MARS in Hyperthyroidism
MARS (Molecular Adsorbent Recirculating System) is NOT a treatment for hyperthyroidism—it is an artificial liver support system used in acute-on-chronic liver failure and has no role in thyroid disease management. 1
What MARS Actually Is
MARS is an albumin dialysis system designed to remove albumin-bound toxins in patients with severe liver dysfunction. 1 The system has been studied primarily in:
- Acute-on-chronic liver failure (ACLF) as a bridge to liver transplantation or recovery 1
- Hepatic encephalopathy and hepatorenal syndrome where post-hoc analyses showed some improvement 1
- Decompensated cirrhosis though randomized trials (MARS and Prometheus systems) failed to demonstrate survival benefit at 28 and 90 days 1
Why This Confusion May Arise
The acronym "MARS" appears in medical literature in completely different contexts:
- In mesothelioma treatment, MARS refers to "Mesothelioma and Radical Surgery" trial, which assessed feasibility of extrapleural pneumonectomy 1
- In liver failure, MARS is the artificial support system described above 1
- There is no MARS protocol or system for hyperthyroidism
Actual Management of Hyperthyroidism
If you're looking for hyperthyroidism treatment protocols, the evidence-based approach is:
First-Line Treatment
- Beta-blockers (atenolol or propranolol) should be initiated immediately to control heart rate to nearly normal, reduce tremors, and mitigate cardiovascular complications 1, 2, 3
Definitive Treatment Options
- Antithyroid drugs (methimazole) for 12-18 months in Graves' disease 1, 4, 5, 6
- Radioactive iodine ablation (treatment of choice in the United States for patients without contraindications) 4, 5, 6
- Thyroidectomy when other treatments fail, are contraindicated, or when goiter causes compressive symptoms 4, 5, 6
Critical Monitoring
- Cardiovascular complications are the chief cause of death after hyperthyroidism treatment, especially in patients >50 years 1, 3
- Atrial fibrillation occurs in 5-15% of hyperthyroid patients, more frequently in those >60 years 1
- Pulmonary artery hypertension can develop from increased pulmonary blood flow, leading to right ventricular dilatation 1, 3
Common Pitfall
Do not confuse medical acronyms across different specialties. MARS has established meanings in hepatology and oncology but has absolutely no application in endocrinology or hyperthyroidism management. 1