Plasma exchange aids thyroidectomy in refractory amiodarone-induced thyrotoxicosis, despite variable biochemical responses

TPE may provide temporary biochemical improvement and clinical stabilisation in refractory AIT, facilitating safe progression to thyroidectomy. However, its biochemical effects can be inconsistent and transient, and complications such as coagulopathy must be anticipated. Our experience supports the use of TPE as a valuable adjunct in selected patients with refractory AIT but illustrates that thyroidectomy should not be unnecessarily delayed in pursuit of complete TH normalisation or rigid biochemical targets.