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Behandling av Graves sjukdom: GÅR MOT PRECISIONSMEDICIN MED NYTT NATIONELLT VÅRDPROGRAM; [Treatment of Graves' disease is moving towards precision medicine]
Sahlgrenska universitetssjukhuset, Göteborg, Sverige; avdelningen för invärtesmedicin och klinisk nutrition, institutionen för medicin, Sahlgrenska akademin, Göteborgs universitet, Sverige.
Sahlgrenska universitetssjukhuset, Göteborg, Sverige; institutionen för kliniska vetenskaper, Sahlgrenska akademin, Göteborgs universitet, Sverige.
Sköldkörtelförbundet, Sverige.
Universitetssjukhuset Örebro, Sverige.
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2024 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 121, article id 23112Article, review/survey (Refereed) Published
Abstract [en]

This is the first national guideline in hyperthyroidism to harmonise and update clinical practice according to what is evidence based and direct care from patients' needs. We present 4 articles in Läkartidningen of different views of the guideline, including family care perspectives, patient care perspectives and perspectives on ophthalmology. This article concerns treatment of Graves' disease and includes endocrinological, surgical and oncological perspectives on what is established practice, but also news in the national guideline that remain to be fully implemented in Sweden in the years to come. News are precision medicine using the GREAT score, preoperative calcium/D vitamin treatment, individualized levothyroxine treatment after thyroid surgery, uniformed levothyroxine replacement strategy, access to national patient information and national guidelines on radiation protection and treatment schemes for radioactive iodine. A national guideline is the creation of many persons' views, including patient representatives, and the recommendations have undergone a thorough national review process from stakeholders. It is a guideline with future perspectives for an improved care.

Abstract [sv]

Nyheter i vårdprogrammet är precisionsmedicin baserad på bedömningsskalan GREAT.  Ytterligare ett sätt att minska postoperativ hypokalcemi är preoperativ kalcium-/vitamin D-behandling till dem med låga nivåer av dessa. Individualiserad levotyroxindosering efter kirurgi baserad på ålder och BMI ger också bättre precision och snabbare rätt substitutionsdos. b Rekommendationer kring sköldkörtelhormonersättning efter ablativ behandling ger också möjligheter till en enhetlig substitutionsbehandling.  Vårdprogramgruppen har också tagit fram nationell patientinformation. I vårdprogrammet inkluderas också nationella strålskyddsrekommendationer och riktlinjer för behandling med radioaktivt jod, så att förutsättning ges för nationell harmonisering.

Place, publisher, year, edition, pages
Sveriges Läkarförbund , 2024. Vol. 121, article id 23112
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-211962PubMedID: 38773921Scopus ID: 2-s2.0-85194021549OAI: oai:DiVA.org:liu-211962DiVA, id: diva2:1941562
Available from: 2025-02-28 Created: 2025-02-28 Last updated: 2025-08-15

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Bergman, Viveka

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Faculty of Medicine and Health SciencesDivision of Surgery, Orthopedics and OncologyDepartment of Oncology
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