SummarySevere iodine-induced thyrotoxicosis may pose a clinical dilemma because of its prolonged refractoriness to most forms of drug therapy. Plasmapheresis was used in five patients with iodine-induced thyrotoxicosis caused by homeopathic drugs, radiographic contrast agents and amiodarone. in two patients with underlying Graves’disease, several months of treatment with high doses of antithyroid drugs and 13-blockers did not improve the thyrotoxicosis. Plasmapheresis eventually resulted in a rapid decline of peripheral thyroid hormone levels and euthyroidism was achieved in one patient. Nevertheless no long term beneficial effect could be demonstrated since both patients further required other therapy. In three patients witli amiodarone-induced thyrotoxicosis, of whom two were in a life-threatening situation, plasmapheresis was able to restore euthyroidism in a short period of time. 1 lowcver, our observations suggest that plasmapheresis alone cannot cure iodine-induced thyrotoxicosis unless other therapeutic agents are added firstly to prevent further synthesis of thyroid hormones (antithyroid drugs) and secondly to block the release of preformed thyroid hormones from the thyroid gland (corticosteroids and iodine).