO 49 Graves’ hyperthyroidism precipitated by an immunomodulatory therapy is not a mandatory indication to stop that precipitating treatment, nor is it a mandatory indication for definitive therapy for hyperthyroidism 1, ØOOO 50 Sequential monitoring of serum TSH-R-Ab levels can be used to guide the duration of ATD therapy in patients with immune reconstitution GD 2, ØOOO Table 6 (continued) http://guide.medlive.cn/