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Sample records for hyperthyroidism cirugia radioguiada

  1. Cirugía radioguiada para la extirpación de un quiste paratiroideo gigante con hiperparatiroidismo Radio-guided surgery for removal of a giant parathyroid cyst related to hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Edelberto Fuentes Valdés

    2009-04-01

    Full Text Available Entre los avances actuales del tratamiento quirúrgico del hiperparatiroidismo se encuentra la localización preoperatoria de la(s glándula(s hiperfuncionante(s mediante gammagrafía preoperatoria e intraoperatoria, esta última a través de una sonda gamma especial. Por otro lado, los quistes paratiroideos son raros; pueden ser funcionantes o no. Se describe un nuevo caso de quiste paratiroideo hiperfuncionante, así como los hallazgos de la gammagrafía con 99mTc-MIBI y el uso intraoperatorio de la sonda gamma para evaluar todos los sitios probables donde pudieran existir glándulas hiperproductoras de hormona paratiroidea. Se describen aspectos de la manipulación, seguridad y administración del radiofármaco en el período preoperatorio inmediato, así como la utilización de la sonda gamma durante la intervención. Se informa la evolución durante el seguimiento. Este caso representa el tercer paciente intervenido por hiperparatiroidismo mediante cirugía radioguiada en nuestro centro, institución en la que se introdujo esta técnica en el paísAmong present advances of surgical treatment of hyperthyroidism is the preoperative localization of hyper-functioning glands by preoperative and intraoperative scan, this later one by a special gamma probe. By the other hand, parathyroid cysts are rare; may be of functioning type or not, as well as the findings of 99mTc-MIBI, and the intraoperative use of gamma probe to assess all the possible sites where could be hyperproductive glands of parathyroid hormone. We describe features of management, safety, and administration of radiological agent during the immediate preoperative period, as well as use of gamma probe during intervention. Evolution over follow-up is reported. This case represents the third patient operated on from hyperthyroidism by radio-guided surgery in our center, which introduced this technique in our country.

  2. Hyperthyroidism

    Science.gov (United States)

    ... hormones than your body needs. This is called hyperthyroidism. Hyperthyroidism is more common in women, people with other ... cause the neck to look swollen To diagnose hyperthyroidism, your doctor will do a physical exam, look ...

  3. Hyperthyroidism

    Science.gov (United States)

    ... affect quality of life. Possible Complications Thyroid crisis (storm) is a sudden worsening of hyperthyroidism symptoms that ... hyperthyroidism; Thyroid hormone - hyperthyroidism Images Endocrine glands Goiter Brain-thyroid link Thyroid gland References Bahn RS, Burch ...

  4. Hyperthyroidism

    Science.gov (United States)

    ... or your loved one show these symptoms. What causes hyperthyroidism? Hyperthyroidism has several causes, including Graves’ disease, thyroid ... sometimes is permanent. Several types of thyroiditis can cause hyperthyroidism and then cause hypothyroidism: Subacute thyroiditis. This condition ...

  5. Hyperthyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Luft, D.

    1982-03-22

    Among the various forms of thyroiditis Hashimoto's chronic lymphocytic thyroiditis and the Quervain's subacute granulomatous thyroiditis are most frequent, which normally do not lead to diagnostic difficulties. During the last years several cases of a chimeric condition, socalled hyperthyroiditis, have been described. Clinical picture, blood chemistry, immunologic and histologic phenomena, therapy, course and prognosis include a mixture of symptoms and signs, otherwise characteristic of either Hashimoto's or de Quervain's thyroiditis. The combination of hyperthyroidism and decreased iodine untake by the thyroid is crucial for diagnosis. Treatment with betaadrenergic blocking agents only is sufficient. Antithyroid drugs, surgical measures or radioiodine are not indicated, because the condition remits spontaneously, resulting in a euthyroid state after about three months.

  6. Estrategias de proteccion pulmonar en cirugia cardiovascular

    National Research Council Canada - National Science Library

    Ariza Cadena, Fredy; Dario Santos-Cerquera, Raul

    2012-01-01

    .... Las respuestas inflamatoria pulmonar y sistemica secundarias en el paciente de cirugia mayor y cardiovascular, es generada en gran parte por la sobredistencion/compresion de la celulas alveolares...

  7. Dosimetry of professionals involved in radio guided surgery; Dosimetria de los profesionales involucrados en la cirugia radioguiada

    Energy Technology Data Exchange (ETDEWEB)

    Barreto, A. C.; Cardoso, G.; Ferreira, L. S.; Santos, A. I.

    2013-07-01

    The procedure of sentinel node localization is important because it allows less invasive staging of breast cancer. With the capture probe after intradermal injection of the radiopharmaceutical, the surgeon can identify the location of the sentinel node. The use of radioactive materials, generated considerable concern in terms of radiation exposure. The main objective is to evaluate the possible individual dose of each professional involved in the process of radio-location. (Author)

  8. Quality Control of a detector probe for radio guided surgery; Control de calidad de una sonda detectora para cirugia radioguiada

    Energy Technology Data Exchange (ETDEWEB)

    Barreto, A. C.; Cardoso, G.; Ferreira, L. S.; Santos, A.

    2013-07-01

    Breast cancer is the most common tumor in women, with increasing incidence worldwide. The dissection axillary lymph node is a reason for increased morbidity of breast surgery and have been replaced by sentinel node biopsy. The quality and performance of the detector probe affect the success of sentinel node surgery. The main objective of this work is to develop a set of practical tests to evaluate the performance of a probe for detecting sentinel node. (Author)

  9. Hyperthyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism...

  10. Hyperthyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism....... METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for primary hyperthyroidism? What are the effects of surgical treatments for primary hyperthyroidism? What are the effects of treatments for subclinical...... hyperthyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US...

  11. Hyperthyroidism (primary)

    OpenAIRE

    Nygaard, Birte

    2008-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma.About 20 times more women than men have hyperthyroidism.

  12. Hyperthyroidism (primary)

    OpenAIRE

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone (TSH). Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma.About 20 times more women than men have hyperthyroidism.

  13. Factitious hyperthyroidism

    Science.gov (United States)

    ... occur from taking too much thyroid hormone medicine. Causes The thyroid gland produces the hormones thyroxine (T4) and triiodothyronine (T3). In most cases of hyperthyroidism , the thyroid gland itself produces too much of ...

  14. Subclinical hyperthyroidism

    OpenAIRE

    2013-01-01

    Background: Subclinical hyperthyroidism occurs when peripheral thyroid hormone levels are within the normal labaratory reference range and serum thyroid stimulating hormone level is less than normal. For patients with sustained subclinical hyperthyroidism (serum TSH level< 0/1mlu/L), therapy is recommended especially in older patients. Observation or selective therapy should be considered for patients with: Serum TSH level between 0/1 and 0/4 mlu/L and postmonoposel osteoprosis, recent atrial...

  15. Subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Kalantar Hormozi

    2013-09-01

    Full Text Available Background: Subclinical hyperthyroidism occurs when peripheral thyroid hormone levels are within the normal labaratory reference range and serum thyroid stimulating hormone level is less than normal. For patients with sustained subclinical hyperthyroidism (serum TSH level< 0/1mlu/L, therapy is recommended especially in older patients. Observation or selective therapy should be considered for patients with: Serum TSH level between 0/1 and 0/4 mlu/L and postmonoposel osteoprosis, recent atrial fibrillation congestive heart failure, angina pectoris and infertility or menstrual disorder. This review article aimed to assess the indication of treatment of the patients with subclinical hypothyroidism. Material and Methods: The sample size of this study was the article index in block cochrance, embase, pubmed databases and enutained the terms subclinical hyperthyroid, thyroxin, and thyrotropin. Results: 209 articles were found that 53 articles were investigated for this issue. The results are discussed under the subtitles such as subclinical hypothyroidism and indication of treatment of subclinical hyperthyroidism. Conclusion: In this summary, we tried to review the current literature about subclinical hyperthyroidism and indication of treatment of subclinical hyperthyroidism.

  16. Hyperthyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2010-01-01

    hyperthyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US...

  17. [Subclinical hyperthyroidism].

    Science.gov (United States)

    Feldkamp, J

    2013-10-01

    Subclinical hyperthyroidism is defined as abnormal low TSH level with thyroid hormones within their reference range. This laboratory condition may be symptomatic in a relevant number of patients leading to tachycardia, sweating, nervousness, anxiety and insomnia. The risk for cardiovascular disease is increased with more frequent atrial fibrillation and increased left ventricular mass including diastolic dysfunction. Cardiovascular mortality and overall mortality surmounts the average of the normal population. Longterm TSH suppression leads to decreased bone mineral density and an increased fracture rate in the hip and in the spine. After evaluation of underlying causes, therapy should be considered, especially if TSH levels are below 0.1 mIU/l. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Prevencion del sindrome doloroso regional complejo asociado a cirugia. Una revision de la literatura

    National Research Council Canada - National Science Library

    Lopez Garcia, Daniel; Cordoba-Fernandez, Antonio; Juarez-Jimenez, Jose Maria; Rayo-Rosado, Rafael

    2011-01-01

    .... Su etiologia es diversa, se asocia con frecuencia a inmovilizaciones prolongadas tras cirugia o a traumatismos y se caracteriza por presentar una clinica variable con presencia de dolor intenso...

  19. Hyperthyroidism and psychiatric morbidity

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2014-01-01

    Thyroid hormones are essential for the normal development of the fetal brain, while hyperthyroidism in adults is associated with mood symptoms and reduced quality of life. We aimed to investigate the association and temporal relation between hyperthyroidism and psychiatric morbidity....

  20. Hyperthyroidism (Overactive Thyroid)

    Science.gov (United States)

    ... Plummer's disease (toxic multinodular goiter) and thyroiditis, can cause hyperthyroidism. Your thyroid is a butterfly-shaped gland at ... too much T-4, is the most common cause of hyperthyroidism. Normally, your immune system uses antibodies to help ...

  1. Excess mortality in hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans; Pedersen, Dorthe Almind; Christensen, Kaare

    2012-01-01

    Hyperthyroidism is associated with severe comorbidity, such as stroke, and seems to confer increased mortality. However, it is unknown whether this increased mortality is explained by hyperthyroidism per se, comorbidity, and/or genetic confounding.......Hyperthyroidism is associated with severe comorbidity, such as stroke, and seems to confer increased mortality. However, it is unknown whether this increased mortality is explained by hyperthyroidism per se, comorbidity, and/or genetic confounding....

  2. Hyperthyroidism and Jaundice

    OpenAIRE

    Bal, CS; Chawla, Madhavi

    2010-01-01

    Development of hyperbilirubinemia, concurrent or subsequent to hyperthyroidism, can be due to thyrotoxicosis per se, or due to drug treatment of hyperthyroidism. Other rare conditions: autoimmune thyroid disease, or causes unrelated to hyperthyroidism like viral hepatitis, alcohol abuse, sepsis, cholangitis, or as a side effect of certain medications. In this article, we review these causes of co-existent hyperthyroidism and jaundice. We also highlight the changes to be expected while interpr...

  3. Hyperthyroidism and Jaundice

    OpenAIRE

    Bal, CS; Chawla, Madhavi

    2010-01-01

    Development of hyperbilirubinemia, concurrent or subsequent to hyperthyroidism, can be due to thyrotoxicosis per se, or due to drug treatment of hyperthyroidism. Other rare conditions: autoimmune thyroid disease, or causes unrelated to hyperthyroidism like viral hepatitis, alcohol abuse, sepsis, cholangitis, or as a side effect of certain medications. In this article, we review these causes of co-existent hyperthyroidism and jaundice. We also highlight the changes to be expected while interpr...

  4. Hyperthyroidism in pregnancy

    OpenAIRE

    Nygaard, Birte

    2015-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone (TSH). Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism in pregnancy are Graves' disease and chorionic gonadotrophin (hCG)-mediated hyperthyroidism.

  5. Hipertiroidismo Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Adalberto Infante Amorós

    2012-12-01

    Full Text Available El hipertiroidismo se presenta con un cuadro clínico característico por la hiperproducción de hormonas tiroideas por el tiroides, y obedece a múltiples causas. Su forma clínica más frecuente es el bocio tóxico difuso o enfermedad de Graves Basedow. Es un síndrome caracterizado por manifestaciones de tirotoxicosis, bocio y manifestaciones extratiroideas, entre las que se encuentra la orbitopatía, que en ocasiones sigue un curso independiente de la enfermedad tiroidea. El interrogatorio, el examen físico y la determinación de hormonas tiroideas, son suficientes para confirmar el diagnóstico. Los pilares básicos del tratamiento, además de una adecuada orientación higiénico-dietética, son: el medicamentoso, el radioyodo y la cirugía, y su indicación debe ser individualizada para evitar la toma de conductas inadecuadas e innecesarias.Hyperthyroidism has a clinical picture characterized by overproduction of thyroid hormones by the thyroid gland and is derived from a number of causes. The most frequent clinical presentation is toxic diffuse goiter or Graves Basedow's disease. It is a syndrome with thyrotoxicosis, goiter and extrathyroid manifestations such as orbitopathy that occasionally develops regardless of the thyroid disease. Questioning, physical exam and estimation of thyroid hormones are enough to confirm the diagnosis. In addition to adequate hygienic-dietary orientation, the basis pillars of the treatment are drugs, radioiodine and surgery, but indication of treatment should be personalized to avoid inadequate and unnecessary behaviors.

  6. Hyperthyroidism in pregnancy.

    Science.gov (United States)

    Cooper, David S; Laurberg, Peter

    2013-11-01

    Changes in thyroid hormone concentrations that are characteristic of hyperthyroidism must be distinguished from physiological changes in thyroid hormone economy that occur in pregnancy, especially in the first trimester. Approximately one to two cases of gestational hyperthyroidism occur per 1000 pregnancies. Identification of hyperthyroidism in a pregnant woman is important because adverse outcomes can occur in both the mother and the offspring. Graves' disease, which is autoimmune in nature, is the usual cause; but hyperthyroidism in pregnancy can be caused by any type of hyperthyroidism--eg, toxic multinodular goitre or solitary autonomously functioning nodule. Gestational transient thyrotoxicosis is typically reported in women with hyperemesis gravidarum, and is mediated by high circulating concentrations of human chorionic gonadotropin. Post-partum thyroiditis occurs in 5-10% of women, and many of those affected ultimately develop permanent hypothyroidism. Antithyroid drug treatment of hyperthyroidism in pregnant women is controversial because the usual drugs--methimazole or carbimazole--are occasionally teratogenic; and the alternative--propylthiouracil--can be hepatotoxic. Fetal hyperthyroidism can be life-threatening, and needs to be recognised as soon as possible so that treatment of the fetus with antithyroid drugs via the mother can be initiated. In this Review, we discuss physiological and pathophysiological changes in thyroid hormone economy in pregnancy, the diagnosis and management of hyperthyroidism during pregnancy, severe life-threatening thyrotoxicosis in pregnancy, neonatal thyrotoxicosis, and post-partum hyperthyroidism.

  7. Hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2015-01-01

    : We conducted a systematic review and aimed to answer the following clinical question: What are the effects of antithyroid drug treatments for hyperthyroidism in pregnancy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews......INTRODUCTION: Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism in pregnancy are Graves' disease and chorionic gonadotrophin (hCG)-mediated hyperthyroidism. METHODS AND OUTCOMES...

  8. Hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2015-01-01

    INTRODUCTION: Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism in pregnancy are Graves' disease and chorionic gonadotrophin (hCG)-mediated hyperthyroidism. METHODS AND OUTCOMES......: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of antithyroid drug treatments for hyperthyroidism in pregnancy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews...

  9. Hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2015-01-01

    INTRODUCTION: Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism in pregnancy are Graves' disease and chorionic gonadotrophin (hCG)-mediated hyperthyroidism. METHODS AND OUTCOMES......: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of antithyroid drug treatments for hyperthyroidism in pregnancy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2014 (Clinical Evidence reviews...

  10. Adrenocortical reserves in hyperthyroidism.

    Science.gov (United States)

    Agbaht, Kemal; Gullu, Sevim

    2014-02-01

    Explicit data regarding the changes in adrenocortical reserves during hyperthyroidism do not exist. We aimed to document the capability (response) of adrenal gland to secrete cortisol and DHEA-S during hyperthyroidism compared to euthyroidism, and to describe factors associated with these responses. A standard-dose (0.25 mg/i.v.) ACTH stimulation test was performed to the same patients before hyperthyroidism treatment, and after attainment of euthyroidism. Baseline cortisol (Cor(0)), DHEA-S (DHEA-S(0)), cortisol binding globulin (CBG), ACTH, calculated free cortisol (by Coolen's equation = CFC), free cortisol index (FCI), 60-min cortisol (Cor(60)), and DHEA-S (DHEA-S(60)), delta cortisol (ΔCor), delta DHEA-S (ΔDHEA-S) responses were evaluated. Forty-one patients [22 females, 49.5 ± 15.2 years old, 32 Graves disease, nine toxic nodular goiter] had similar Cor(0), DHEA-S(0), CFC, FCI, and DHEA-S(60) in hyperthyroid and euthyroid states. Cor(60), ΔCor, and ΔDHEA-S were lower in hyperthyroidism. In four (10 %) patients the peak ACTH-stimulated cortisol values were lower than 18 μg/dL. When the test repeated after attainment of euthyroidism, all of the patients had normal cortisol response. Regression analysis demonstrated an independent association of Cor(60) with free T3 in hyperthyroidism. However, the predictors of CFC, FCI, and DHEA-S levels were serum creatinine levels in hyperthyroidism, and both creatinine and transaminase levels in euthyroidism. ACTH-stimulated peak cortisol, delta cortisol, and delta DHEA-S levels are decreased during hyperthyroidism, probably due to increased turnover. Since about 10 % of the subjects with hyperthyroidism are at risk for adrenal insufficiency, clinicians dealing with Graves' disease should be alert to the possibility of adrenal insufficiency during hyperthyroid stage.

  11. Hyperthyroidism in pregnancy.

    Science.gov (United States)

    Mestman, Jorge H

    2012-10-01

    Successful outcome in pregnancy hyperthyroidism depends on the cause, interpretation of laboratory tests, and careful use of antithyroid drug (ATD) therapy. Planning of a pregnancy in a woman with active or past history of Graves' hyperthyroidism is mandatory in order to avoid complications. Fetal health may be affected by three factors: poor control of maternal hyperthyroidism, titer of maternal TRAb, and inappropriate use of ATD. Careful assessment of thyroid function through pregnancy and evaluation of fetal development by ultrasonography is the cornerstone for a successful outcome. In a subgroup of women previously treated with ablation therapy, those whose serum TSRAb titers remained elevated, are at risk of having a fetus/neonate with Graves' hyperthyroidism. Use of ATD during lactation is well tolerated, if recommended guidelines are followed. Women during their childbearing age with active Graves' hyperthyroidism should plan their pregnancy. Causes of hyperthyroidism in pregnancy include Graves' disease or autonomous adenoma, and transient gestational thyrotoxicosis as a consequence of excessive production of human chroionic gonadotropin by the placenta. Careful interpretation of thyroid function tests and frequent adjustment of ATD is of utmost importance in the outcome of pregnancy. Graves' hyperthyroidism may relapse early in pregnancy or at the end of the first year postpartum.

  12. Lithium-associated hyperthyroidism.

    Science.gov (United States)

    Siyam, Fadi F; Deshmukh, Sanaa; Garcia-Touza, Mariana

    2013-08-01

    Goiters and hypothyroidism are well-known patient complications of the use of lithium for treatment of bipolar disease. However, the occurrence of lithium-induced hyperthyroidism is a more rare event. Many times, the condition can be confused with a flare of mania. Monitoring through serial biochemical measurement of thyroid function is critical in patients taking lithium. Hyperthyroidism induced by lithium is a condition that generally can be controlled medically without the patient having to discontinue lithium therapy, although in some circumstances, discontinuation of lithium therapy may be indicated. We report on a patient case of lithium-associated hyperthyroidism that resolved after discontinuation of the medication.

  13. Hyperthyroid hypokalemic periodic paralysis.

    Science.gov (United States)

    Neki, N S

    2016-01-01

    Hyperthyroid periodic paralysis (HPP) is a rare life threatening complication of hyperthyroidism commonly occurring in young Asian males but sporadically found in other races. It is characterised by hypokalemia and acute onset paraparesis with prevalence of one in one hundred thousand (1 in 100000). The symptoms resolve promptly with potassium supplementation. Nonselective beta blockers like propranol can also be used to ameliorate and prevent subsequent paralytic attack. We report a case of 22 year old male presenting with hyperthyroid periodic paralysis (HPP) having very low serum potassium level.

  14. [Hyperthyroidism in molar pregnancy].

    Science.gov (United States)

    Boufettal, H; Mahdoui, S; Noun, M; Hermas, S; Samouh, N

    2014-03-01

    Hyperthyroidism is a rare complication of molar pregnancy. We report a 39-year-old woman who presented a thyrotoxic syndrome accompanying a molar pregnancy. Serum thyroid hormones were elevated and returned to normal level after uterine evacuation of a molar pregnancy. The authors detail the role of thyroid stimulating property of human gonadotropin chorionic hormone and its structural changes during the gestational trophoblastic diseases. These changes give the latter the thyroid stimulating properties and signs of hyperthyroidism. Molar pregnancy may be a cause of hyperthyroidism. The diagnosis of molar pregnancy should be a mention to thyrotoxicosique syndrome in a woman of childbearing age. Copyright © 2013. Published by Elsevier SAS.

  15. Cardiovascular manifestations in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Vairamani Kandan

    2016-07-01

    Conclusions: This study shows that cardiovascular manifestations are quite common and varied in hyperthyroidism which are to be looked for in the management. [Int J Res Med Sci 2016; 4(7.000: 3032-3038

  16. Predictivos de las actitudes hacia la cirugia cosmetica entre mujeres universitarias colombianas y estadounidenses: los roles de las conductas de alimentacion y de las variables demograficas

    National Research Council Canada - National Science Library

    Carrion, Carmen; Weinberger-Litman, Sarah; Rabin, Laura A; Fogel, Joshua

    2011-01-01

    .... Ademas, los procedimientos de cirugia estetica se han incrementado rapidamente en los Estados Unidos y Colombia, e investigaciones preliminares sugieren una relacion positiva entre los TCA y el...

  17. Update on subclinical hyperthyroidism.

    Science.gov (United States)

    Donangelo, Ines; Braunstein, Glenn D

    2011-04-15

    Subclinical hyperthyroidism is defined by low or undetectable serum thyroid-stimulating hormone levels, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (as in Graves disease or toxic nodular goiter), administration of thyroid hormone for treatment of malignant thyroid disease, or unintentional excessive thyroid hormone therapy. The rate of progression to overt hyperthyroidism is higher in persons who have suppressed thyroid-stimulating hormone levels compared with those who have low but detectable levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation in older adults, and with decreased bone mineral density in postmenopausal women; however, the effectiveness of treatment in preventing these conditions is unknown. There is lesser-quality evidence suggesting an association between subclinical hyperthyroidism and other cardiovascular effects, including increased heart rate and left ventricular mass, and increased bone turnover markers. Possible associations between subclinical hyperthyroidism and quality of life parameters, cognition, and increased mortality rates are controversial. Prospective randomized controlled trials are needed to address the effects of early treatment on potential morbidities to help determine whether screening should be recommended in the asymptomatic general population.

  18. Hyperthyroidism and pregnancy.

    Science.gov (United States)

    Gargallo Fernández, Manuel

    2013-11-01

    Association of hyperthyroidism and pregnancy is not an unusual event, and has an impact on both the mother and fetus. After delivery, it may also affect the newborn and the nursing mother. Clinical management of this situation is quite different from that required by non-pregnant hyperthyroid women and poses significant diagnostic and therapeutic challenges. This review addresses aspects related to the unique characteristics of biochemical assessment of thyroid function in pregnancy, the potential causes of hyperthyroidism in pregnancy, and the clinical and therapeutic approach in each case. Special attention is paid to pregnancy complicated with Graves' disease and its different the maternal, fetal, neonatal, and postnatal consequences. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  19. Managing hyperthyroidism in pregnancy

    DEFF Research Database (Denmark)

    Andersen, Stine Linding; Laurberg, Peter

    2016-01-01

    -associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development...... of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management...... involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering...

  20. Hyperthyroidism: Diagnosis and Treatment.

    Science.gov (United States)

    Kravets, Igor

    2016-03-01

    Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of thyroid hormones are Graves disease, toxic multinodular goiter, and toxic adenoma. The most common cause of an excessive passive release of thyroid hormones is painless (silent) thyroiditis, although its clinical presentation is the same as with other causes. Hyperthyroidism caused by overproduction of thyroid hormones can be treated with antithyroid medications (methimazole and propylthiouracil), radioactive iodine ablation of the thyroid gland, or surgical thyroidectomy. Radioactive iodine ablation is the most widely used treatment in the United States. The choice of treatment depends on the underlying diagnosis, the presence of contraindications to a particular treatment modality, the severity of hyperthyroidism, and the patient's preference.

  1. Criteria of quality in radio guided surgery for detection and removal of sentinel node in non-palpable lesions; Criterios de calidad en cirugia radioguiada pra deteccion y extirpacion de ganclio centinela en lesiones no palpables

    Energy Technology Data Exchange (ETDEWEB)

    Prieto, D.; Esteve, S.; Sanchez, K.; Rodriguez, P.; Barquero, R.; Ferrer, N.; Arranz, L.

    2013-07-01

    The first objective of this study is to carry out a theoretical study of the dose absorbed in the breast, comparing different types of source used, and according to location of the same. On the other hand, for the location of these nodes, or tumors in the operating room, can be used as well as portable gamma-cameras, intraoperative sensor probes of gamma radiation, facilitating the work the surgeon. Currently there is no protocol at national level describing quality control tests to be carried out on these computers. The second objective of the study is to collect a series of tests that enable to verify the correct operation of an intraoperative probe. These tests are classified according to their frequency, specialist, and test type, and allow you to check if the effectiveness of the operation of the probe is provided in your acquisition. Among the parameters that let you check the performance specifications are sensitivity, angular resolution and spatial resolution. (Author)

  2. Management of subclinical hyperthyroidism.

    Science.gov (United States)

    Santos Palacios, Silvia; Pascual-Corrales, Eider; Galofre, Juan Carlos

    2012-01-01

    The ideal approach for adequate management of subclinical hyperthyroidism (low levels of thyroid-stimulating hormone [TSH] and normal thyroid hormone level) is a matter of intense debate among endocrinologists. The prevalence of low serum TSH levels ranges between 0.5% in children and 15% in the elderly population. Mild subclinical hyperthyroidism is more common than severe subclinical hyperthyroidism. Transient suppression of TSH secretion may occur because of several reasons; thus, corroboration of results from different assessments is essential in such cases. During differential diagnosis of hyperthyroidism, pituitary or hypothalamic disease, euthyroid sick syndrome, and drug-mediated suppression of TSH must be ruled out. A low plasma TSH value is also typically seen in the first trimester of gestation. Factitial or iatrogenic TSH inhibition caused by excessive intake of levothyroxine should be excluded by checking the patient's medication history. If these nonthyroidal causes are ruled out during differential diagnosis, either transient or long-term endogenous thyroid hormone excess, usually caused by Graves' disease or nodular goiter, should be considered as the cause of low circulating TSH levels. We recommend the following 6-step process for the assessment and treatment of this common hormonal disorder: 1) confirmation, 2) evaluation of severity, 3) investigation of the cause, 4) assessment of potential complications, 5) evaluation of the necessity of treatment, and 6) if necessary, selection of the most appropriate treatment. In conclusion, management of subclinical hyperthyroidism merits careful monitoring through regular assessment of thyroid function. Treatment is mandatory in older patients (> 65 years) or in presence of comorbidities (such as osteoporosis and atrial fibrillation).

  3. Management of Subclinical Hyperthyroidism

    Science.gov (United States)

    Santos Palacios, Silvia; Pascual-Corrales, Eider; Galofre, Juan Carlos

    2012-01-01

    The ideal approach for adequate management of subclinical hyperthyroidism (low levels of thyroid-stimulating hormone [TSH] and normal thyroid hormone level) is a matter of intense debate among endocrinologists. The prevalence of low serum TSH levels ranges between 0.5% in children and 15% in the elderly population. Mild subclinical hyperthyroidism is more common than severe subclinical hyperthyroidism. Transient suppression of TSH secretion may occur because of several reasons; thus, corroboration of results from different assessments is essential in such cases. During differential diagnosis of hyperthyroidism, pituitary or hypothalamic disease, euthyroid sick syndrome, and drug-mediated suppression of TSH must be ruled out. A low plasma TSH value is also typically seen in the first trimester of gestation. Factitial or iatrogenic TSH inhibition caused by excessive intake of levothyroxine should be excluded by checking the patient’s medication history. If these nonthyroidal causes are ruled out during differential diagnosis, either transient or long-term endogenous thyroid hormone excess, usually caused by Graves’ disease or nodular goiter, should be considered as the cause of low circulating TSH levels. We recommend the following 6-step process for the assessment and treatment of this common hormonal disorder: 1) confirmation, 2) evaluation of severity, 3) investigation of the cause, 4) assessment of potential complications, 5) evaluation of the necessity of treatment, and 6) if necessary, selection of the most appropriate treatment. In conclusion, management of subclinical hyperthyroidism merits careful monitoring through regular assessment of thyroid function. Treatment is mandatory in older patients (> 65 years) or in presence of comorbidities (such as osteoporosis and atrial fibrillation). PMID:23843809

  4. Radioactive Iodine (I-131) Therapy for Hyperthyroidism

    Science.gov (United States)

    ... treatment for an overactive thyroid, a condition called hyperthyroidism, and also may be used to treat thyroid ... treatment for an overactive thyroid, a condition called hyperthyroidism . Hyperthyroidism can be caused by Graves' disease, in ...

  5. Hipertireoidismo felino Feline hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Marina Gabriela Monteiro Carvalho Mori da Cunha

    2008-08-01

    Full Text Available O hipertireoidismo é considerado a endocrinopatia mais comum em felinos de meia idade a idosos, nos Estados Unidos e na Europa. No entanto, ainda existem poucos casos relatados no Brasil. O diagnóstico precoce e o tratamento adequado tornam o prognóstico do animal mais favorável, podendo até se obter a cura do paciente. Devido à importância desta afecção em felinos, são abordados, nesta revisão, os aspectos clínicos, diagnósticos e terapêuticos do hipertireoidismo felino.Hyperthyroidism is the most common endocrinopathy of middle aged and older cats in the United States and Europe, however there are few related cases in Brazil yet. The early diagnosis and the correct treatment become the prognosis more favorable, leading to patient cure. This paper reviews the clinical, diagnosis and therapeutic aspects of feline hyperthyroidism.

  6. Practical management of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Houston, M.S.; Hay, I.D. (Mayo Clinic, Rochester, MN (USA))

    1990-03-01

    There are several causes of hyperthyroidism, and correct diagnosis is essential for management. Graves' disease is most commonly managed with radioactive iodine therapy ({sup 131}I), antithyroid drugs or surgery. Toxic adenomas (single or multiple) may be treated with {sup 131}I or surgery. Most types of thyroiditis are managed expectantly. Pregnant women, children and the elderly deserve special consideration. Follow-up is vital to identify the later development of hypothyroidism.18 references.

  7. Congenital hyperthyroidism: autopsy report

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    Lima Marcus Aurelho de

    1999-01-01

    Full Text Available We report the autopsy of a stillborn fetus with congenital hyperthyroidism born to a mother with untreated Graves' disease, whose cause of death was congestive heart failure. The major findings concerned the skull, thyroid, heart, and placenta. The cranial sutures were closed, with overlapping skull bones. The thyroid was increased in volume and had intense blood congestion. Histological examination showed hyperactive follicles. The heart was enlarged and softened, with dilated cavities and hemorrhagic suffusions in the epicardium. The placenta had infarctions that involved at least 20% of its surface, and the vessels of the umbilical cord were fully exposed due to a decrease in Wharton 's jelly. Hyperthyroidism was confirmed by the maternal clinical data, the fetal findings of exophthalmia, craniosynostosis, and goiter with signs of follicular hyperactivity. Craniosynostosis is caused by the anabolic action of thyroid hormones in bone formation during the initial stages of development. The delayed initiation of treatment in the present case contributed to the severity of fetal hyperthyroidism and consequent fetal death.

  8. Differential diagnosis of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Emrich, D.

    1984-04-23

    There are probably two reasons for hyperthyroidism: 1. A disturbance in the immune system. This leads to the production of autoantibodies which predominantly stimulate thyroid function. 2. An increased formation of autonomus follicles in the thyroid gland during the development of a goiter. Autonomus follicies can be located within the thyroid gland in a focal or disseminated pattern. They are found predominantly in bigger, long-standing goiters with degenerative areas. The extent of autonomy is probably determined by the amount to autonomous follicles and their activity. In the euthyroid state autonomy can be detected by a subnormal TRH test. Quantitative scintigraphy under suppression is probably more sensitive. In goiters with autonomy, transition from the euthyroid into the hyperthyroid state especially in areas of iodine deficiency is often induced by application of iodine containing drugs and X-ray media. It the patient is already in a hyperthyroid state its immunogenic and non-immunogenic origin can be recognized with rather high probability by certain clinical symptoms and by some simple laboratory investigations. This may have significance for the selection of therapy.

  9. Stepwise diagnosis of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Hehrmann, R.

    1982-03-22

    In vitro and in vivo procedures available for the diagnosis of thyroid diseases and for hyperthyroidism in particular are summarizid in a stepwise diagnostic program, which is in agreement with the recommendations of the 'Sektion Schilddruese der Deutschen Gesellschaft fuer Endokrinologie'. The in vitro methods (determinations of total T/sub 3/ and T/sub 4/, TSH before and after TRH, TBG and thyroglobulin, parameters of the binding capacity and of free hormone concentrations, antibody determinations) are convenient for the patient, since all measurements can be done from one or two blood samples, and they are not influenced by iodine exposure. The laboratory methods - mainly radio-immunoassays are complicated and need careful quality control. The in vivo procedures are inconvenient for the patient and mean - in the case of the two phase radioiodine uptake test - interruption of work, multiple clinic visits and exposure to radiation. They are influenced by iodine exposure but are easy to perform, and quality control is simple. Because of the high radiation dose to the tyroid gland in vivo methods (radioiodine uptake test, technetium uptake test, suppression tests, iodide clearances and scintigraphy) should no longer be carried out with /sup 131/J, but rather with sup(99m)Tc or /sup 123/J. Stepwise approaches are proposed for excluding or confirming hyperthyroidism, characterizing Graves' disease, diagnosing solitary or multilocular toxic adenoma and for supervising the therapy of hyperthyroidism.

  10. Descripcion de las causas y tipos de tratamiento efectuados en dientes con invasion del espacio biologico o con necesidad de cirugia preprotesica: serie de casos

    National Research Council Canada - National Science Library

    Andrade Acevedo, Roberto Antonio; Hernandez, Morena; Machon, Lourdes; Espinoza, Manuel Antonio; Hidalgo de Andrade, Laura Elena

    2010-01-01

    ...) o necesidad de cirugia preprotesica. Metodo: este trabajo es una serie de casos de 162 pacientes de ambos sexos, quienes fueron atendidos en las clinicas de pregrado de la Universidad Evangelica de El Salvador (UEES...

  11. Hyperthyroidism-associated hypercalcemic crisis

    Science.gov (United States)

    Chen, Ke; Xie, Yanhong; Zhao, Liling; Mo, Zhaohui

    2017-01-01

    Abstract Rationale: Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion. Patient concerns: A 58-year-old female patient was found to have Graves’ disease, a marked elevated serum calcium level (adjusted serum calcium: 3.74 mmol/L), and reduced parathyroid hormone level. Diagnoses: She was diagnosed as hyperthyroidism-associated hypercalcemic crisis. Interventions: Treatment with methimazole to correct the hyperthyroidism and treatment of the patient's hypercalcaemia was achieved by physiological saline, salmon calcitonin and furosemide. Outcomes: After treatment for hypercalcaemia and hyperthyroidism, her symptoms and serum calcium levels quickly returned to normal. Lessons: hyperthyroid-associated hypercalcaemia crisis is rare, however, the diagnosis should pay attention to screening for other diseases caused by hypercalcemia. Timely treatment of hypercalcaemia is a critical step for rapidly control of symptoms, and treatment of hyperthyroidism is beneficial to relief the symptoms and maintain the blood calcium level. PMID:28121960

  12. HYPERTHYROIDISM AND ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    I. M. Marusenko

    2017-01-01

    Full Text Available Review on a problem of the development of atrial fibrillation in patients with thyrotoxicosis is presented. Thyrotoxicosis is one of the most frequent endocrine diseases, conceding only to a diabetes mellitus. The most frequent reasons of hyperthyroidism are Graves’ disease and functional thyroid autonomy. The authors give an analysis of data on the cardiac effects of thyrotoxicosis, features of heart remodeling under the influence of thyroid hyperfunction, prevalence of atrial fibrillation in thyrotoxicosis, depending on age, as well as the possibility of restoring sinus rhythm in the combination of these diseases. Particular attention is paid to the effect on the heart of subclinical thyrotoxicosis, which is defined as a dysfunction of the thyroid gland, characterized by low serum concentration of thyrotropin, normal values of free thyroxine and free triiodothyronine. Subclinical hyperthyroidism is also capable of causing heart remodeling and diastolic dysfunction.Prevalence of thyrotoxicosis in elderly people is higher in areas of iodine deficiency; it is relevant for our country due to the large territory of iodine deficiency. In elderly patients, the cardiac effects of thyrotoxicosis prevail in the clinical picture, that makes it difficult to diagnose endocrine disorders, and correction of thyrotoxicosis is critically important for the successful control of the heart rhythm. The article also discusses the problem of thyrotoxic cardiomyopathy, caused by the toxic effect of excess thyroid hormones: features of this heart disorder, factors affecting its formation, clinical significance and contribution to the development of rhythm disturbances. The greatest significance is the development of atrial fibrillation as a result of thyrotox-icosis in older patients who already have various cardiovascular diseases.Atrial fibrillation is the most frequent heart rhythm disorder in thyrotoxicosis. The main cause of arrhythmia in hyperthyroidism is the

  13. Hyperthyroidism-associated hypercalcemic crisis

    OpenAIRE

    Chen, Ke; Xie, Yanhong; Zhao, Liling; Mo, Zhaohui

    2017-01-01

    Abstract Rationale: Hyperthyroidism is one of the major clinical causes of hypercalcaemia, however, hyperthyroidism-related hypercalcemic crisis is rare, only 1 case have been reported. The potential mechanisms are still not too clear. It may be related that thyroid hormone stimulate bone turnover, elevate serum calcium, increase urinary and fecal calcium excretion. Patient concerns: A 58-year-old female patient was found to have Graves? disease, a marked elevated serum calcium level (adjuste...

  14. [Classification and etiology of hyperthyroidism].

    Science.gov (United States)

    Łacka, Katarzyna; Fraczek, Magdalena Maria

    2014-03-01

    The prevalence of hyperthyroidism in women is between 0.5-2% and it is 10 times less common in men. The most common causes are Graves' disease, toxic multinodular goiter, and autonomously functioning thyroid adenoma. Rare causes of hyperthyroidisms are as follow: pituitary adenoma, autoimmune thyroiditis (Hashitoxicosis), levothyroxine overdose, inadequate iodine supplementation (including amiodaron induced hyperthyroidism, iodine-based contrast media), hCG excess (pregnancy, gestational trophoblastic disease, germ-cell tumors), drug induced hyperthyroidism, differentiated thyroid carcinomas and/or their metastases, struma ovarii, and familial nonautoimmune hyperthyroidism. This article focuses on the current data of etiopathogenesis of hyperthyroidisms. Genetic factors (like HLA-DR3,CD40, CTLA-4, PTPN22, FOXP3 CD25) and thyroid specific genes (thyroglobulin, TSHR, G(s)alpha) and environmental and endogenous factors (such as age, iodine, selenium, emotional stress, smoking, gender, pregnancy, sex hormones, fetal microchimerism, fetal growth, bacterial infections, viral infections, allergies, drugs (alemtuzumab, interferon alpha, iplimumab/tremelimumab, tyrosine kinase inhibitors, denileukindiftitox, thalidomide/lenalidomide, exposition to fallout and radiotherapy) have been described.

  15. Se trata de determinar la eficacia y seguridad del acido tranexamico frente a placebo en la reduccion de las perdidas sanguineas asociadas a la cirugia de reemplazo total de cadera | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available reduccion de las perdidas sanguineas asociadas a la cirugia de reemplazo total de cadera MedDRA Classificat...de edad que se les vaya a realizar cirugia de reemplazo total de cadera (CRT)---ASA I-III-Sin alergias al ác

  16. Contrast induced hyperthyroidism due to iodine excess

    OpenAIRE

    Mushtaq, Usman; Price, Timothy; Laddipeerla, Narsing; Townsend, Amanda; Broadbridge, Vy

    2009-01-01

    Iodine induced hyperthyroidism is a thyrotoxic condition caused by exposure to excessive iodine. Historically this type of hyperthyroidism has been described in areas of iodine deficiency. With advances in medicine, iodine induced hyperthyroidism has been observed following the use of drugs containing iodine—for example, amiodarone, and contrast agents used in radiological imaging. In elderly patients it is frequently difficult to diagnose and control contrast related hyperthyroidism, as most...

  17. Biventricular Takotsubo cardiomyopathy in Graves hyperthyroidism.

    Science.gov (United States)

    Perkins, Matthew J; Schachter, David T

    2014-03-01

    Graves hyperthyroidism is commonly seen in clinical practice and Takotsubo stress cardiomyopathy is an increasingly recognized cardiac complication of physical or emotional stress. We report the rare case of a patient with Graves hyperthyroidism that was complicated by severe biventricular takotsubo cardiomyopathy, which was demonstrated on heart catheterization. After appropriate pharmacologic treatment of her hyperthyroidism, she had complete resolution of her cardiomyopathy.

  18. [Management of hypothyroidism and hyperthyroidism].

    Science.gov (United States)

    Jiskra, Jan

    2015-10-01

    Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed. The drug of choice in substitution therapy of hypothyroidism is levothyroxine, in the treatment of hyperthyroidism it is methimazole. Administration of propylthiouracil should be limited to the first trimester of pregnancy, because its serious hepatotoxicity has been described. Hyperthyroidism based on thyroid nodules and immunogenic hyperthyroidism not reaching long-term remission, need to be treated radically: by surgery or radioiodine treatment. When radiation protection requirements are met, radioiodine can also be administered on an outpatient basis. Exceptionally, small doses of methimazole can be administered over an extended period of time in individual cases.

  19. [Reversible first-degree atrioventricular block due to hyperthyroidism].

    Science.gov (United States)

    Çelebi, Aksüyek Savaş; Amasyalı, Basri

    2017-04-01

    Hyperthyroidism often causes tachyarrhythmia. Reversible atrioventricular block caused by hyperthyroidism is rare occurrence. Presently described is a case of atrioventricular block due to hyperthyroidism and recovery after antithyroid treatment.

  20. [Subclinical hyperthyroidism: from diagnosis to treatment].

    Science.gov (United States)

    Corvilain, B

    2012-09-01

    Subclinical hyperthyroidism is a common clinical entity. Subclinical hyperthyroidism is defined as a serum TSH below the reference range but a normal T4 and T3 level in an asymptomatic patient. Whether or not subclinical hyperthyroidism should be treated remains a matter of debate. Cross-sectional studies and longitudinal population-based studies demonstrate association between subclinical hyperthyroidism and risk of atrial fibrillation, osteoporosis and cardiovascular and global mortality. However, there are no randomized clinical trials answering the question whether long term-health outcomes are improved by the treatment of subclinical hyperthyroidism. Therefore in the absence of evidence for or against treatment of subclinical hyperthyroidism, it seems appropriate to follow algorithms that consider the level of TSH and the presence of risks factors (age > 65 years, osteoporosis, post menopause and cardiac disease).

  1. Paroxysmal kinesigenic choreoathetosis in hyperthyroidism.

    OpenAIRE

    Drake, M. E.

    1987-01-01

    Paroxysmal kinesigenic choreoathetosis is an unusual movement disorder often triggered by attempts to use the limbs, and has sometimes been associated with diffuse or focal brain injury. We report its occurrence in hyperthyroidism, with which choreoathetosis has rarely been described in the past without known cause. Choreoathetosis has also occurred with other metabolic and toxic disorders, and the mechanism is uncertain. The development of involuntary movements activated by limb motion durin...

  2. Thyroid Hemiagenesis Associated with Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Gunay Gurleyik

    2015-01-01

    Full Text Available Thyroid hemiagenesis (TH, very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism. Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot nodules in the right one. The diagnosis was toxic multinodular goitre. Case Two. The thyroid was not palpable in this patient presented with signs and symptoms of thyrotoxicosis. Biochemical analysis revealed the diagnosis of autoimmune thyrotoxicosis. Ultrasound showed mild diffuse hyperplasia of the right lobe and agenesis of the left lobe. Nuclear scan, confirming absence of the left lobe, showed increasing diffuse uptake of radiotracer in the right one. The diagnosis was Graves’ disease in this patient. After antithyroid medication, the patients were surgically treated with total excision of the thyroid tissue. TH is sometimes associated with disorders of the thyroid. Hyperthyroidism makes TH cases symptomatic. During evaluation of patients, ultrasound and nuclear scan usually report agenesis of one lobe and establish the diagnosis of TH. The surgical treatment is total removal of hyperactive tissue and total excision of the remaining lobe.

  3. Hyperthyroidism in a renal transplant recipient.

    Science.gov (United States)

    Peces, R; Navascués, R A; Baltar, J; Laurés, A S; Ortega, F; Alvarez-Grande, J

    1998-01-01

    We report a case of toxic multinodular goiter with severe symptomatic hyperthyroidism in a female diagnosed 5 months after successful renal transplantation. To our knowledge, this is the first well-documented case of hyperthyroidism in a renal transplant recipient that responded well to methimazole. Special attention should be made to the use of methimazole and the possible interaction with immunosuppressive drugs.

  4. Hyperthyroidism caused by acquired immune deficiency syndrome.

    Science.gov (United States)

    Wang, J-J; Zhou, J-J; Yuan, X-L; Li, C-Y; Sheng, H; Su, B; Sheng, C-J; Qu, S; Li, H

    2014-01-01

    Acquired immune deficiency syndrome (AIDS) is an immune deficiency disease. The etiology of hyperthyroidism, which can also be immune-related, is usually divided into six classical categories, including hypophyseal, hypothalamic, thyroid, neoplastic, autoimmune and inflammatory hyperthyroidism. Hyperthyroidism is a rare complication of highly active antimicrobial therapy (HAART) for human immunodeficiency virus (HIV). Hyperthyroidism caused directly by AIDS has not been previously reported. A 29-year-old man who complained of dyspnea and asthenia for 1 month, recurrent fever for more than 20 days, and breathlessness for 1 week was admitted to our hospital. The thyroid function test showed that the level of free thyroxine (FT4) was higher than normal and that the level of thyroid-stimulating hormone (TSH) was below normal. He was diagnosed with hyperthyroidism. Additional investigations revealed a low serum albumin level and chest infection, along with diffuse lung fibrosis. Within 1 month, he experienced significant weight loss, no hand tremors, intolerance of heat, and perspiration proneness. We recommended an HIV examination; subsequently, AIDS was diagnosed based on the laboratory parameters. This is the first reported case of hyperthyroidism caused by AIDS. AIDS may cause hyperthyroidism by immunization regulation with complex, atypical, and easily ignored symptoms. Although hyperthyroidism is rare in patients with AIDS, clinicians should be aware of this potential interaction and should carefully monitor thyroid function in HIV-positive patients.

  5. Atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. We present a case of atrial fibrillation associated with subclinical hyperthyroidism, in a 78-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  6. Approach to the patient with subclinical hyperthyroidism.

    Science.gov (United States)

    Cooper, David S

    2007-01-01

    Endogenous subclinical hyperthyroidism, defined by normal circulating levels of free T4 and T3 and low levels of TSH, is a common clinical entity and is typically caused by the same conditions that account for the majority of cases of overt hyperthyroidism: Graves' disease, toxic multinodular goiter, and solitary autonomously functioning thyroid nodules. Subclinical hyperthyroidism has been associated with an increased risk of atrial fibrillation and mortality, decreased bone mineral density in postmenopausal women, and mild hyperthyroid symptoms. Treatment of subclinical hyperthyroidism remains controversial, given the lack of prospective randomized controlled trials showing clinical benefit with restoration of the euthyroid state. Nevertheless, it seems reasonable to treat older individuals whose serum TSH levels are less than 0.1 mU/liter and certain high-risk patients, even when the serum TSH is between 0.1 and the lower limit of the normal range.

  7. Hyperthyroidism Evokes Myocardial Ceramide Accumulation

    Directory of Open Access Journals (Sweden)

    Agnieszka Mikłosz

    2015-01-01

    Full Text Available Background: Thyroid hormones (THs are key regulators of cardiac physiology as well as modulators of different cellular signals including the sphingomyelin/ceramide pathway. The objective of this study was to examine the effect of hyperthyroidism on the metabolism of sphingolipids in the muscle heart. Methods: Male Wistar rats were treated for 10 days with triiodothyronine (T3 at a dose of 50µg/100g of body weight. Animals were then anaesthetized and samples of the left ventricle were excised. Results: We have demonstrated that prolonged, in vivo, T3 treatment increased the content of sphinganine (SFA, sphingosine (SFO, ceramide (CER and sphingomyelin (SM, but decreased the level of sphingosine-1-phosphate (S1P in cardiac muscle. Accordingly, the changes in sphingolipids content were accompanied by a lesser activity of neutral sphingomyelinase and without significant changes in ceramidases activity. Hyperthyroidism also induced activation of AMP-activated protein kinase (AMPK with subsequently increased expression of mitochondrial proteins: cytochrome c oxidase IV (COX IV, β-hydroxyacyl-CoA dehydrogenase (β-HAD, carnityne palmitoyltransferase I (CPT I and nuclear peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α. Conclusions: We conclude that prolonged T3 treatment increases sphingolipids metabolism which is reflected by higher concentration of SFA and CER in heart muscle. Furthermore, hyperthyroidism-induced increase in heart sphingomyelin (SM concentration might be one of the mechanisms underlying maintenance of CER at relatively low level by its conversion to SM together with decreased S1P content.

  8. Treatment of hyperthyroidism in community hospital

    Energy Technology Data Exchange (ETDEWEB)

    Gossain, V.V.; Heath, R.C.; Rovner, D.R.

    1989-01-01

    The preferred treatment of hyperthyroidism remains controversial. Most of this data is derived from large, university-based medical centers. We report here our experience with treatment of hyperthyroidism in a community setting. This involves 144 patients with hyperthyroidism who were seen over a 10 year period at Michigan State University Clinical Center and were treated in the community hospitals and private physicians' offices, and by community surgeons. Follow-up data were available on 119 of these patients; 105 of them were hyperthyroid because of Graves' disease and multinodular goiter. Patients were encouraged to make their own decisions regarding choice of therapy, as independently as possible. Sixty-five percent of these patients were treated by 131I, 18% by antithyroid drugs, and 17% by surgery. The mean follow-up period was 2.5 years (range 2 months to 19 years). Hyperthyroidism was controlled in 84% of the patients treated by 131I and 83% of the patients treated by surgery. Forty percent of the patients treated by 131I and 33% treated by surgery became hypothyroid. Fifty percent of the patients achieved remission when treated by antithyroid drugs alone. Our results indicate that when patients are encouraged to make their own decisions regarding the treatment of hyperthyroidism, their choices are similar to those of the thyroidologists. Secondly, the results obtained with different modalities of treatment for hyperthyroidism in a community setting are similar to those obtained in university medical centers.

  9. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Puneet Khanna

    2012-01-01

    Full Text Available The coexistence of hyperthyroidism with gestational trophoblastic disease is a known albeit rare clinical condition. We herein report the successful anesthetic management of such a case in our institute. There are only few case reports in literature of this association. Often, the diagnosis of hyperthyroid state is retrospective one, as it can be missed in the emergency scenario of patient requiring molar evacuation. This case report highlights the perioperative management and optimization of hyperthyroid state prior to surgical evacuation of the invasive hydatidiform mole.

  10. Reversible dilated cardiomyopathy due to subclinical hyperthyroidism.

    Science.gov (United States)

    Tsarouhas, Kostantinos; Kafantaris, Ioannis; Antonakopoulos, Athanasios; Vavetsi, Spiridoula; Pavlidis, Pavlos; Constantinou, Loizos L

    2010-01-01

    We present a patient without primary heart disease in whom subclinical hyperthyroidism was accompanied by manifestations of dilated cardiomyopathy, as evaluated by echocardiography, coronary angiography, and radionuclide ventriculography. His condition was reversed 6 months after conventional treatment (furosemide, carvedilol, angiotensin-converting-enzyme inhibitor and thiamazole administration). This patient represents an exceptional case, as overt congestive heart failure with left ventricular dilatation and depressed ventricular ejection fraction is not a common finding in patients with hyperthyroidism, let alone patients with subclinical hyperthyroidism and no underlying heart disease.

  11. [Neonatal hyperthyroidism and maternal Graves disease].

    Science.gov (United States)

    Ben Ameur, K; Chioukh, F Z; Marmouch, H; Ben Hamida, H; Bizid, M; Monastiri, K

    2015-04-01

    The onset of Graves disease during pregnancy exposes the neonate to the risk of hyperthyroidism. The newborn must be monitored and treatment modalities known to ensure early treatment of the newborn. We report on the case of an infant born at term of a mother with Graves disease discovered during pregnancy. He was asymptomatic during the first days of life, before declaring the disease. Neonatal hyperthyroidism was confirmed by hormonal assays. Hyperthyroidism was treated with antithyroid drugs and propranolol with a satisfactory clinical and biological course. Neonatal hyperthyroidism should be systematically sought in infants born to a mother with Graves disease. The absence of clinical signs during the first days of life does not exclude the diagnosis. The duration of monitoring should be decided according to the results of the first hormonal balance tests.

  12. [Atypical presentation of an induced hyperthyroidism].

    Science.gov (United States)

    Duque, María Del Pilar Velásquez; Miranda, Jaime Bernal

    2013-03-01

    We present the case of a person with baseline Bipolar Affective Disorder, who starts receiving medical treatment for subclinical Hypothyroidism, during this time the patient develops Hyperthyroidism. During the course of the latter, the patient started to exhibit depressed mood symptoms and worsening of her baseline disorder. Typically there are depressive symptoms in hypothyroidism and manic symptoms in hyperthyroidism, there have been a few cases of depressive symptoms (depressed mood, asthenia and apathy) reported in patients with hyperthyroidism. Up till now it's a fact that Hyperthyroidism constitutes itself as a risk factor for developing or precipitating depressive states, thus increasing hospital readmissions, and another important fact is that of manifesting or worsening affective symptoms due to the influence of thyroid hormones. We also present the well-known relationship between thyroid malfunction and affective disorders. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  13. Neuropsychiatric complications of 500 cases of hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Moetamedi M

    1998-07-01

    Full Text Available Hyperthyroidism is often accompanied by diverse types of neuropychiatric complications. To demonstrate these complications we studied 500 hyperthyroid patients, who developed neuropsychiatric complications of hyperthyroidism for which other causes of these neuropsychiatric findings were carefully excluded. The patients were 15 to 65 years old (female to male ratio was 5:1, most of the cases were in third and fourth decades of life. Nervousness, tense dysphoria, insomnia and anxiousness were among the most common psychiatric complications, and tremor, hyperreflexia, thyrotoxic myopathy, thyrotoxic periodic paralysis were the most common neurologic complications. Therefore any physician, wether he or she is a general practitioner or a specialist must be aware of these diverse complications, because these neuropsychiatric complications can lead to the diagnosis of hyperthyroidism and treatment of these potentially serious complications.

  14. Aetiology of hyperthyroidism in Canada and Wales.

    OpenAIRE

    Williams, I; Ankrett, V O; Lazarus, J. H.; Volpe, R.

    1983-01-01

    A retrospective, comparative review of 100 consecutive new outpatients presenting with hyperthyroidism in Cardiff, South Wales, and in Toronto, Canada, was performed. The aim was to quantify the causes of hyperthyroidism with particular emphasis on the prevalence of viral thyroiditis and "silent" thyroiditis. The proportional morbidity of Graves' disease (approximately 70%) was similar in the two groups. Toxic multinodular goitre and toxic adenoma (Plummers' disease) occurred significantly mo...

  15. Management of hyperthyroidism during pregnancy in Asia.

    Science.gov (United States)

    Azizi, Fereidoun; Amouzegar, Atieh; Mehran, Ladan; Alamdari, Shahram; Subekti, Imam; Vaidya, Bijay; Poppe, Kris; Sarvghadi, Farzaneh; San Luis, Teofilo; Akamizu, Takashi

    2014-01-01

    Maternal hyperthyroidism in pregnancy is associated with adverse impacts on both mother and fetus. Recently, the American Thyroid Association and the Endocrine Society have published guidelines for the management of thyroid diseases in pregnancy. We aimed to disclose the impact of these guidelines in current practices of Asian members of the Asia-Oceania Thyroid Association (AOTA) regarding the management of hyperthyroidism in pregnancy. Completed questionnaire survey, based on clinical case scenarios, was collected from 321 Asian physician members of AOTA from 21 Asian countries in 2013. For a woman with Graves' disease planning pregnancy, 92% of clinicians favored antithyroid treatment, 52% with propylthiouracil (PTU) while 40% preferred methimazole (MMI). For a pregnant woman with newly diagnosed overt hyperthyroidism, nearly all responders initiated PTU treatment. To monitor dosage of antithyroid drugs, approximately 73% of responders used TSH and free T4 (FT4) levels without free T3 (FT3) (53%) or with FT3 (20%). Majority of responders targeted achieving low serum TSH with FT4 (or total T4) in the upper end of the normal range. For management of gestational thyrotoxicosis, 40% chose to follow up and 52% treated patients with PTU. Although timing of TSH receptor antibodies measurement in pregnant hyperthyroid patients was variable, 53% of responders would check it at least once during pregnancy. Nearly 80% of responders do not treat subclinical hyperthyroidism in pregnancy. Therefore, despite wide variations in the management of hyperthyroidism during pregnancy in Asia, majority of Asian physicians practice within the recommendations of major professional societies.

  16. Atrial fibrillation associated with exogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover acute myocardial infarction has been reported during L-thyroxine substitution therapy. Far more common and relatively less studied is exogenous subclinical hyperthyroidism caused by L-thyroxine administration to thyroidectomized or hypothyroid patients or patients with simple or nodular goiter. We present a case of atrial fibrillation associated with exogenous subclinical hyperthyroidism, in a 72-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  17. Managing hyperthyroidism in pregnancy: current perspectives

    Directory of Open Access Journals (Sweden)

    Andersen SL

    2016-09-01

    Full Text Available Stine Linding Andersen,1,2 Peter Laurberg1,3,† 1Department of Endocrinology, Aalborg University Hospital, 2Department of Clinical Biochemistry, Aalborg University Hospital, 3Department of Clinical Medicine, Aalborg University, Aalborg, Denmark †Peter Laurberg passed away on June 20, 2016 Abstract: Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves’ disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs. These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6–10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the

  18. Morbidity before and after the diagnosis of hyperthyroidism

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Pedersen, Dorthe Almind

    2013-01-01

    Hyperthyroidism has been linked with different morbidities, like atrial fibrillation, stroke and diabetes mellitus. However, our knowledge regarding the extent and temporal relation between hyperthyroidism and other diseases is fragmented. Here, we aimed at evaluating various morbidities before...

  19. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports

    Directory of Open Access Journals (Sweden)

    Soylu Aliye

    2008-04-01

    Full Text Available Abstract Introduction Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice. Case presentation Here we present two cases of cholestasis that accompanied two distinct forms of clinical hyperthyroidism. The first patient had a clinical presentation of severe cholestasis in the absence of congestive failure related to hyperthyroidism. The second case had developed intrahepatic cholestasis in the presence of subclinical hyperthyroidism, and improved with rifampicin treatment. Conclusion Hyperthyroidism should be a consideration in non-specific liver dysfunction.

  20. Influence of subclinical hyperthyroidism on the cardiovascular system

    Directory of Open Access Journals (Sweden)

    T Y Demidova

    2015-06-01

    Full Text Available Subclinical hyperthyroidism occurs when the serum TSH is below the lower limit of the reference range and the free T4 and T3 concentrations are normal. Тhe clinical significance of subclinical hyperthyroidism is much debated. Subclinical hyperthyroidism has been associated with several biological effects on cardiovascular system, such as increased heart rate, left ventricular mass. Observational studies have reported an association between subclinical hyperthyroidism and coronary heart disease, incident atrial fibrillation, and cardiac dysfunction.

  1. Influence of subclinical hyperthyroidism on the cardiovascular system

    OpenAIRE

    2015-01-01

    Subclinical hyperthyroidism occurs when the serum TSH is below the lower limit of the reference range and the free T4 and T3 concentrations are normal. Тhe clinical significance of subclinical hyperthyroidism is much debated. Subclinical hyperthyroidism has been associated with several biological effects on cardiovascular system, such as increased heart rate, left ventricular mass. Observational studies have reported an association between subclinical hyperthyroidism and coronary heart diseas...

  2. Intrahepatic cholestasis in subclinical and overt hyperthyroidism: two case reports

    OpenAIRE

    2008-01-01

    Abstract Introduction Non-specific abnormalities in liver function tests might accompany the clinical course of hyperthyroidism. Hyperthyroidism can cause the elevation of hepatic enzymes and bilirubin. Jaundice is rare in overt hyperthyroidism, especially in subclinical hyperthyroidism. On the other hand, the use of anti-thyroid drugs has rarely been associated with toxic hepatitis and cholestatic jaundice. Case presentation Here we present two cases of cholestasis that accompanied two disti...

  3. Protocol for quality control in radio guided surgery procedures for detection and removal of sentinel node and non palpable lesions; Protocolo de control de calidad para procedimientos de cirugia radioguiada para deteccion y extirpacion de ganglio centinela y de lesiones no palpables

    Energy Technology Data Exchange (ETDEWEB)

    Prieto Moran, D.; Sanchez Noriega, K.; Rodriguez Meijide, P.

    2015-05-01

    In this work the process for the detection and/or removal of the sentinel lymph node and nonpalpable lesions has been optimized. For the latter, a {sup 1}25 I, seed an isotope that is not usually used for this purpose, is employed. It was recycled from radiotherapy treatments surpluses, having requested the necessary authorizations. A detailed procedure for the management, storage, transport and sterilization of the {sup 1}25 I seed in the hospital has been developed. A custom protocol has been defined for quality control of intraoperative probes with different tests, providing methods, frequencies, tolerances, etc. The overall result is an improvement of the process and a decrease of the inconveniences for the patient. (Author)

  4. Subclinical hyperthyroidism: current concepts and scintigraphic imaging.

    Science.gov (United States)

    Intenzo, Charles; Jabbour, Serge; Miller, Jeffrey L; Ahmed, Intekhab; Furlong, Kevin; Kushen, Medina; Kim, Sung M; Capuzzi, David M

    2011-09-01

    Subclinical hyperthyroidism is defined as normal serum free thyroxine and a free triiodothyronine level, with a thyroid-stimulating hormone level suppressed below the normal range and is usually undetectable. Although patients with this diagnosis have no or few signs and symptoms of overt thyrotoxicosis, there is sufficient evidence that it is associated with a relatively higher risk of supraventricular arrhythmias as well as the acceleration or the development of osteoporosis. Consequently, the approach to the patient with subclinical hyperthyroidism is controversial, that is, therapeutic intervention versus watchful waiting. Regardless, it is imperative for the referring physician to identify the causative thyroid disorder. This is optimally accomplished by a functional study, namely scintigraphy. Recognition of the scan findings of the various causes of subclinical hyperthyroidism enables the imaging specialist to help in diagnosing the underlying condition causing thyroid-stimulating hormone suppression thereby facilitating the workup and management of this thyroid disorder.

  5. Managing hyperthyroidism in pregnancy: current perspectives

    Science.gov (United States)

    Andersen, Stine Linding; Laurberg, Peter

    2016-01-01

    Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves’ disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain. Untreated or inadequately treated hyperthyroidism is associated with pregnancy complications and may even program the fetus to long-term development of disease. Thus, hyperthyroidism in pregnant women should be carefully managed and controlled, and proper management involves different medical specialties. The treatment of choice in pregnancy is antithyroid drugs (ATDs). These drugs are effective in the control of maternal hyperthyroidism, but they all cross the placenta, and so need careful management and control during the second half of pregnancy considering the risk of fetal hyper- or hypothyroidism. An important aspect in the early pregnancy is that the predominant side effect to the use of ATDs in weeks 6–10 of pregnancy is birth defects that may develop after exposure to available types of ATDs and may be severe. This review focuses on four current perspectives in the management of overt hyperthyroidism in pregnancy, including the etiology and incidence of the disease, how the diagnosis is made, the consequences of untreated or inadequately treated disease, and finally how to treat overt hyperthyroidism in pregnancy. PMID:27698567

  6. [Hypoglycaemic periodic paralysis in hyperthyroidism patients].

    Science.gov (United States)

    Kratochvíl, J; Masopust, J; Martínková, V; Charvát, J

    2008-11-01

    Hypokalemic periodic paralysis (HPP) is a rare disorder characterised by acute, potentially fatal atacks of muscle weakness or paralysis. Massive shift of potassium into cells is caused by elevated levels of insulin and catecholamines in the blood. Hypophosphatemia and hypomagnesemia may be also present. Acidobasic status usually is not impaired. HPP occurs as familiar (caused by ion channels inherited defects) or acquired (in patients with hyperthyroidism). On the basis of two clinical cases we present a review of hypokalemic periodic paralysis in hyperthyroid patients. We discuss patogenesis, clinical and laboratory findings as well as the principles of prevention and treatment of this rare disorder.

  7. Acute myocardial infarction and subclinical hyperthyroidism without significant coronary stenoses.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Di Bella, Gianluca; Turiano, Giuseppe

    2009-05-29

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. Moreover, it has been reported that simply measuring maximum P wave duration and P wave dispersion values, may help to determine the patients with subclinical hyperthyroidism and high risk for the development of atrial fibrillation. We present a case of an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  8. Doctor Pan Cures the Hyperthyroidism and Hypothyroidism

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    THE Pan Danian Clinic. located in the Puhui Residential Area in western Beijing, is small but attracts countless patients. It is specific for those suffering from hyperthyroidism and hypothyroidism. Doctor Pan is gentle and refined, and often smiles with closed lips.

  9. Severe Cerebral Vasospasm in Patients with Hyperthyroidism

    Science.gov (United States)

    Oh, Hyuk-Jin; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-01-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur. PMID:28184350

  10. Severe Cerebral Vasospasm in Patients with Hyperthyroidism.

    Science.gov (United States)

    Oh, Hyuk-Jin; Yoon, Seok-Mann; Oh, Jae-Sang; Shim, Jai-Joon; Bae, Hack-Gun

    2016-12-01

    Cerebral vasospasm associated with hyperthyroidism has not been reported to cause cerebral infarction. The case reported here is therefore the first of cerebral infarction co-existing with severe vasospasm and hyperthyroidism. A 30-year-old woman was transferred to our hospital in a stuporous state with right hemiparesis. At first, she complained of headache and dizziness. However, she had no neurological deficits or radiological abnormalities. She was diagnosed with hyperthyroidism 2 months ago, but she had discontinued the antithyroid medication herself three days ago. Magnetic resonance imaging and angiography showed cerebral infarction with severe vasospasm. Thus, chemical angioplasty using verapamil was performed two times, and antithyroid medication was administered. Follow-up angiography performed at 6 weeks demonstrated complete recovery of the vasospasm. At the 2-year clinical follow-up, she was alert with mild weakness and cortical blindness. Hyperthyroidism may influence cerebral vascular hemodynamics. Therefore, a sudden increase in the thyroid hormone levels in the clinical setting should be avoided to prevent cerebrovascular accidents. When neurological deterioration is noticed without primary cerebral parenchyma lesions, evaluation of thyroid function may be required before the symptoms occur.

  11. Hyperthyroidism as a cause of persistent vomiting.

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Cools, B.M.

    2004-01-01

    A 32-year-old woman presented with persistent vomiting, epigastric pain and weight loss. A sinus tachycardia was the clue to the diagnosis of hyperthyroidism due to Graves' disease. On treatment with propylthiouracil and a beta-blocking agent, her symptoms resolved within one day, even though her fr

  12. Reduction of radioiodine uptake in hyperthyroid patients

    Energy Technology Data Exchange (ETDEWEB)

    Goebel, R.; Leb, G.; Passath, A.

    1984-04-01

    We compared the /sup 131/I-uptake values in hyperthyroid patients for the two years 1973 and 1982. A pronounced fall (70,8% and 61,1% resp.) was found. This fall was greater in Graves' disease than in autonomous adenoma.

  13. Fetuin-A levels in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Bariş Onder Pamuk

    2013-01-01

    Full Text Available OBJECTIVE: Fetuin-A is a protein secreted from the liver that inhibits arterial calcification deposition and can contribute to insulin resistance. Hyperthyroidism is also associated with insulin resistance. It is not known whether hyperthyroidism has an effect on fetuin-A levels. METHODS: We measured fetuin-A levels and homeostasis model of assessment-insulin resistance before hyperthyroidism treatment was initiated and after euthyroidism was achieved. A total of 42 patients diagnosed with hyperthyroidism were enrolled in this study. Fetuin-A, insulin, high-sensitivity C-reactive protein, fasting blood glucose, free T3 (fT3, free T4 (fT4, and thyrotropin were measured before and after euthyroidism was established. RESULTS: Basal fasting blood glucose, high-sensitivity C-reactive protein, insulin, c-peptide, homeostasis model of assessment-insulin resistance, fT3, fT4 and fetuin-A levels were significantly decreased after euthyroidism was achieved (Table 1. Basal fasting blood glucose (r:0.407, p:0.008, high-sensitivity C-reactive protein (r:0.523, p<0.0001, insulin (r:0.479, p:0.001, homeostasis model of assessment-insulin resistance (r:0.541, p<0.0001, fT3 (r:0.492, p:0.001 and fT4 (r:0.473, p:0.002 were positively correlated with basal fetuin-A levels. Basal thyrotropin levels were significantly negatively correlated (r:-0.553, p<0.0001 with basal fetuin-A levels. CONCLUSION: Our findings suggest that hyperthyroidism influences fetuin-A levels.

  14. Hyperthyroidism: a risk factor for female sexual dysfunction.

    Science.gov (United States)

    Atis, Gokhan; Dalkilinc, Ayhan; Altuntas, Yuksel; Atis, Alev; Gurbuz, Cenk; Ofluoglu, Yilmaz; Cil, Esra; Caskurlu, Turhan

    2011-08-01

    Hyperthyroidism is a common hormonal disorder in women that may cause female sexual dysfunction (FSD). To assess sexual function in women with hyperthyroidism. A total of 40 women with clinical hyperthyroidism and 40 age-matched voluntary healthy women controls were included in the study. All the subjects were evaluated with a detailed medical and sexual history, including a Female Sexual Function Index (FSFI) questionnaire for sexual status and the Beck Depression Inventory (BDI) for psychiatric assessment. The levels of serum thyroid-stimulating hormone (TSH), thyroid hormones, sex hormone binding globulin (SHBG), total testosterone (tT), free testosterone (fT), prolactin, estradiol, follicle-stimulating hormone, and luteinizing hormone were measured. The mean total FSFI scores were 24.2 ± 9.96 in the hyperthyroidic group and 29 ± 10.4 in the control group (P hyperthyroidism. The mean BDI score for hyperthyroidic patients was significantly greater than the score for the control group (P hyperthyroidic group was found to be significantly higher than the level in the controls (P hyperthyroidic group was lower than in the control group (P hyperthyroidism had sexual dysfunction. Increased depressive symptoms, increased SHBG level, and decreased fT levels were all found to be associated with FSD in clinical hyperthyroidism. © 2011 International Society for Sexual Medicine.

  15. Estudo do efeito do uso de colimador na sonda gama utilizada em cirurgia radioguiada Study of the effect of using a collimator on a gamma probe in radioguided surgery

    Directory of Open Access Journals (Sweden)

    Iran José Oliveira da Silva

    2006-12-01

    Full Text Available OBJETIVO: O objetivo deste trabalho consiste em estudar a influência da resolução espacial da sonda gama Europrobe que é utilizada em cirurgia radioguiada. MATERIAIS E MÉTODOS: Na técnica de cirurgia radioguiada, após a injeção de um radiotraçador no tumor primário, é utilizada uma sonda detectora de radiação gama a fim de determinar a localização do linfonodo sentinela. Para simular a região dos pontos de injeção do radiotraçador e o linfonodo sentinela, duas fontes de Tc-99m, com 20,42 MBq e 0,70 MBq, foram posicionadas no interior de um recipiente preenchido com água. Em seguida, com a janela de entrada da sonda coberta com um colimador, realizou-se varredura sobre a superfície da água. Assim, foi possível registrar a taxa de contagens variando-se a distância lateral da sonda em relação às duas fontes, as quais foram separadas por uma distância variando entre 30 mm e 60 mm. RESULTADOS: Os resultados mostraram que o uso do colimador contribui para melhorar a resolução espacial da sonda, permitindo a identificação do linfonodo sentinela distante até 30 mm do ponto de injeção. CONCLUSÃO: Esse estudo permite concluir que a sonda Europrobe, quando utilizada com capa colimadora com orifício central de 3,5 mm de diâmetro, é capaz de identificar o linfonodo sentinela posicionado a até 30 mm de distância em relação à região do ponto de injeção do radiotraçador.OBJECTIVE: The aim of the present study is to evaluate the performance of the Europrobe gamma probe spatial resolution in radioguided surgery. MATERIALS AND METHODS: In the radioguided surgery technique, after a radiotracer injection into the primary tumor, a gamma detector probe is utilized to determine the localization of the sentinel lymph node. In order to simulate the region of the radiotracer injection the sentinel lymph node, two Tc-99m sources, with 20.42 MBq and 0.70 MBq, were positioned in a water-filled tank. With a collimator cap

  16. Impairment of attention networks in patients with untreated hyperthyroidism.

    Science.gov (United States)

    Yuan, Lili; Tian, Yanghua; Zhang, Fangfang; Dai, Fang; Luo, Li; Fan, Jin; Wang, Kai

    2014-06-27

    Attention disorders are common symptoms in patients with untreated hyperthyroidism. Nevertheless, it is unknown whether they represent a global attention deficit or selective impairment of attention networks. Thirty-seven patients with hyperthyroidism were recruited and underwent the Attention Network Test (ANT), which provided measures of three independent attention networks (alerting, orienting and executive control), before being treated with methimazole. This study demonstrated that patients with untreated hyperthyroidism had significant deficits in the alerting and executive control networks. Interestingly, a significant positive association was also found between T4 level and the value of the executive network in patients with hyperthyroidism. These results suggest that the patients with hyperthyroidism may not just exist a specific impairment of attention networks, and there was some relationship between the level of T4, not T3 or TSH, and the value of the executive control network in patients with hyperthyroidism.

  17. Endogenous subclinical hyperthyroidism and cardiovascular system: time to reconsider?

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Sturiale, Mauro

    2011-05-19

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Exogenous sublinical hyperthyroidism is a thyroid metabolic state caused by L-thyroxine administration. Endogenous subclinical hyperthyroidism is a thyroid metabolic state in patients with autonomously functioning thyroid nodule or multinodular goiter, various forms of thyroiditis, in areas with endemic goiter and particularly in elderly subjects. Endogenous subclinical hyperthyroidism is currently the subject of numerous studies and it yet remains controversial particularly as it relates to its treatment and to cardiovascular impact nevertheless established effects have been demonstrated. Recently, acute myocardial infarction without significant coronary stenoses and recurrent acute pulmonary embolism have been reported associated with subclinical hyperthyroidism without L-thyroxine administration. So, it is very important to recognize and to treat promptly also endogenous subclinical hyperthyroidism. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  18. Is previous hyperthyroidism associated with long-term cognitive dysfunction?

    DEFF Research Database (Denmark)

    Lillevang-Johansen, Mads; Petersen, Inge; Christensen, Kaare

    2014-01-01

    OBJECTIVE: Hyperthyroidism has been suggested to adversely affect cognitive function. However, this association could also be caused by genetic and environmental factors affecting both the development of hyperthyroidism and cognitive functioning. By investigating twin pairs discordant...... for hyperthyroidism, this potential confounding can be minimized. The aim of the study was to examine if hyperthyroidism is associated with long-term cognitive dysfunction. DESIGN: Twin case-control study. PATIENTS: Twin pairs discordant for hyperthyroidism were identified by record-linkage between The Danish...... tests. Based on five of the tests a composite cognitive score was calculated. RESULTS: 55 out of 3036 twin pairs were discordant for hyperthyroidism. The mean time from diagnosis until survey participation was 7.3 years (range: 0-24.1 years). In both the intra-pair and individual level analyses...

  19. A rare cause of hyperthyroidism: functioning thyroid metastases.

    Science.gov (United States)

    Gardner, Daphne; Ho, Su Chin

    2014-10-09

    Hyperthyroidism is a common medical problem that is readily treated with antithyroid medications. However, attributing the correct aetiology of hyperthyroidism alters management and outcome. We present a case of a 66-year-old woman with a seemingly common problem of hyperthyroidism associated with a goitre, which was initially attributed to a toxic nodule. However, Tc-99m pertechnetate uptake scan and thyroid-stimulating hormone receptor antibody were negative, inconsistent with a toxic nodule or Grave's disease. Her thyroid function tests proved difficult to control over the next few months. She eventually proceeded to a total thyroidectomy and histology revealed follicular variant papillary thyroid carcinoma. She was started on levothyroxine postoperatively but developed severe hyperthyroidism, revealing the cause of hyperthyroidism to be autonomously functioning thyroid metastases. Although functioning thyroid metastases are very rare, they need to be considered among the differential diagnoses of hyperthyroidism, as there are nuances in management that could alter the eventual outcome. 2014 BMJ Publishing Group Ltd.

  20. The long-term consequences of previous hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans

    2015-01-01

    of hyperthyroidism and outcome as well as sporadic control for confounding such as co-morbidity. In addition, since hyperthyroidism and various morbidities (and mortality) as well as a number of environmental risk factors are under genetic influence, a possible co-inheritance could, at least theoretically, cause......-up (>10 years) as well as control for co-morbidity and genetic confounding. The results provide a number of interesting insights into the long-term consequences of hyperthyroidism. Firstly, hyperthyroidism is associated with an approximately 30% increased all-cause mortality. The all-cause mortality does...... with CVD, LD and DM both before and after the diagnosis of hyperthyroidism. Although the design used does not allow a stringent distinction between cause and effect, the findings indicate a possible direct association between hyperthyroidism and these morbidities, or vice versa....

  1. Fracturas faciales en pacientes menores de veinte anos atendidos en la unidad de cirugia maxilofacial y estomatologia del hospital universitario san vicente de Paul y la facultad de odontologia de la universidad de Antioquia entre los anos 1998 Y 2007.(Perspectiva general de la enfermedad/trastorno)

    National Research Council Canada - National Science Library

    Duque Serna, Francisco Levi; Sanchez Correa, Carlos Alberto; Segura Cardona, Angela Maria

    2010-01-01

    Introduccion: el proposito de este estudio fue encontrar la incidencia de fracturas de huesos faciales en pacientes menores de veinte anos admitidos en la Unidad de Cirugia Maxilofacial y Estomatologia...

  2. Hyperthyroid hypokalemic periodic paralysis in a Hispanic male.

    Science.gov (United States)

    Baumgartner, F. J.; Lee, E. T.

    1990-01-01

    A case of hyperthyroid periodic paralysis in a Hispanic male is reported, the disorder in this race being described only once before. He presented with complete paralysis below the neck, and his admission potassium of 1.3 mEq/L is the lowest reported in the literature. Correction of the hypokalemia resolved his symptoms. Radionuclide imaging and thyroid function tests revealed the presence of hyperthyroidism which was managed medically. The pathophysiology of hyperthyroid hypokalemic periodic paralysis is discussed. PMID:2304102

  3. Dr. Cheng Yichun's Experience in Treating Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Sun Fenglei; Feng Jianhua; Wang Xinzhong

    2006-01-01

    @@ Having been engaged in the TCM clinical practice for more than 40 years, Dr. Cheng Yichun from the Affiliated Hospital of Shandong University of TCM has rich experience in treating endocrine metabolic diseases. Authors have had the good fortune to follow Dr. Chen for 10 years. Following is his train of thought in diagnosing and treating hyperthyroidism and his prescriptions most in use for the disease.

  4. Selenium supplementation for patients with Graves’ hyperthyroidism (the GRASS trial)

    DEFF Research Database (Denmark)

    Watt, Torquil; Cramon, Per; Bjorner, Jakob Bue

    2013-01-01

    Graves' hyperthyroidism is an autoimmune disease causing hyperfunction of the thyroid gland. The concentration of selenium is high in the thyroid gland and two important groups of enzymes within the thyroid are selenoproteins, that is, they depend on selenium. Selenium may have beneficial effects...... on autoimmune hypothyroidism and on Graves' orbitopathy, but the effects of selenium on Graves' hyperthyroidism is unknown.We hypothesize that adjuvant selenium may be beneficial in the treatment of Graves' hyperthyroidism. The objective is to investigate if selenium supplementation plus standard treatment......, anti-thyroid drug treatment success), and improved quality of life in patients with Graves' hyperthyroidism....

  5. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S

    2001-01-01

    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart...... rate. Subclinical hyperthyroidism is characterised by reduced serum TSH levels despite free thyroxine (T4) and tri-iodothyronine (T3) estimates within the reference range, in subjects with no obvious symptoms of hyperthyroidism. We measured haemodynamic changes (using impedance cardiography......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  6. Transient Non-Autoimmune Hyperthyroidism of Early Pregnancy

    Directory of Open Access Journals (Sweden)

    Alexander M. Goldman

    2011-01-01

    Full Text Available It is characterized by chemical and sometimes clinical hyperthyroidism, without evidence of thyroid autoimmunity that resolves spontaneously by 16 weeks gestation without significant obstetrical complications.

  7. Radioiodine treatment in McCune-Albright syndrome with hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Dhritiman Chakraborty

    2012-01-01

    Full Text Available McCune-Albright syndrome (MAS is a sporadic disease characterized by polyostotic fibrous dysplasia, "café-au-lait" spots and hyperfunctional endocrinopathies. Pathophysiological basis is activating mutation of the gene that encodes the alpha subunit of Gs membrane protein that stimulates the intracellular production of cAMP, conferring autonomous secretion of the gland in particular. One of the uncommon endocrine manifestations is hyperthyroidism. We present a patient who had café-au-lait spots, polyostotic fibrous dysplasia and hyperthyroidism. She was treated with radioactive iodine for the symptoms of hyperthyroidism and subsequently relieved from hyperthyroid features.

  8. A case report of suicidal behavior related to subclinical hyperthyroidism.

    Science.gov (United States)

    Joo, Soo-Hyun; Jeong, Jong-Hyun; Hong, Seung-Chul

    2014-01-01

    Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability resolved. This case demonstrates that subclinical hyperthyroidism can be associated with suicidal behavior as well as overt hyperthyroidism. Early intervention is required to prevent suicidal behavior in patients with subclinical hyperthyroidism.

  9. Radioiodine treatment in McCune-Albright syndrome with hyperthyroidism.

    Science.gov (United States)

    Chakraborty, Dhritiman; Mittal, Bhagwant Rai; Kashyap, Raghava; Manohar, Kuruva; Bhattacharya, Anish; Bhansali, Anil

    2012-07-01

    McCune-Albright syndrome (MAS) is a sporadic disease characterized by polyostotic fibrous dysplasia, "café-au-lait" spots and hyperfunctional endocrinopathies. Pathophysiological basis is activating mutation of the gene that encodes the alpha subunit of Gs membrane protein that stimulates the intracellular production of cAMP, conferring autonomous secretion of the gland in particular. One of the uncommon endocrine manifestations is hyperthyroidism. We present a patient who had café-au-lait spots, polyostotic fibrous dysplasia and hyperthyroidism. She was treated with radioactive iodine for the symptoms of hyperthyroidism and subsequently relieved from hyperthyroid features.

  10. Psychiatric manifestations of Graves' hyperthyroidism: pathophysiology and treatment options.

    Science.gov (United States)

    Bunevicius, Robertas; Prange, Arthur J

    2006-01-01

    Graves' disease is an autoimmune disorder that is the most common cause of hyperthyroidism. Other symptoms associated with the disease are goitre, ophthalmopathy, and psychiatric manifestations such as mood and anxiety disorders and, sometimes, cognitive dysfunction. Graves' hyperthyroidism may result in these latter manifestations via the induction of hyperactivity of the adrenergic nervous system. This review addresses the psychiatric presentations, and their pathophysiology and treatment, in patients with hyperthyroidism, based on literature identified by a PubMed/MEDLINE database search. Although the focus is on mental symptoms associated with Graves' disease, it is not always clear from the literature whether patients had Graves' disease: in some studies, the patients were thought to have Graves' disease based on clinical findings such as diffuse goitre or ophthalmopathy or on measurements of thyroid antibodies in serum; however, in other studies, no distinction was made between Graves' hyperthyroidism and hyperthyroidism from other causes. Antithyroid drugs combined with beta-adrenoceptor antagonists are the treatments of choice for hyperthyroidism, as well as for the psychiatric disorders and mental symptoms caused by hyperthyroidism. A substantial proportion of patients have an altered mental state even after successful treatment of hyperthyroidism, suggesting that mechanisms other than hyperthyroidism, including the Graves' autoimmune process per se and ophthalmopathy, may also be involved. When psychiatric disorders remain after restoration of euthyroidism and after treatment with beta-adrenoceptor antagonists, specific treatment for the psychiatric symptoms, especially psychotropic drugs, may be needed.

  11. Selenium supplementation for patients with Graves’ hyperthyroidism (the GRASS trial)

    DEFF Research Database (Denmark)

    Watt, Torquil; Cramon, Per; Bjorner, Jakob Bue

    2013-01-01

    Graves' hyperthyroidism is an autoimmune disease causing hyperfunction of the thyroid gland. The concentration of selenium is high in the thyroid gland and two important groups of enzymes within the thyroid are selenoproteins, that is, they depend on selenium. Selenium may have beneficial effects...... on autoimmune hypothyroidism and on Graves' orbitopathy, but the effects of selenium on Graves' hyperthyroidism is unknown.We hypothesize that adjuvant selenium may be beneficial in the treatment of Graves' hyperthyroidism. The objective is to investigate if selenium supplementation plus standard treatment......, anti-thyroid drug treatment success), and improved quality of life in patients with Graves' hyperthyroidism....

  12. Hyperthyroidism--cause of depression and psychosis: a case report

    National Research Council Canada - National Science Library

    Marian, G; Nica, E A; Ionescu, B E; Ghinea, D

    2009-01-01

    .... The link between psychosis and hyperthyroidism is poorly understood. Because of this association of psychiatric symptoms is important to exclude a somatic cause, when assessing a patient first...

  13. The mechanisms of atrial fibrillation in hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Bielecka-Dabrowa Agata

    2009-04-01

    Full Text Available Abstract Atrial fibrillation (AF is a complex condition with several possible contributing factors. The rapid and irregular heartbeat produced by AF increases the risk of blood clot formation inside the heart. These clots may eventually become dislodged, causing embolism, stroke and other disorders. AF occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and is more common in men and in patients with triiodothyronine (T3 toxicosis. The incidence of AF increases with advancing age. Also, subclinical hyperthyroidism is a risk factor associated with a 3-fold increase in development of AF. Thyrotoxicosis exerts marked influences on electrical impulse generation (chronotropic effect and conduction (dromotropic effect. Several potential mechanisms could be invoked for the effect of thyroid hormones on AF risk, including elevation of left atrial pressure secondary to increased left ventricular mass and impaired ventricular relaxation, ischemia resulting from increased resting heart rate, and increased atrial eopic activity. Reentry has been postulated as one of the main mechanisms leading to AF. AF is more likely if effective refractory periods are short and conduction is slow. Hyperthyroidism is associated with shortening of action potential duration which may also contribute to AF.

  14. Dietary-induced hyperthyroidism marginally affects neonatal testicular development

    NARCIS (Netherlands)

    Rijntjes, E.; Wientjes, A.T.; Swarts, H.J.; Rooij, de D.G.; Teerds, K.J.

    2008-01-01

    The objective of this study was to determine whether dietary-induced mild fetal/neonatal hyperthyroidism influenced the initiation of spermatogenesis and the development of the adult-type Leydig cell population. Previously, the effects of neonatally induced hyperthyroidism have been investigated in

  15. Effects of hyperthyroidism on hand grip strength and function.

    Science.gov (United States)

    Erkol İnal, Esra; Çarlı, Alparslan Bayram; Çanak, Sultan; Aksu, Oğuzhan; Köroğlu, Banu Kale; Savaş, Serpil

    2015-01-01

    Hyperthyroidism is a pathologic condition in which the body is exposed to excessive amounts of circulating thyroid hormones. Skeletal muscle is one of the major target organs of thyroid hormones. We evaluated hand grip strength and function in patients with overt hyperthyroidism. Fifty-one patients newly diagnosed with hyperthyroidism and 44 healthy controls participated in this study. Age, height, weight, and dominant hand of all participants were recorded. The diagnosis of hyperthyroidism was confirmed by clinical examination and laboratory tests. Hand grip strength was tested at the dominant hand with a Jamar hand dynamometer. The grooved pegboard test (PGT) was used to evaluate hand dexterity. The Duruöz Hand Index (DHI) was used to assess hand function. No significant differences were found in terms of clinical and demographic findings between the patients with hyperthyroidism and healthy controls (p > 0.05). Significant differences were found between the patients with hyperthyroidism and healthy controls regarding PGT and DHI scores (p Hyperthyroidism seemed to affect hand dexterity and function more than hand grip strength and seemed to be associated with reduced physical function more than muscle strength. This may also indicate that patients with hyperthyroidism should be evaluated by multidisplinary modalities.

  16. Diagnosis and management of feline hyperthyroidism: current perspectives

    OpenAIRE

    Vaske HH; Schermerhorn T; Armbrust L; Grauer GF

    2014-01-01

    Heather H Vaske, Thomas Schermerhorn, Laura Armbrust, Gregory F Grauer Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA Abstract: Previous and ongoing research has provided insights to the pathophysiology and diagnosis of hyperthyroidism as well as new treatment modalities. This paper reviews the etiology, clinical presentation, and clinicopathologic changes associated with hyperthyroidism, and provides a thorough explanation of confirmatory testing and treatment ...

  17. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S

    2001-01-01

    Hyperthyroidism has profound effects on the cardiovascular system, including reduced systemic vascular resistance (SVR) due to relaxation of vascular smooth muscle cells, enhanced heart rate (HR) and cardiac output (CO) due to an increase in cardiac diastolic relaxation, contractility and heart......) in subjects with endogenous subclinical hyperthyroidism in order to elucidate whether these patients had signs of excess thyroid hormone at the tissue level....

  18. Subclinical hyperthyroidism in patients with type 2 diabetes.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2012-08-01

    Both subclinical hyperthyroidism and type 2 diabetes (T2D) have been associated with an increase in cardiovascular disease risk and mortality. We aimed to assess the prevalence of newly diagnosed subclinical hyperthyroidism in a cohort of patients with T2D, and also to analyse the relationships between diabetes-related characteristics and the presence of subclinical hyperthyroidism. 933 diabetic patients without previous history of thyroid disease (45.4% females, mean age 66.3 years, median duration of diabetes 10 years) were evaluated. A sample of 911 non-diabetic subjects without known thyroid dysfunction was studied as control group. Serum concentrations of thyrotropin were measured in all subjects. Subclinical hyperthyroidism was present in 4.3% of female and 3.5% of male diabetic patients. Relative risk was significant only for the female gender (OR 3.69, 95% CI 1.56-8.71). In comparison with diabetic patients without thyroid hyperfunction, patients with subclinical hyperthyroidism were older, had longer duration of diabetes, showed lower fasting glucose levels, had greater proportion of goitre and diet therapy, and had lower proportion of treatment with oral agents. Logistic regression analysis showed that age and the presence of goitre were significantly related to subclinical hyperthyroidism in patients with T2D. The risk for subclinical hyperthyroidism is increased in women with T2D. Advanced age and the presence of goitre are significantly and independently related with the presence of subclinical hyperthyroidism in diabetic population.

  19. A case report of suicidal behavior related to subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Joo SH

    2014-04-01

    Full Text Available Soo-Hyun Joo, Jong-Hyun Jeong, Seung-Chul HongDepartment of Psychiatry, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, KoreaAbstract: Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability resolved. This case demonstrates that subclinical hyperthyroidism can be associated with suicidal behavior as well as overt hyperthyroidism. Early intervention is required to prevent suicidal behavior in patients with subclinical hyperthyroidism.Keywords: suicidal behavior, subclinical hyperthyroidism, anxiolytics

  20. Causes of anorexia in untreated hyperthyroidism: a prospective study

    Science.gov (United States)

    Dai, W.; Meng, X.

    2000-01-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after antithyroid drug treatment in the two groups. This prospective study suggested that the causes of anorexia in untreated hyperthyroidism are complicated. Older age, abnormal liver function, and the level of anxiety are significantly related to anorexia in untreated hyperthyroidism, but hypercalcaemia was not confirmed to be related to anorexia in the study.


Keywords: hypercalcaemia; hyperthyroidism; anorexia; anxiety PMID:10775283

  1. Neonatal thyrotoxicosis caused by maternal autoimmune hyperthyroidism

    Science.gov (United States)

    Correia, Miguel Fragata; Maria, Ana Teresa; Prado, Sara; Limbert, Catarina

    2015-01-01

    Neonatal immune hyperthyroidism is a rare but potentially fatal condition. It occurs in 1–5% of infants born to women with Graves’ disease (GD). In most of the cases it is due to maternal antibodies transferred from the mother into the fetal compartment, stimulating the fetal thyroid by binding thyrotropin (thyroid-stimulating hormone, TSH) receptor. We present a case of neonatal thyrotoxicosis due to maternal GD detected at 25 days of age and discuss the potential pitfalls in the diagnosis. PMID:25750228

  2. Cirugía radioguiada: extirpación de metástasis de un carcinoma papilar de tiroides Probe-guided surgery: metastases of a papillary thyroid carcinoma. Surgical Excision

    Directory of Open Access Journals (Sweden)

    A. R. Kowadlo

    2008-09-01

    Full Text Available Paciente de sexo masculino operado de Carcinoma Papilar Tiroideo (variedad folicular con recurrencia tumoral luego de tiroidectomía, linfadenectomía y Dosis Terapéutica de Iodo 131. Bajo tratamiento con hormonas tiroideas a dosis inhibitorias de TSH, persistencia de valores elevados de Tiroglobulina Plasmática e imágenes detectables en la Ecografía y Resonancia Magnética Nuclear ( RMN. Por la Dosis Terapéutica se sospechaba que las mismas concentrarían radioyodo. Se planificó por lo tanto cirugía radioguiada, según el protocolo del Instituto Gustave Roussy (modificado. Dosis Terapéutica de Iodo 131; al 4º día Rastreo Corporal Total en Cámara Gamma (RCT; al 5º día cirugía con sonda exploradora (gamma probe y a las 48 hs. poscirugía nuevo RCT. El procedimiento fue exitoso, pudiendo extirparse adenopatías metastásicas con la desaparición en el RCT posquirúrgico de las imágenes que fijaban francamente radioyodo en el preoperatorio. Los vlores de Tiroglobulina plasmática descendieron francamente con terapia hormonal de reemplazo, a los sesenta y noventa días postratamiento.A male patient with papillary thyroid cancer -folliculary variety- is chosen to be presented. After thyroidectomy, lymfhadenectomy and therapeutic dose of radioiodine treatments, cancer relapse was observed. After thyrotrophyn supressive therapy with l-thyroxine, a high serum thyroglobulin concentration was observed. The Ultrasonography ( US and Magnetic Resonance (MR images showed visible node structures in the neck. This node structures were probably going to concentrate I-131 as seen in the first whole body scan after therapeutic dose. Therefore a radio-guided surgery was planned as the best choice. (Institute Gustave Roussy protocol. A therapeutic dose of radioiodine (I-131 was given and up to the 4th day a whole body scan was performed. In the 5th day a gamma- probe-guided surgery was performed as well, and localized metastatic foci in the

  3. Cardiac abnormalities in children with hyperthyroidism.

    Science.gov (United States)

    Lester, L A; Sodt, P C; Rich, B H; Lucky, A W; Hutcheon, N; Arcilla, R A

    1982-01-01

    The cardiac status of 18 hyperthyroid (HT) children (9 black and 9 white) was evaluated by echocardiography. Mitral regurgitation (MR) was diagnosed clinically in 33% (6 of the 9 blacks). None of the 9 white children had MR. Left ventricular end-diastolic diameter (LVEDD) and volume (LVEDV) did not differ from the predicted normal (PN) based on body surface area and heart rate, except in those with MR where increased LVEDD and LVEDV were noted (p less than 0.02). LV mass was +1.75 standard deviations (sigma) of the PN (p less than 0.01), due to increased wall thickness of LVEDV. Left ventricular output (LVO) was +0.35 sigma PN (p = ns); however, when compared to that of normal children, LVO of HT was higher (p less than 0.001) due to the increased heart rate. Enhanced left ventricular contractility was suggested by increased rate of dimensional change during ejection (peak dD/dt-syst), with a mean value of -11.39 cm/sec as compared to the normal of -9.54 cm/sec (p less than 0.01). A linear multivariate regression equation differentiated the cardiac status of HT from that of normal children. Following treatment to euthyroid state, MR disappeared in 2 and became less in 4 patients. LVO, LV mass, and peak dD/dt-syst also became less. Significant cardiac changes occur in children with hyperthyroidism, which may be reversible in part after euthyroidism is restored.

  4. Should we treat mild subclinical/mild hyperthyroidism? No.

    Science.gov (United States)

    Vanderpump, Mark P J

    2011-08-01

    The management of a patient with subclinical hyperthyroidism or mild thyroid over-activity is controversial. Subclinical hyperthyroidism is defined as a serum thyrotrophin (TSH) below the reference range but a normal thyroxine (T4) and triiodothyronine (T3) level in a patient who is either asymptomatic or has only non-specific symptoms. Epidemiological studies report an overall prevalence of approximately 3%, with men and women over 65 years and those in iodine deficient regions having the highest prevalence. Approximately 50% of subjects are taking levothyroxine. The aetiology for those with endogenous subclinical hyperthyroidism is Graves' disease, toxic nodular goitre or rarely a solitary toxic adenoma or thyroiditis. Non-thyroidal illness is an important cause of false positive low serum TSH test results. Subjects with low but detectable serum TSH values (0.1-0.4 mU/L) usually recover spontaneously when re-tested. It has been estimated that in those with an undetectable serum TSH (hyperthyroidism occurs at a rate up to 5% per year. Advocates of intervening for subclinical hyperthyroidism argue that early treatment might reduce mortality, prevent the later development of atrial fibrillation, osteoporotic fractures, and overt hyperthyroidism but data supporting improvement in outcomes are sparse. No appropriately powered prospective, randomised, controlled, double-blinded trial of intervention for subclinical hyperthyroidism exists. For the vast majority of patients adopting a "wait and see" policy rather than intervention may avoid unnecessary treatment or the potential for harm. Any potential benefits of therapy in subclinical hyperthyroidism must be weighed against the significant morbidity associated with the treatment of hyperthyroidism.

  5. Antioxidant status in hyperthyroid cats before and after radioiodine treatment.

    Science.gov (United States)

    Branter, E; Drescher, N; Padilla, M; Trepanier, L A

    2012-01-01

    Reversible antioxidant depletion is found in hyperthyroid humans, and antioxidant depletion increases the risk of methimazole toxicosis in rats. To determine whether abnormalities in concentrations of blood antioxidants or urinary isoprostanes were present in hyperthyroid cats, and were reversible after radioiodine treatment. To determine whether or not antioxidant abnormalities were associated with idiosyncratic methimazole toxicosis. Hyperthyroid cats presented for radioiodine treatment (n = 44) and healthy mature adult control cats (n = 37). Prospective, controlled, observational study. Red blood cell glutathione (GSH), plasma ascorbate (AA), plasma free retinol (vitamin A), α-tocopherol (vitamin E), and urinary free 8-isoprostanes in hyperthyroid cats were compared to healthy cats and to hyperthyroid cats 2 months after treatment. Blood antioxidants were not significantly different in hyperthyroid cats (mean GSH 1.6 ± 0.3 mM; AA 12.8 ± 4.9 μM, and vitamin E, 25 ± 14 μg/mL) compared to controls (GSH 1.4 ± 0.4 mM; AA 15.0 ± 6.6 μM, and vitamin E, 25 ± 17 μg/mL). Urinary isoprostanes were increased in hyperthyroid cats (292 ± 211 pg/mg creatinine) compared to controls (169 ± 82 pg/mg; P = .006), particularly in hyperthyroid cats with a USG cats (0.54 ± 0.28 μg/mL versus 0.38 ± 0.21 in controls; P = .007). Both abnormalities normalized after radioiodine treatment. No association was found between oxidative status and prior idiosyncratic methimazole toxicosis. Increased urinary isoprostane could reflect reversible renal oxidative stress induced by hyperthyroidism, and this requires additional evaluation. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  6. The long-term consequences of previous hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans

    2015-01-01

    all nation-wide medical databases. Based on The Danish Civil Registration System and The Danish Twin Registry, in combination with The Danish National Patient Registry and The Danish National Prescription Registry, two study populations were identified. The first included 4,850 hyperthyroid and 19...... of genetic-confounding could not be ruled out. Secondly, hyperthyroidism is positively associated with cardiovascular disease (CVD), lung disease (LD) and diabetes mellitus (DM). Stratification for the period before and after the diagnosis of hyperthyroidism revealed an increased risk of being diagnosed...

  7. Pregnancy Complicated with Pulmonary Edema Due to Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Ming-Jie Yang

    2005-07-01

    Full Text Available Hyperthyroidism is one of the most common causes of cardiac failure. Blood volume expands greatly during pregnancy, especially after the last part of the second trimester. Such expansion exacerbates the symptoms of heart failure and accelerates the development of pulmonary edema when abnormal thyroid function is not well controlled. Two cases of pregnancy complicated with congestive heart failure and pulmonary edema due to hyperthyroidism are reported here. Both patients did not receive treatment for hyperthyroidism during pregnancy, and both sought clinical help during the third trimester. The clinical problems were resolved by medical management before delivery.

  8. Persistent high TRAb values during pregnancy predict increased risk of neonatal hyperthyroidism following radioiodine therapy for refractory hyperthyroidism.

    Science.gov (United States)

    Hamada, Noboru; Momotani, Naoko; Ishikawa, Naofumi; Yoshimura Noh, Jaeduk; Okamoto, Yasuyuki; Konishi, Toshiaki; Ito, Koichi; Ito, Kunihiko

    2011-01-01

    Serum levels of TSH receptor antibody (TRAb) often increase after radioiodine treatment for Graves' disease, and high-serum levels of maternal TRAb in late pregnancy indicate a risk of neonatal hyperthyroidism. The aim of this retrospective study is to investigate the characteristics of Graves' women who had a history of radioiodine treatment for intractable Graves' disease, and whose neonates suffered from hyperthyroidism. The subjects of this study were 45 patients with Graves' disease who became pregnant during the period from 1988 to 1998 after receiving radioiodine treatment at Ito Hospital. 25 of the 45 subjects had had a relapse of hyperthyroidism after surgical treatment for Graves' disease. 19 pregnancies were excluded because of artificial or spontaneous abortion. In the remaining 44 pregnancies of 35 patients, neonatal hyperthyroidism developed in 5 (11.3%) pregnancies of 4 patients. Serum levels of TRAb at delivery were higher in patients whose neonates suffered from hyperthyroidism (NH mother) than those of patients who delivered normal infants (N mother). Furthermore, serum levels of TRAb in NH mother did not change during pregnancy, although those of 4 patients of N mother, in which serum levels of TRAb before radioiodine treatment were as high as in NH mother, decreased significantly during pregnancy. In conclusion, women who delivered neonates with hyperthyroidism following radioiodine treatment seem to have very severe and intractable Graves' disease. Persistent high TRAb values during pregnancy observed in those patients may be a cause of neonatal hyperthyroidism.

  9. Subclinical hyperthyroidism and cardiovascular risk: recommendations for treatment.

    Science.gov (United States)

    Palmeiro, Christopher; Davila, Maria I; Bhat, Mallika; Frishman, William H; Weiss, Irene A

    2013-01-01

    Subclinical hyperthyroidism (SHy), the mildest form of hyperthyroidism, is diagnosed in patients having a persistently low or undetectable serum concentration of thyroid-stimulating hormone (TSH) with normal free T4 and T3 concentrations. Although overt hyperthyroidism is associated with an increased risk of adverse cardiovascular outcomes, the cardiovascular risk of SHy is controversial. Multiple studies have demonstrated an increased risk of atrial fibrillation, especially in older individuals with TSH levels cause and cardiovascular mortality are not clear, but recent meta-analyses suggest a modest increase in mortality, with the risk increasing with age and associated with the lowest TSH levels. The long-term consequences of SHy in young- and middle-aged adults, and in those with TSH levels are mildly low, are uncertain. For these reasons, guidelines for treatment are based on patient age, the degree of TSH suppression, symptoms consistent with hyperthyroidism, and overall cardiovascular and osteoporotic fracture risks.

  10. [Rare side effects in management of hyperthyroidism. Case report].

    Science.gov (United States)

    Sohár, Gábor; Kovács, Mónika; Györkös, Andrea; Gasztonyi, Beáta

    2016-05-29

    The authors present the case history of a patient suffering from hyperthyroidism. The diagnostic procedures revealed the presence of propylthiouracyl induced vasculitis with renal involvement, that recovered completely after the withdrawal of propylthiouracyl and corticosteroid treatment. Thereafter, the patient was treated with thiamasol, that caused agranulocytosis with fever. After transient litium carbonate therapy a succesful thyreoidectomy was performed. Cumulative serious side effects of antithyroid drugs are rare. This case highlights some of the challenges and complications encountered in the management of hyperthyroidism.

  11. Hyperthyroidism in four guinea pigs: clinical manifestations, diagnosis, and treatment.

    Science.gov (United States)

    Künzel, F; Hierlmeier, B; Christian, M; Reifinger, M

    2013-12-01

    Hyperthyroidism was diagnosed in four guinea pigs by demonstration of an increased serum total thyroxine concentration. The main clinical signs were comparable with those observed in feline hyperthyroidism and included weight loss despite maintenance of appetite and a palpable mass in the ventral cervical region. Three animals were treated successfully with methimazole for between 13 and 28 months. Clinical signs and regular measurement of circulating total thyroxine concentrations appear to be convenient parameters for monitoring response to medical therapy.

  12. Levels of Malondialdehyde and Superoxide Dismutase in Subclinical Hyperthyroidism

    OpenAIRE

    2005-01-01

    We aimed to determine whether patients with subclinical hyperthyroidism (SH) are subject to oxidative stress. Twenty-two women and 8 men having endogenous subclinical hyperthyroidism for a duration of at least 6 months, and 21 women and 9 men healthy controls were included in this study. We measured the level of plasma malondialdehyde, as one of the lipid peroxidation markers, and the activity of erythrocyte superoxide dismutase, which is an antioxidant enzyme. The activity of erythrocyte sup...

  13. Bladder pain syndrome/interstitial cystitis is associated with hyperthyroidism.

    Directory of Open Access Journals (Sweden)

    Shiu-Dong Chung

    Full Text Available BACKGROUND: Although the etiology of bladder pain syndrome/interstitial cystitis (BPS/IC is still unclear, a common theme with BPS/IC patients is comorbid disorders which are related to the autonomic nervous system that connects the nervous system to end-organs. Nevertheless, no study to date has reported the association between hyperthyroidism and BPS/IC. In this study, we examined the association of IC/BPS with having previously been diagnosed with hyperthyroidism in Taiwan. DESIGN: Data in this study were retrieved from the Longitudinal Health Insurance Database. Our study consisted of 736 female cases with BPS/IC and 2208 randomly selected female controls. We performed a conditional logistic regression to calculate the odds ratio (OR for having previously been diagnosed with hyperthyroidism between cases and controls. RESULTS: Of the 2944 sampled subjects, there was a significant difference in the prevalence of prior hyperthyroidism between cases and controls (3.3% vs. 1.5%, p<0.001. The conditional logistic regression analysis revealed that compared to controls, the OR for prior hyperthyroidism among cases was 2.16 (95% confidence interval (CI: 1.27∼3.66. Furthermore, the OR for prior hyperthyroidism among cases was 2.01 (95% CI: 1.15∼3.53 compared to controls after adjusting for diabetes, coronary heart disease, obesity, hyperlipidemia, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraines, sicca syndrome, allergies, endometriosis, and asthma. CONCLUSIONS: Our study results indicated an association between hyperthyroidism and BPS/IC. We suggest that clinicians treating female subjects with hyperthyroidism be alert to urinary complaints in this population.

  14. Causes of anorexia in untreated hyperthyroidism: a prospective study

    OpenAIRE

    Dai, W; Meng, X.

    2000-01-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after ...

  15. Evaluation of dermal symptoms in hypothyroidism and hyperthyroidism.

    Science.gov (United States)

    Razi, Ahad; Golforoushan, Farideh; Nejad, Amir Bahrami Shahla Babaee; Goldust, Mohamad

    2013-06-01

    Many symptoms arise in thyroid diseases. The aim of this study was to evaluate the dermal symptoms in hypothyroidism and hyperthyroidism. In this cross sectional study, 120 patients with hyperthyroidism and 50 patients suffering from hypothyroidism were studied. Cutaneous, hair and nail clinical symptoms were studied and registered in a special questionnaire. Mean age of patients suffering from hypothyroidism and hyperthyroidism were 38.24 +/- 14.45 and 25.86 +/- 14.69 years old. Dry and Coarse/rough skin were the most prevalent manifestations in the skin involvement in hypothyroidism since softness was the most prevalent ones in hyperthyroidism. Fragileness was the most prevalent symptom in patients with nail involvement in hypothyroidism since soft skin was the most prevalent ones in hyperthyroidism. Coarse/rough skin was observed more in patients with hair involvement in hypothyroidism since the most prevalent ones was separation of nail from its bed in hyperthyroidism. High prevalence of skin, hair and nail symptoms in thyroid patients, early diagnosis of the signs may be helpful in premature diagnosis and treatment of thyroid diseases.

  16. Cardiovascular involvement in patients with different causes of hyperthyroidism.

    Science.gov (United States)

    Biondi, Bernadette; Kahaly, George J

    2010-08-01

    Various clinical disorders can cause hyperthyroidism, the effects of which vary according to the patient's age, severity of clinical presentation and association with other comorbidities. Hyperthyroidism is associated with increased morbidity and mortality from cardiovascular disease, although whether the risk of specific cardiovascular complications is related to the etiology of hyperthyroidism is unknown. This article will focus on patients with Graves disease, toxic adenoma and toxic multinodular goiter, and will compare the cardiovascular risks associated with these diseases. Patients with toxic multinodular goiter have a higher cardiovascular risk than do patients with Graves disease, although cardiovascular complications in both groups are differentially influenced by the patient's age and the cause of hyperthyroidism. Atrial fibrillation, atrial enlargement and congestive heart failure are important cardiac complications of hyperthyroidism and are prevalent in patients aged > or = 60 years with toxic multinodular goiter, particularly in those with underlying cardiac disease. An increased risk of stroke is common in patients > 65 years of age with atrial fibrillation. Graves disease is linked with autoimmune complications, such as cardiac valve involvement, pulmonary arterial hypertension and specific cardiomyopathy. Consequently, the etiology of hyperthyroidism must be established to enable correct treatment of the disease and the cardiovascular complications.

  17. New-Onset Atrial Fibrillation Is a Predictor of Subsequent Hyperthyroidism

    DEFF Research Database (Denmark)

    Selmer, Christian; Hansen, Morten Lock; Olesen, Jonas Bjerring

    2013-01-01

    To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism.......To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism....

  18. Analysis of Subclinical Hyperthyroidism Influence on Parameters of Bone Metabolism

    Directory of Open Access Journals (Sweden)

    I.V. Pankiv

    2015-04-01

    Full Text Available State of subclinical hypothyroidism can be considered as the optimal model for assessing the significance of thyroid stimulating hormone (TSH for bone tissue in clinical practice. Objective: to make a comparative analysis of the impact of subclinical hyperthyroidism of various origins on the performance of bone mineral density (BMD and bone metabolism parameters. Materials and methods. The study in an outpatient setting included 112 women with a diagnosis of subclinical hyperthyroidism and duration of menopause for at least 5 years. Among the examinees, endogenous subclinical hyperthyroidism has been detected in 78 women (group I, exogenous subclinical hyperthyroidism on the background of suppressive levothyroxine therapy (group II — in 34. The control group (group III included 20 women without thyroid dysfunction. Results. The study first conducted a comparative analysis of bone metabolism, BMD indicators, as well as parameters of phosphorus and calcium, blood lipids in women with subclinical hyperthyroidism of various origins. A positive correlation between markers of bone metabolism and free triiodothyronine (fT3 as hormones necessary for the development of the skeleton and to maintain its homeostasis indicates a physiological effect of parathyroid hormone and fT3 on bone tissue. It is shown that the bone metabolism and BMD depend not only on the content of TSH, but also on the causes of subclinical hyperthyroidism.Conclusions. In postmenopausal women with endogenous subclinical hyperthyroidism, there is a significant decline in BMD indices, more pronounced in the bones with the cortical structure. A negative correlation between markers of bone metabolism and TSH has been observed among all patients included in the study.

  19. Evaluation of endothelial function in exogenous subclinical hyperthyroidism and the effect of treatment

    Directory of Open Access Journals (Sweden)

    Sayed Mohammad Hosseini

    2016-01-01

    Conclusions: This study demonstrated that FMD decreased in exogenous subclinical hyperthyroid patients which could be partially restored by treatment. These findings suggest that treatment of subclinical hyperthyroid state could improve endothelial dysfunction and at the end decreased the cardiovascular complications.

  20. Clinical analysis of radioactive iodine treatment in Grave’s hyperthyroidism patients with leucopenia

    Institute of Scientific and Technical Information of China (English)

    石丽红

    2013-01-01

    Objective To evaluate the effects of131 I treatment for Graves hyperthyroidism patients with leucopenia and the alteration of WBC levels after treatment.Methods A total of 257 Graves hyperthyroidism cases were

  1. Worldwide prevalence and risk factors for feline hyperthyroidism: A review

    Directory of Open Access Journals (Sweden)

    Joanne L. McLean

    2014-02-01

    Full Text Available Since first reported in the late 1970s, there has been a steady but dramatic increase in the worldwide prevalence of hyperthyroidism in cats. It is now regarded as the most common feline endocrine disorder, with diabetes mellitus coming a close second. Not only is there evidence for an increased worldwide prevalence of feline hyperthyroidism, but also for geographical variation in the prevalence of the disease. Despite its frequency, the underlying cause(s of this common disease is or are not known, and therefore prevention of the disease is not possible. Due to the multiple risk factors that have been described for feline hyperthyroidism, however, it is likely that more than one factor is involved in its pathogenesis. Continuous, lifelong exposure to environmental thyroid-disruptor chemicals or goitrogens in food or water, acting together or in an additive fashion, may lead to euthyroid goitre and ultimately to autonomous adenomatous hyperplasia, thyroid adenoma and hyperthyroidism. This review aims to summarise the available published evidence for the changes observed in the worldwide prevalence of the disease, as well as risk factors that may contribute to development of hyperthyroidism in susceptible cats.

  2. Functional Effects of Hyperthyroidism on Cardiac Papillary Muscle in Rats

    Science.gov (United States)

    Vieira, Fabricio Furtado; Olivoto, Robson Ruiz; da Silva, Priscyla Oliveira; Francisco, Julio Cesar; Fogaça, Rosalvo Tadeu Hochmuller

    2016-01-01

    Background Hyperthyroidism is currently recognized to affect the cardiovascular system, leading to a series of molecular and functional changes. However, little is known about the functional influence of hyperthyroidism in the regulation of cytoplasmic calcium and on the sodium/calcium exchanger (NCX) in the cardiac muscle. Objectives To evaluate the functional changes in papillary muscles isolated from animals with induced hyperthyroidism. Methods We divided 36 Wistar rats into a group of controls and another of animals with hyperthyroidism induced by intraperitoneal T3 injection. We measured in the animals' papillary muscles the maximum contraction force, speed of contraction (+df/dt) and relaxation (-df/dt), contraction and relaxation time, contraction force at different concentrations of extracellular sodium, post-rest potentiation (PRP), and contraction force induced by caffeine. Results In hyperthyroid animals, we observed decreased PRP at all rest times (p < 0.05), increased +df/dt and -df/dt (p < 0.001), low positive inotropic response to decreased concentration of extracellular sodium (p < 0.001), reduction of the maximum force in caffeine-induced contraction (p < 0.003), and decreased total contraction time (p < 0.001). The maximal contraction force did not differ significantly between groups (p = 0.973). Conclusion We hypothesize that the changes observed are likely due to a decrease in calcium content in the sarcoplasmic reticulum, caused by calcium leakage, decreased expression of NCX, and increased expression of a-MHC and SERCA2.

  3. Functional Effects of Hyperthyroidism on Cardiac Papillary Muscle in Rats

    Directory of Open Access Journals (Sweden)

    Fabricio Furtado Vieira

    Full Text Available Abstract Background: Hyperthyroidism is currently recognized to affect the cardiovascular system, leading to a series of molecular and functional changes. However, little is known about the functional influence of hyperthyroidism in the regulation of cytoplasmic calcium and on the sodium/calcium exchanger (NCX in the cardiac muscle. Objectives: To evaluate the functional changes in papillary muscles isolated from animals with induced hyperthyroidism. Methods: We divided 36 Wistar rats into a group of controls and another of animals with hyperthyroidism induced by intraperitoneal T3 injection. We measured in the animals' papillary muscles the maximum contraction force, speed of contraction (+df/dt and relaxation (-df/dt, contraction and relaxation time, contraction force at different concentrations of extracellular sodium, post-rest potentiation (PRP, and contraction force induced by caffeine. Results: In hyperthyroid animals, we observed decreased PRP at all rest times (p < 0.05, increased +df/dt and -df/dt (p < 0.001, low positive inotropic response to decreased concentration of extracellular sodium (p < 0.001, reduction of the maximum force in caffeine-induced contraction (p < 0.003, and decreased total contraction time (p < 0.001. The maximal contraction force did not differ significantly between groups (p = 0.973. Conclusion: We hypothesize that the changes observed are likely due to a decrease in calcium content in the sarcoplasmic reticulum, caused by calcium leakage, decreased expression of NCX, and increased expression of a-MHC and SERCA2.

  4. Clinical update: treatment of hyperthyroidism in Graves' ophthalmopathy.

    Science.gov (United States)

    Azzam, Ibrahim; Tordjman, Karen

    2010-03-01

    The presence of thyroid eye disease (TED) may influence the treatment of hyperthyroidism in patients with Graves' disease. Moreover, treatment of hyperthyroidism may affect the course of Graves' ophthalmopathy (GO). We review the literature and summarise recent knowledge about the impact of treatment modality for hyperthyroidism in GO. Anti-thyroid drugs (ATDs) remain the simplest and safest way to treat hyperthyroidism in patients with GO, but they are associated with a high relapse rate of hyperthyroidism and they have no effect on the course of GO. Radioactive iodine (RAI) treatment may be associated with exacerbation of GO especially in high risk patients, when glucocorticoid prophylaxis may be indicated. Large prospective trials are still lacking to define the exact effect of RAI on the course of GO, particularly in relation to other known risk factors. Likewise, clear guidelines for prophylactic glucocorticoid therapy are needed. RAI should be cautiously used in patients with more severe ophthalmopathy and concomitant I.V glucocorticoids should be considered. Thyroid surgery, whether total or subtotal thyroidectomy, has no effect on the course of ophthalmopathy. However, total thyroid ablation that combines surgery with radioactive iodine, as a means of achieving thyroid antigen disappearance, is increasingly gaining attention for the treatment of patients with GO, especially those undergoing thyroid surgery, but also for those with severe unresponsive ophthalmopathy. Studies supporting this approach are awaited.

  5. Serum nesfatin-1 levels in overt and subclinical hyperthyroidism.

    Science.gov (United States)

    Gungunes, A; Ozbek, M; Ginis, Z; Sahin, M; Demirci, T; Cakir Ozkaya, E; Karbek, B; Sayki Arslan, M; Ozturk Unsal, I; Tutal Akkaya, E; Ucan, B; Gultuna Ozguclu, S; Cakal, E; Topaloglu, O; Delibasi, T

    2014-09-01

    Nesfatin-1 was recently discovered anorexigenic peptide in the brain which is derived from nucleobindin-2. Central and peripheral administration of nesfatin-1, inhibits food intake, dose-dependently. Hyperthyroid patients have increased appetite and food intake with a craving for carbohydrate-rich food, at the beginning of disease, but the physiological mechanisms underlying this behavior is not known exactly. In this study, we investigated whether nesfatin-1 is involved in the regulation of appetite and body weight in hyperthyroidism, or not. A total of 70 patients with subclinical (35) and overt hyperthyroidism (35) compared with 35 control patients. Serum nesfatin-1 level was measured from all samples by commercial ELISA kit. Serum nesfatin-1 levels were similar between three groups (P=0.293). After adjusting for age and body mass index, nesfatin-1 levels in control group was not different from subclinical and overt hyperthyroid group, respectively (P=0.567 and P=0.519). These data showed that serum nesfatin-1 levels do not significant change in overt and subclinical hyperthyroidism.

  6. Worldwide prevalence and risk factors for feline hyperthyroidism: A review.

    Science.gov (United States)

    McLean, Joanne L; Lobetti, Remo G; Schoeman, Johan P

    2014-11-14

    Since first reported in the late 1970s, there has been a steady but dramatic increase in the worldwide prevalence of hyperthyroidism in cats. It is now regarded as the most common feline endocrine disorder, with diabetes mellitus coming a close second. Not only is there evidence for an increased worldwide prevalence of feline hyperthyroidism, but also for geographical variation in the prevalence of the disease. Despite its frequency, the underlying cause(s) of this common disease is or are not known, and therefore prevention of the disease is not possible. Due to the multiple risk factors that have been described for feline hyperthyroidism, however, it is likely that more than one factor is involved in its pathogenesis. Continuous, lifelong exposure to environmental thyroid-disruptor chemicals or goitrogens in food or water, acting together or in an additive fashion, may lead to euthyroid goitre and ultimately to autonomous adenomatous hyperplasia, thyroid adenoma and hyperthyroidism. This review aims to summarise the available published evidence for the changes observed in the worldwide prevalence of the disease, as well as risk factors that may contribute to development of hyperthyroidism in susceptible cats.

  7. Serum thyrotrophin at baseline predicts the natural course of subclinical hyperthyroidism.

    Science.gov (United States)

    Das, G; Ojewuyi, T A; Baglioni, P; Geen, J; Premawardhana, L D; Okosieme, O E

    2012-07-01

    Optimal therapeutic strategies for subclinical hyperthyroidism are undecided. Overt disease develops in a minority of cases, but the risk factors for progression remain unclear. We examined whether a baseline thyrotrophin (TSH) predicted progression to overt hyperthyroidism in asymptomatic individuals with subclinical hyperthyroidism. This was a retrospective study of 323 patients with subclinical hyperthyroidism seen in our institution from 2003 to 2010 (mean age 71 years, males 26·9%, females 73·1%, mean follow-up duration 32 months, range 6-93 months). Serum TSH and free thyroxine (FT4) were documented at baseline and during follow-up. After excluding individuals with nonthyroid causes of low TSH, patients were grouped according to initial TSH as: TSH 0·10-0·39 mU/l (grade I) and TSH hyperthyroidism with annual progression rates of 0·6-3·7%. Most patients reverted to normal thyroid status (31·6%) or remained subclinically hyperthyroid (56·7%). Progression to frank hyperthyroidism was higher in grade II than in grade I patients (20·3% vs 6·8%, P hyperthyroidism (hazard ratio 3·4, confidence interval 1·6-7·0), whereas age, gender, FT4 and aetiological diagnosis were not associated with hyperthyroidism. Thyrotrophin predicts overt hyperthyroidism in asymptomatic individuals with subclinical hyperthyroidism. Patients with TSH hyperthyroidism than those with TSH 0·10-0·39 mU/l. © 2012 Blackwell Publishing Ltd.

  8. Thyrotropinoma and multinodular goiter: A diagnostic challenge for hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Duygu Yazgan Aksoy

    2013-01-01

    Full Text Available Thyroid disorders are frequently encountered. The diagnosis is straightforward unless clinical or laboratory findings are inconclusive and/or perplexing. Hyperthyroidism due to a thyrotropin-secreting pituitary adenoma rarely occurs and symptoms due to thyroid hormone excess are subtle. The presentation of the disease becomes unusual when co-secretion of other hormones with thyrotropin or concomitant thyroid parenchymal pathology exist. We present the case of a 63-year-old female patient with thyrotropinoma co-secreting growth hormone and multinodular goiter. She developed hyperthyroidism first due to thyrotropinoma and later due to a toxic nodule. Herein, we discuss the diagnostic and therapeutic challenges of hyperthyroidism with atypical presentation.

  9. An update on the medical treatment of Graves' hyperthyroidism.

    Science.gov (United States)

    Marinò, Michele; Latrofa, Francesco; Menconi, Francesca; Chiovato, Luca; Vitti, Paolo

    2014-11-01

    Medical treatment of Graves' hyperthyroidism is based on the use of thionamides; namely, methimazole and propylthiouracil. In the past, methimazole was preferred by European endocrinologists, whereas propylthiouracil was the first choice for the majority of their North American colleagues. However, because of the recent definition of a better side-effect profile, methimazole is nowadays the first choice world while. Although thionamides are quite effective for the short-term control of Graves' hyperthyroidism, a relatively high proportion of patients relapses after thionamide withdrawal. Other possible medical treatments, include iodine and compounds containing iodine, perchlorate, lithium (as an adjuvant in patients undergoing radioiodine therapy), β-adrenergic antagonists, glucocorticoids, and some new molecules still under investigation. Management of Graves' hyperthyroidism using thionamides as well as the other available medical treatments is here reviewed in detail, with a special mention of situations such as pregnancy and lactation, as well as neonatal and fetal thyrotoxicosis.

  10. The influence of hyperthyroidism on implant restoration treatment outcome

    Directory of Open Access Journals (Sweden)

    Suhandi Sidjaja

    2006-09-01

    Full Text Available There is limited information about bone implant restoration treatment on edentulous patient with hyperthyroidism. This clinical report is presenting the making of dental bone implant restoration on patient with hyperthyroidism history. A 60 years old male patient with hyperthyroidism came to Prosthodontic Clinic Faculty of Dentistry University of Indonesia to improve his ailing denture. After comprehensive evaluation we treated the patient with Implant-Tissue-Supported Overdenture (4 Implants for rehabilitating upper edentulous jaw, and 2 Implant-Tooth-Supported Fixed Partial Denturesfor rehabilitating Kennedy class II lower edentulous jaw respectively. Short term clinical and radiographic evaluation based on Buser’s criteria showed positive result. (Med J Indones 2006; 15:191-5Keywords: Hyperthyroidsm, implant restoration

  11. Methimazole Associated Neutropenia in a Preterm Neonate Treated for Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Dimitrios Angelis

    2015-01-01

    Full Text Available Maternal Graves’ disease is relatively uncommon with an estimated incidence of 0.4%–1% of all pregnancies, but only 1–5% of newborns delivered to mothers with Graves’ disease develop overt clinical signs and symptoms of hyperthyroidism. Here, we describe a case of a 1380-gram female neonate who was born at 30-week gestation to a mother with Graves’ disease. Our patient presented with hyperthyroidism followed by transient hypothyroidism requiring treatment with levothyroxine. While hyperthyroid, she was treated with methimazole, iodine, and a beta-blocker. 20 days after the initiation of methimazole, she developed neutropenia. The neutrophil counts started to improve immediately after the initiation of the weaning of methimazole. To the best of our knowledge, this is the first case reported in the literature of methimazole induced neutropenia in a preterm infant being treated for neonatal Graves’ disease.

  12. Evidence for a possible calcium flux dependent cardiomyopathy in hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Barat, J.L.; Wicker, P.; Manley, W.; Brendel, A.J.; Lefort, G.; San Galli, F.; Commenges-Ducos, M.; Latapie, J.L.; Riviere, J.; Ducassou, D.

    1985-05-01

    This study was designed to test the hypothesis that the impaired functional cardiac reserve to exercise in hyperthyroidism is related to alterations in the regulation of calcium transport. In 2l hyperthyroid patients, the left ventricular ejection fraction (LVEF) was measured using equilibrium gated radionuclide angiocardiography at rest and during supine dynamic exercise. After a recovery period, the patients performed a second exercise study after random administration of Verapamil, a calcium entry blocker (11 pts), or propanolol, a beta adrenergic antagonist (10 pts) for comparison. The results showed i) normal resting LVEF with no significant change during exercise before any medication, ii) resting LVEF significantly decreased after Propanolol, and no significantly changed after Verapamil, iii) during exercise, significant increase of LVEF after Verapamil, and no significant change after Propanolol. These results are consistent with previous studies showing that abnormal change in LVEF during exercise in hyperthyroidism seems independent of beta adrenergic activation, and suggest a reversible functional cardiomyopathy dependent of calcium transporting systems.

  13. Long-term outcomes of treatment of hyperthyroidism in Ireland.

    LENUS (Irish Health Repository)

    Leary, A C

    2012-02-03

    We investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1\\/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves\\' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves\\' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.

  14. Prevalence of hyperthyroidism according to type of vegetarian diet.

    Science.gov (United States)

    Tonstad, Serena; Nathan, Edward; Oda, Keiji; Fraser, Gary E

    2015-06-01

    Vegetarian diets may be associated with low prevalence of autoimmune disease, as observed in rural sub-Saharan Africans. Graves' disease, an autoimmune disorder, is the most common cause of hyperthyroidism. We studied prevalence of hyperthyroidism according to dietary pattern in a population with a high proportion of vegetarians. Cross-sectional prevalence study. The association between diet and prevalence of hyperthyroidism was examined using multivariate logistic regression analyses controlling for sociodemographic characteristics and salt use. The Adventist Health Study-2 conducted in the USA and Canada. Church members (n 65 981) provided demographic, dietary, lifestyle and medical history data by questionnaire. The prevalence of self-reported hyperthyroidism was 0·9 %. Male gender (OR=0·32; 95 % CI 0·26, 0·41) and moderate or high income (OR=0·67; 95 % CI 0·52, 0·88 and OR=0·73; 95 % CI 0·58, 0·91, respectively) protected against hyperthyroidism, while obesity and prevalent CVD were associated with increased risk (OR=1·25; 95 % CI 1·02, 1·54 and OR=1·92; 95 % CI 1·53, 2·42, respectively). Vegan, lacto-ovo and pesco vegetarian diets were associated with lower risk compared with omnivorous diets (OR=0·49; 95 % CI 0·33, OR=0·72, 0·65; 95 % CI 0·53, 0·81 and OR=0·74; 95 % CI 0·56, 1·00, respectively). Exclusion of all animal foods was associated with half the prevalence of hyperthyroidism compared with omnivorous diets. Lacto-ovo and pesco vegetarian diets were associated with intermediate protection. Further study of potential mechanisms is warranted.

  15. The Incidence and Risk of Inducing Hyperthyroidism Following Amiodarone Treatment

    Directory of Open Access Journals (Sweden)

    Cozlea D L

    2013-06-01

    Full Text Available Introduction: Amiodarone, a frequently used antiarrhythmic drug in cardiology, is very efficient in the treatment of ventricular and supraventricular tachiarrithmyas. The iodine content of amiodarone is 39%. Its chemical structure is similar to tyrosine. It is estimated that 1-23% of patients treated with amiodarone can develop hyperthyroidism. The purpose of this study is to assess and monitor the incidence of hyperthyroidism induced by amiodarone in patients admitted for various types of cardiac dysrhythmias, considering that most of the patients included in the study came from an endemic goitre area.

  16. Exploring the Experiences of People With Hypo- and Hyperthyroidism

    DEFF Research Database (Denmark)

    Nexø, Mette A; Watt, Torquil; Cleal, Bryan

    2015-01-01

    Thyroid diseases evoke a complex range of psychological and physical symptoms. The psychosocial aspects of living with diseases causing hypo- or hyperthyroidism are poorly understood. In this article, we report the findings of a qualitative interview study in which we explored the lived experiences...... of 16 people with hypo- or hyperthyroidism. We purposefully selected participants from Danish outpatient clinics according to their diagnosis (Hashimoto's thyroiditis or Graves' disease with or without orbitopathy), age (18 to 65 years), and duration of treatment (more than 6 months). We used...

  17. Pancytopenia in the first trimester: An indicator of hidden hyperthyroidism.

    Science.gov (United States)

    Imai, Ken; Ohkuchi, Akihide; Nagayama, Shiho; Saito, Shinsuke; Matsubara, Shigeki; Suzuki, Mitsuaki

    2015-12-01

    Pancytopenia in the first trimester is very rare. A 33-year-old multiparous woman presented with nausea, loss of appetite, and bodyweight loss of 7.4 kg at 9(1/7) weeks of gestation due to hyperemesis gravidarum. Her laboratory data demonstrated pancytopenia involving white blood cell count of 3500/μL, a hemoglobin level of 9.8 g/dL, and a platelet count of 10.5 × 10(4)/μL. An extensive investigation into the causes of the pancytopenia detected true hyperthyroidism: thyroid-stimulating hormone, hyperthyroidism. © 2015 Japan Society of Obstetrics and Gynecology.

  18. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case.

    Science.gov (United States)

    Hegde, Swati; Shaikh, Mohammed Aslam; Gummadi, Thejaswi

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous history of thyroid disorder or any signs and symptoms suggestive of hyperthyroidism. He was subsequently diagnosed with Graves' disease with subclinical hyperthyroidism.

  19. A Prospective Study on Cardiovascular Dysfunction in Patients with Hyperthyroidism and Its Reversal After Surgical Cure.

    Science.gov (United States)

    Muthukumar, Sankaran; Sadacharan, Dhalapathy; Ravikumar, Krishnan; Mohanapriya, Gajarajan; Hussain, Zahir; Suresh, R V

    2016-03-01

    Cardiovascular dysfunction (CVD) is a major cause of mortality and morbidity in hyperthyroidism. CVD and its reversibility after total thyroidectomy (TT) are not adequately addressed. This prospective case-control study evaluates the effect of hyperthyroidism on myocardium and its reversibility after TT. Surgical candidates of new onset hyperthyroidism, Group A (n = 41, age Hyperthyroidism. Various parameters of CVD improved consistently after surgical cure. NT-proBNP levels correlated well with the severity and duration of CVD and hence can be an objective tool in monitoring of hyperthyroid cardiac dysfunction.

  20. Effect of transient postpubertal hypo- and hyperthyroidism on ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-10-19

    Oct 19, 2009 ... hyperthyroidism on reproductive parameters of Iranian broiler breeder hens ... Large doses of thyroxine (5 mg/kg diet), had an inhibit- tory effect on ..... DISCUSSION. Figures 1 and 2 show the trends of changes in plasma T3 ...

  1. Treatment of Graves' hyperthyroidism: evidence-based and emerging modalities

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Currently there are three well-established treatment options for hyperthyroid Graves' disease (GD): antithyroid drug therapy with thionamides (ATD), radioactive iodine treatment with (131)I, and thyroid surgery. This article reviews the current evidence so the reader can evaluate advantages...

  2. Subclinical hyperthyroidism: to treat or not to treat?

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Heijer, M. den; Dijk, A.P.J. van; Hermus, A.R.M.M.

    2004-01-01

    Subclinical hyperthyroidism may be defined as the presence of free thyroxine and tri-iodothyronine levels within the reference range and a reduced serum thyroid stimulating hormone (TSH) level. In this review the prevalence of low TSH in the population and health consequences of subclinical hyperthy

  3. Treatment of Hyperthyroidism in Pregnancy and Birth Defects

    NARCIS (Netherlands)

    Clementi, Maurizio; Di Gianantonio, Elena; Cassina, Matteo; Leoncini, Emanuele; Botto, Lorenzo D.; Mastroiacovo, Pierpaolo

    2010-01-01

    Context: Clinical hyperthyroidism is not uncommon in pregnancy, with a reported prevalence of 0.1 to 0.4%. The available antithyroid drugs are propylthiouracil and methimazole/carbimazole. Objectives: In this report we examined the association of both drugs with congenital malformations using data f

  4. Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat.

    Science.gov (United States)

    Snead, Elisabeth; Kerr, Moira; Macdonald, Valerie

    2013-10-01

    A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.

  5. The adverse effects of hypothyroidism and hyperthyroidism during pregnancy

    Directory of Open Access Journals (Sweden)

    Mahnaz Boroumand Rezazadeh

    2015-06-01

    Full Text Available Due to the important role of thyroid disorders on reproductive health of the women of childbearing age, pregnancy outcome, fetal health, and neurodevelopment of the infant, providing comprehensive assessment of the treatments used for preventing hyperthyroidism and hypothyroidism seems to be essential. Therefore, evaluating the efficacy of different treatments of the thyroid disorders would be beneficial in better managing and controlling the disease during pregnancy. Hypothyroidism (a deficiency of thyroid hormone is a common thyroid disorder, which might increase the incidence rate of miscarriage, pre-eclampsia, placental abruption, and preterm delivery. Hyperthyroidism, which is not a common disorder during the pregnancy not only leads to similar adverse effects as hypothyroidism but also can result in stillbirth and intrauterine growth restriction. Levothyroxine is the preferred treatment of hypothyroidism and the only drug therapy recommended for treating hyperthyroidism during pregnancy. In this study, we aimed to briefly review the adverse effects of hyperthyroidism and hypothyroidism during pregnancy and review the effects of recent suggested treatments for controlling thyroid disorders on pregnancy outcomes.

  6. Tempol improves renal hemodynamics and pressure natriuresis in hyperthyroid rats.

    Science.gov (United States)

    Moreno, Juan Manuel; Rodríguez Gómez, Isabel; Wangensteen, Rosemary; Alvarez-Guerra, Miriam; de Dios Luna, Juan; García-Estañ, Joaquín; Vargas, Félix

    2008-03-01

    Hyperthyroidism in rats is associated with increased oxidative stress. These animals also show abnormal renal hemodynamics and an attenuated pressure-diuresis-natriuresis (PDN) response. We analyzed the role of oxidative stress as a mediator of these alterations by examining acute effects of tempol, a superoxide dismutase mimetic. The effects of increasing bolus doses of tempol (25-150 micromol/kg) on mean arterial pressure (MAP), renal vascular resistance (RVR), and cortical (CBF) and medullary (MBF) blood flow were studied in control and thyroxine (T4)-treated rats. In another experiment, tempol was infused at 150 micromol.kg(-1).h(-1) to analyze its effects on the glomerular filtration rate (GFR) and on PDN response in these animals. Tempol dose dependently decreased MAP and RVR and increased CBF and MBF in control and T4-treated rats, but the T4 group showed a greater responsiveness to tempol in all of these variables. The highest dose of tempol decreased RVR by 13.5 +/- 2.1 and 5.5 +/- 1.2 mmHg.ml(-1).min(-1) in hyperthyroid (P natriuresis (T4+tempol: 0.17 +/- 0.05; T4: 0.09 +/- 0.03 microeq.min(-1).g(-1).mmHg(-1); P < 0.05) and reduced 8-isoprostane excretion in hyperthyroid rats. These results show that antioxidant treatment with tempol improves renal hemodynamic variables and PDN response in hyperthyroid rats, indicating the participation of an increased oxidative stress in these mechanisms.

  7. Psychoimmunomodulating activity of Phenibut under conditions of experimental hyperthyroidism

    Directory of Open Access Journals (Sweden)

    M A Samotrueva

    2012-03-01

    Full Text Available Psychoimmunomodulating action of Phenibut has been shown on the model of experimental hyperthyroidism. It has been found that the drug (intra-abdominal injection in the dose 25 mg/kg is able to restore humoral immunoreactivity and liquidate disturbances of the behaviour reactions appearing in the result of induced pathology as well.

  8. Hyperthyroidism in Graves disease. Current trends in management and diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Haibach, H.

    1976-06-01

    The radioimmunoassay for T/sub 3/ is now widely available and is a useful diagnostic tool for hyperthyroidism, especially in T/sub 3/-thyrotoxicosis. It is an essential tool in the management of hyperthyroidism that persists after treatment with normal T/sub 4/ serum levels or, in euthyroid cases, with low T/sub 4/ serum levels. In these conditions, it reflects the metabolic state more accurately than serum levels of T/sub 4/. A promising new test is the response of radioimmunoassayable TSH to protirelin relin (TRH) administration. An absent response indicates pituitary suppression and thyroid autonomy as seen in frank hyperthyroidism or euthyroid Graves disease, treated or untreated. It is safer and quicker than the conventional T/sub 3/ suppression test of thyroid radioactive iodine uptake and may replace it at least partly in the future. The recently recognized sharp decline in the remission rate of patients subjected to thyroid drug therapy in the last decade has made this treatment much less efficacious. By necessity, it will probably lead to greater reliance on treatment with radioactive iodine in the majority of the patients with the hyperthyroidism of Graves disease.

  9. Hyperthyroidism in childhood: causes, when and how to treat.

    Science.gov (United States)

    Léger, Juliane; Carel, Jean Claude

    2013-01-01

    Graves' disease (GD) is the most common cause of hyperthyroidism in children. This review gives an overview and update of management of GD. Antithyroid drugs (ATD) are recommended as the initial treatment, but the major problem is the high relapse rate (30%) as remission is achieved after a first course of ATD. More prolonged medical treatment may increase the remission rate up to 50%. Alternative treatments, such as radioactive iodine or thyroidectomy, are considered in cases of relapse, lack of compliance, or ATD toxicity. Therefore, clinicians have sought prognostic indicators of remission. Relapse risk decreases with longer duration of the first course of ATD treatment, highlighting the positive impact of a long period of primary ATD treatment on outcome. The identification of other predictive factors such as severe biochemical hyperthyroidism at diagnosis, young age, and absence of other autoimmune conditions has made it possible to stratify patients according to the risk of relapse after ATD treatment, leading to improvement in patient management by facilitating the identification of patients requiring long-term ATD or early alternative therapy. Neonatal autoimmune hyperthyroidism is generally transient, occurring in only about 2% of the offspring of mothers with GD. Cardiac insufficiency, intrauterine growth retardation, craniostenosis, microcephaly and psychomotor disabilities are the major risks in these infants and highlight the importance of thyroid hormone receptor antibody determination throughout pregnancy in women with GD, as well as highlighting the need for early diagnosis and treatment of hyperthyroidism.

  10. Anesthetic management of patient with myasthenia gravis and uncontrolled hyperthyroidism for thymectomy

    Directory of Open Access Journals (Sweden)

    Datt Vishnu

    2010-01-01

    Full Text Available The relationship between myasthenia gravis (MG and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently orafter the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.

  11. The Diagnosis and Management of Hyperthyroidism in Korea: Consensus Report of the Korean Thyroid Association

    Directory of Open Access Journals (Sweden)

    Jae Hoon Moon

    2013-12-01

    Full Text Available Hyperthyroidism is one of the causes of thyrotoxicosis and the most common cause of hyperthyroidism in Korea is Graves disease. The diagnosis and treatment of Graves disease are different according to geographical area. Recently, the American Thyroid Association and the American Association of Clinical Endocrinologists suggested new management guidelines for hyperthyroidism. However, these guidelines are different from clinical practice in Korea and are difficult to apply. Therefore, the Korean Thyroid Association (KTA conducted a survey of KTA members regarding the diagnosis and treatment of hyperthyroidism, and reported the consensus on the management of hyperthyroidism. In this review, we summarized the KTA report on the contemporary practice patterns in the diagnosis and management of hyperthyroidism, and compared this report with guidelines from other countries.

  12. Evaluation of atrial electromechanical delay and diastolic functions in patients with hyperthyroidism.

    Science.gov (United States)

    Sokmen, Abdullah; Acar, Gurkan; Sokmen, Gulizar; Akcay, Ahmet; Akkoyun, Murat; Koroglu, Sedat; Nacar, Alper Bugra; Ozkaya, Mesut

    2013-11-01

    Hyperthyroidism is a well-known cause of atrial fibrillation (AF) which is associated with increased morbidity and mortality. Atrial electromechanical delay (EMD) is a significant predictor of AF. The aim of this study was to assess the atrial EMD and diastolic functions in subclinical and overt hyperthyroidism by using tissue Doppler imaging (TDI). The study population consisted of 3 groups: group I (30 healthy subjects), group II (38 patients with subclinical hyperthyroidism), and group III (25 patients with overt hyperthyroidism). Atrial electromechanical coupling was measured with TDI. Standard echocardiographic measurements and parameters of diastolic function were obtained by conventional echocardiography and TDI. Intra- and inter-atrial EMD were significantly prolonged in subclinical and overt hyperthyroidism compared with control group (P = 0.03 and P hyperthyroidism. TSH level and mitral Em /Am ratio were found as independent predictors of atrial EMD. © 2013, Wiley Periodicals, Inc.

  13. Hyperthyroidism is associated with work disability and loss of labour market income

    DEFF Research Database (Denmark)

    Brandt, Frans; Thvilum, Marianne; Hegedüs, Laszlo

    2015-01-01

    in labour market income. RESULTS: Hyperthyroid individuals had an increased risk of receiving disability pension: hazard ratio (HR) was 1.88, (95% CI: 1.57-2.24). Subdividing as to the cause of hyperthyroidism did not change this finding: Graves' disease (GD) HR was 1.51 (95% CI: 0.87-2.63) and toxic......OBJECTIVE: To examine the risk of disability pension and changes in labour market income in patients with hyperthyroidism. METHODS: From a 5% random sample of the Danish population and twins from the Danish Twin Registry we identified 1942 hyperthyroid singletons and 7768 non-hyperthyroid (matched...... 1:4) controls as well as 584 same-sex twin pairs discordant for hyperthyroidism. Singletons and twins were followed for a mean of 9 years (range 1-20). Cox regression analysis was used to examine the risk of disability pension and a difference-in-differences model was used to evaluate changes...

  14. A critical review and meta-analysis of the association between overt hyperthyroidism and mortality

    DEFF Research Database (Denmark)

    Brandt, Frans; Green, Anders; Hegedüs, Laszlo

    2011-01-01

    Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study...... design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis....

  15. Hypokalaemic Periodic Paralysis in a Patient with Subclinical Hyperthyroidism: A Rare Case

    OpenAIRE

    2016-01-01

    Thyrotoxic Periodic Paralysis (TPP) is an uncommon disorder. Though many cases of hypokalaemic periodic paralysis are reported in overt hyperthyroidism, hypokalaemic paralysis in subclinical hyperthyroidism is very rare. Subclinical hyperthyroidism is characterised by circulating TSH levels below reference range and normal thyroid hormone levels. We describe a case of 32-year-old Asian male who presented to the emergency department with acute onset weakness and hypokalaemia with no previous h...

  16. The Diagnosis and Management of Hyperthyroidism in Korea: Consensus Report of the Korean Thyroid Association

    OpenAIRE

    Jae Hoon Moon; Ka Hee Yi

    2013-01-01

    Hyperthyroidism is one of the causes of thyrotoxicosis and the most common cause of hyperthyroidism in Korea is Graves disease. The diagnosis and treatment of Graves disease are different according to geographical area. Recently, the American Thyroid Association and the American Association of Clinical Endocrinologists suggested new management guidelines for hyperthyroidism. However, these guidelines are different from clinical practice in Korea and are difficult to apply. Therefore, the Kore...

  17. Severe Hyperthyroidism Presenting with Acute ST Segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Dayan Zhou

    2015-01-01

    Full Text Available Introduction. Acute myocardial infarction is life-threatening. A cardiac troponin rise accompanied by typical symptoms, ST elevation or depression is diagnostic of acute myocardial infarction. Here, we report an unusual case of a female who was admitted with chest pain. However, she did not present with a typical profile of an acute myocardial infarction patient. Case Presentation. A 66-year-old Han nationality female presented with chest pain. The electrocardiogram (ECG revealed arched ST segment elevations and troponin was elevated. However, the coronary angiography showed a normal coronary arterial system. Thyroid function tests showed that this patient had severe hyperthyroidism. Conclusion. Our case highlights the possibility that hyperthyroidism may cause a large area of myocardium injury and ECG ST segment elevation. We suggest routine thyroid function testing in patients with chest pain.

  18. Cardiovascular risk with subclinical hyperthyroidism and hypothyroidism: pathophysiology and management.

    Science.gov (United States)

    Duggal, Jasleen; Singh, Sarabjeet; Barsano, Charles P; Arora, Rohit

    2007-01-01

    Previous studies have suggested that subclinical thyroid dysfunction, as manifested by abnormalities in thyroid-stimulating hormone (TSH) levels, are associated with detrimental effects on the cardiovascular system. Subclinical hypothyroidism is characterized by abnormal lipid metabolism, cardiac dysfunction, diastolic hypertension conferring an elevated risk of atherosclerosis, and ischemic heart disease. Similarly, patients with subclinical hyperthyroidism have nearly 3 times the likelihood of atrial fibrillation over a 10-year follow-up interval, raising the question of whether patients with subclinical hyperthyroidism should be treated to prevent atrial fibrillation. A single measurement of low serum TSH in individuals aged 60 years or older has been reported to be associated with increased mortality from all causes and in particular from circulatory and cardiovascular disease in a 10-year follow-up study. Subclinical thyroid dysfunction is currently the subject of numerous studies and remains controversial, particularly as it relates to cardiovascular morbidity and mortality and clinical applications.

  19. Screening and diagnosis of hyperthyroidism: an attempt at test reduction.

    Science.gov (United States)

    Fragu, P; Alpérovitch, A; Patois, E

    1979-09-01

    A sequencial strategy for the diagnosis of hyperthyroidism has been prospectively appraised on 410 patients using a pocket calculator-aided diagnostic system. It was found that for 64% of the patients final diagnosis could be established from nine clinical signs, ankle jerk time and free thyroxin index. For the 36% of doubtful subjects, T3 determination permitted the reduction of uncertainty to 9%. No misdiagnosis was observed. By comparing this strategy with the physician's usual diagnosis process, in which all clinical signs and several thyroid function tests were used, it appeared that the number of tests was reduced by 65% for T3 requests and by 70% for other tests (99mTc uptake and TRH). The cost-saving was estimated to be about 28%. The interest of this calculator-aided decision model resides in the possibility for the general practitioner to refer only doubtful and hyperthyroid subjects to a thyroid unit.

  20. Impact of lithium on radioactive iodine therapy for hyperthyroidism

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    Brahmanandam Lingudu

    2014-01-01

    Full Text Available Context: Radioactive Iodine (RAI is a common therapy for hyperthyroidism. However hyperthyroidism recurs or persists in 15-18% of patients after RAI. Studies report variable percentage of failure after RAI therapy depending on several variables including I 1310 . Lithium enhances efficacy of treatment by increasing RAI retention in the thyroid. Aims: To evaluate the efficacy of Lithium to RAI therapy in terms of cure, reduction of mean thyroid volume, and its safety. Settings and Design: A prospective comparative study. Subjects and Methods: Forty hyperthyroid patients were assigned to two groups, RAI alone and RAI plus lithium and followed for 1 year. Lithium was given in a dose of 900 mg/day in three divided doses for 6 days starting on the day of RAI therapy. Total T3, total T4, and thyroid-stimulating hormone (TSH were done at baseline, 2,4,6,9, and 12 months. Ultrasound of thyroid was done at baseline and at the end of 1 year. Monitoring was done for side effects of lithium and RAI therapy. Statistical Analysis: Cure rate and time to cure were assessed by Chi-square test. Mean change in thyroid volume was compared by student′s t-test. P < 0.05 was considered significant. Results: RAI combined with lithium had a trend towards better cure rate (90% compared to RAI alone (70% (P 0.11. Mean time taken to cure was 4.69 months in RAI plus lithium and 7.12 months in RAI alone (P 0.001. Mean change in thyroid volume was similar in both the groups (P = 0.75. There were no side effects of Lithium or RAI. Conclusions: RAI therapy combined with lithium showed a trend towards higher cure rate, safe and time to cure was less than RAI alone. Hence RAI combined with lithium is a better option in the management of hyperthyroidism than RAI alone.

  1. A case report of suicidal behavior related to subclinical hyperthyroidism

    OpenAIRE

    2014-01-01

    Abnormalities in thyroid function are associated with many psychiatric symptoms. We present a report of a 15-year-old girl who was admitted to the psychiatry inpatient unit with symptoms of suicidal behavior, irritability, and impulsivity. One year previously, she had become more short-tempered, and had started to cut her wrists impulsively. Laboratory tests revealed subclinical hyperthyroidism. She was treated with anxiolytic and antithyroid drugs, and her suicidal ideation and irritability ...

  2. Radioiodine treatment of recurrent hyperthyroidism in patients previously treated for Graves' disease by subtotal thyroidectomy

    DEFF Research Database (Denmark)

    Vestergaard, H; Laurberg, P

    1992-01-01

    Radioiodine therapy is often employed for treatment of patients with relapse of hyperthyroidism due to Graves' disease, after previous thyroid surgery. Little is known about the outcome of this treatment compared to patients with no previous surgery. A total of 20 patients who had received surgical...... treatment for Graves' hyperthyroidism 1-46 years previously and with relapse of the hyperthyroidism, and 25 patients with hyperthyroidism due to Graves' disease and no previous thyroid surgery were treated with radioiodine, following the same protocol. Early after treatment the previously operated patients...

  3. High Age Predicts Low Referral of Hyperthyroid Patients to Specialized Hospital Departments

    DEFF Research Database (Denmark)

    Carlé, Allan; Pedersen, Inge Bülow; Perrild, Hans

    2013-01-01

    , and analyzed how referral depended on subtype of disease, sex, age, and degree of biochemical hyperthyroidism. Results: In a 4-year period, 1,032 hyperthyroid patients were diagnosed at primary care offices, and 435 of these (42.2%) were referred to specialized units, 92 patients had hyperthyroidism diagnosed...... in other hospital departments (referral: 43, 46.7%), and 24 patients had hyperthyroidism diagnosed at the specialized unit after referral for other diseases. Patients suffering from Graves' disease (GD; n=474, median age=65.8 years) were referred more often (odds ratio=1.7 [95% confidence interval 1...

  4. Clinical aspects of hyperthyroidism, hypothyroidism, and thyroid screening in pregnancy.

    Science.gov (United States)

    Negro, Roberto; Stagnaro-Green, Alex

    2014-06-01

    To evaluate the peer-reviewed literature on hypothyroidism, hyperthyroidism, and thyroid autoimmunity in pregnancy. We review published studies on thyroid autoimmunity and dysfunction in pregnancy, the impact of thyroid disease on pregnancy, and discuss implications for screening. Overt hyperthyroidism and hypothyroidism are responsible for adverse obstetric and neonatal events. Several studies of association suggest that either subclinical hypothyroidism or thyroid autoimmunity increase the risk of complications. One randomized controlled trial showed that pregnant women with subclinical hypothyroidism benefit from treatment in terms of obstetric and neonatal complications, whereas another study demonstrated no benefit in the intelligence quotient of babies born to women with subclinical hypothyroidism. Thyroid autoimmunity has been associated with increased rate of pregnancy loss, recurrent miscarriage, and preterm delivery. Current guidelines agree that overt hyperthyroidism and hypothyroidism need to be promptly treated and that as potential benefits outweigh potential harm, subclinical hypothyroidism also requires substitutive treatment. The chance that women with thyroid autoimmunity may benefit from levothyroxine treatment to improve obstetric outcome is intriguing, but adequately powered randomized controlled trials are needed. The issue of universal thyroid screening at the beginning of pregnancy is still a matter of debate, and aggressive case-finding is supported.

  5. Efficacy and safety of methimazole ointment for patients with hyperthyroidism.

    Science.gov (United States)

    Wu, Xi; Liu, Hong; Zhu, Xixing; Shen, Jun; Shi, Yongquan; Liu, Zhimin; Gu, Mingjun; Song, Zhimin

    2013-11-01

    Oral methimazole has been widely used to treat hyperthyroidism, but its usage is restricted by its adverse systemic effects. The aim of this study was to investigate the efficacy and safety of methimazole ointment for the treatment of hyperthyroidism. One hundred forty-four subjects with hyperthyroidism were initially enrolled. These patients were initially divided into two groups and given the following treatments for 12 weeks: patients in group A received 5% methimazole ointment applied to the skin around the thyroid and an oral placebo; and patients in group B received methimazole tablets and placebo ointment. One hundred thirty-one subjects were included in the final analysis. Therapeutic efficacy was assessed via the levels of free triiodothyronine and thyroxine in the serum and by biweekly monitoring of the symptoms of thyrotoxicosis. Adverse effects were recorded. Fifty-nine (89.40%) patients in group A and 57 (87.69%) patients in group B were euthyroid and experienced alleviation of thyrotoxicosis symptoms (complete control; p>0.05). The median times required to achieve complete control for the patients in the two groups were 6.5 weeks and 6.4 weeks for groups A and B, respectively (p>0.05). Systemic adverse effects (e.g., rash, liver dysfunction, leucopenia, etc.) were significantly less common in group A (1.5%) than in group B (12.3%; phyperthyroidism.

  6. [Increased serum PIVKA-II levels in hyperthyroidism].

    Science.gov (United States)

    Morimoto, M; Takeda, K; Ohara, E; Nishimori, Y; Hisahara, T; Nishida, M; Sugiura, T

    2001-11-01

    PIVKA-II has been practically used as a tumor marker of hepatocellular carcinoma. On the other hand, increased serum PIVKA-II concentration was reported in a Japanese patient who had hyperthyroidism without liver diseases. To evaluate whether thyroid hormone is related with serum PIVKA-II, we examined serum PIVKA-II concentrations in patients with various thyroid diseases. Eight patients with Hashimoto disease, 24 patients with Graves' disease, and 8 healthy subjects were studied. There was no significant difference of serum PIVKA-II levels among the three groups. However, serum PIVKA-II concentrations(mean +/- SD mAU/ml) in hyperthyroidism(37 +/- 27) were significantly higher than those in hypothyroidism(16 +/- 9) and normal controls(12 +/- 4) (p PIVKA-II concentrations decreased in accordance with the decrease of serum FT4 concentrations. Our data indicate that serum PIVKA-II concentration was increased in patients with hyperthyroidism, but further in vivo studies are necessary to clarify the mechanism related to increased serum PIVKA-II by thyroid hormone.

  7. Hyperthyroidism causes cardiac dysfunction by mitochondrial impairment and energy depletion.

    Science.gov (United States)

    Maity, Sangeeta; Kar, Dipak; De, Kakali; Chander, Vivek; Bandyopadhyay, Arun

    2013-05-01

    This study elucidates the role of metabolic remodeling in cardiac dysfunction induced by hyperthyroidism. Cardiac hypertrophy, structural remodeling, and expression of the genes associated with fatty acid metabolism were examined in rats treated with triiodothyronine (T3) alone (8 μg/100 g body weight (BW), i.p.) for 15 days or along with a peroxisome proliferator-activated receptor alpha agonist bezafibrate (Bzf; 30 μg/100 g BW, oral) and were found to improve in the Bzf co-treated condition. Ultrastructure of mitochondria was damaged in T3-treated rat heart, which was prevented by Bzf co-administration. Hyperthyroidism-induced oxidative stress, reduction in cytochrome c oxidase activity, and myocardial ATP concentration were also significantly checked by Bzf. Heart function studied at different time points during the course of T3 treatment shows an initial improvement and then a gradual but progressive decline with time, which is prevented by Bzf co-treatment. In summary, the results demonstrate that hyperthyroidism inflicts structural and functional damage to mitochondria, leading to energy depletion and cardiac dysfunction.

  8. Exogenous subclinical hyperthyroidism: effect on the cardiovascular system.

    Science.gov (United States)

    Federico Moreno, Karol; Paoli de Valeri, Mariela; Odreman, Rodolfo; Núñez, Tulio; Arata-Bellabarba, Gabriela

    2008-06-01

    To evaluate the effects of exogenous subclinical hyperthyroidism on left ventricular structure and function. Twenty-three patients of both sexes, aged 27 to 70 years, with a diagnosis of exogenous subclinical hyperthyroidism (serum thyroid-stimulating hormone [TSH] ≤ 0.4mU/ml and normal free thyroxine [FT4]) were evaluated. The patients had been taking levothyroxine in suppressive doses for an average of 6.7 years (1 to 35 years). Twenty euthyroid individuals matched for age, sex and body mass index were selected as controls. A medical history was obtained and symptoms of thyrotoxicosis were quantified in all subjects. To evaluate left ventricular structure and function, as well as atrial conduction time, a two-dimensional echocardiogram and pulsed echo and tissue echo Doppler with electrocardiography monitoring were performed. The index of hemodynamic compensation of the left ventricular mass was calculated. Hyperthyroid symptom scores were significantly higher in patients than in controls (p=0.0001). A positive correlation was found between hyperthyroidism scores and FT4 (p=0.005) and ejection fraction (p=0.04) and a negative correlation was found with TSH levels (p=0.03). End-diastolic volume, stroke volume, cardiac output and stroke work were significantly higher in patients with SH (p=0.04, p=0.02, p=0.05 and p=0.01, respectively). A positive correlation was found between fractional shortening and FT4 level (p=0.022) and levothyroxine dose (p=0.016) and between stroke work and FT4 level (p=0.034). Left ventricular mass, diastolic function and atrial conduction time were similar in patients and controls. Our study suggests that patients with exogenous subclinical hyperthyroidism have hemodynamic changes resulting from adaptation to the biological effects of levothyroxine on the cardiovascular system. However, structural changes are not produced. Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights

  9. The fracture risk assessment tool (FRAX® score in subclinical hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Polovina Snežana

    2015-01-01

    Full Text Available Background/Aim. The Fracture Risk Assessment Tool (FRAX® score is the 10-year estimated risk calculation tool for bone fracture that includes clinical data and hip bone mineral density measured by dual-energy x-ray absorptiometry (DXA. The aim of this cross-sectional study was to elucidate the ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and post-menopausal women with subclinical hyperthyroidism. Methods. The bone mineral density (by DXA, thyroid stimulating hormone (TSH level, free thyroxine (fT4 level, thyroid peroxidase antibodies (TPOAb titre, osteocalcin and beta-cross-laps were measured in 27 pre- and post-menopausal women with newly discovered subclinical hyperthyroidism [age 58.85 ± 7.83 years, body mass index (BMI 27.89 ± 3.46 kg/m2, menopause onset in 46.88 ± 10.21 years] and 51 matched euthyroid controls (age 59.69 ± 5.72 years, BMI 27.68 ± 4.66 kg/m2, menopause onset in 48.53 ± 4.58 years. The etiology of subclinical hyperthyroisims was autoimmune thyroid disease or toxic goiter. FRAX® score calculation was performed in both groups. Results. In the group with subclinical hyperthyroidism the main FRAX® score was significantly higher than in the controls (6.50 ± 1.58 vs 4.35 ± 1.56 respectively; p = 0.015. The FRAX® score for hip was also higher in the evaluated group than in the controls (1.33 ± 3.92 vs 0.50 ± 0.46 respectively; p = 0.022. There was no correlations between low TSH and fracture risk (p > 0.05. The ability of the FRAX® score in discriminating between bone fracture positive and negative pre- and postmenopausal female subjects (p < 0.001 is presented by the area under the curve (AUC plotted via ROC analysis. The determined FRAX score cut-off value by this analysis was 6%, with estimated sensitivity and specificity of 95% and 75.9%, respectively. Conclusion. Pre- and postmenopausal women with subclinical hyperthyroidism have higher FRAX® scores and thus

  10. Role of colestipol in the treatment of hyperthyroidism.

    Science.gov (United States)

    Hagag, P; Nissenbaum, H; Weiss, M

    1998-12-01

    The enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) is higher in thyrotoxicosis. Bile-salt sequestrants bind iodothyronines and thereby increase their fecal excretion. We, therefore, evaluated the effect of colestipol-hydrochloride administration on clinical and biochemical indices of patients with hyperthyroidism. In a prospective, controlled trial, ninety-two adult volunteers with Graves' disease, toxic autonomous nodule or toxic multinodular goiter were randomly assigned into the following treatment protocols: Group 1, 30 mg of methimazole (MMI) and 20 g of colestipol-hydrochloride (COL) daily; Group 2, 30 mg of MMI daily; and Group 3, 15 mg of MMI 20 g of COL daily. The patients were further classified into Group A, severe hyperthyroidism (baseline levels of total T3 (TT3) > or =5 nmol/l) and Group B, mild to moderate thyrotoxicosis (baseline levels of TT-3<5 nmol/l). Crook's clinical index, serum free T4 (FT4), TT3 and thyroid stimulating hormone (TSH) levels were determined before (WO), following one week (W1) and two weeks (W2) of treatment. Serum TT3 level decreased (mean+/-SE) at W1 by 40.8+/-2.6% of WO in Group1 and by 29.2+/-2.4% in Group 2 (p<0.001), and down further to 47.8+/-3.0% at W2 in Group 1, and 40.6+/-2.8% in Group 2 (p=0.01). Serum FT4 level decreased (mean+/-SE) from WO to W1 by 31.7+/-2.7% in Group 1 and by 16.2+/-3.1% in Group 2 (p=0.005), and down to 49.1+/-2.8% of WO at W2 in Group 1 and to 38.7+/-3.5% in Group 2 (p=0.07). In sub groups B COL was not effective in reducing thyroid hormone levels nor in ameliorating the clinical status of the patients. However, in Group A3 COL lowered FT4 (p=0.001) and TT3 (p=0.05) levels as compared to group A2. At W2 the clinical hyperthyroidism score improved faster in Group A1 (p<0.001) and Group A3 (p=0.012) as compared to the control Group A2. In conclusion, COL is an effective and well tolerated adjunctive agent in the treatment of hyperthyroidism. Its main effect is in severe

  11. Early-Onset Oligohydramnios Complicated with Hypertension, Hyperthyroidism and Coexisting Elevated Urine Vanillylmandelic Acid of Unknown Origin, Mimicking a Pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Joung-Liang Wu

    2004-12-01

    Conclusion: A combination of hypertension, oligohydramnios and hyperthyroidism is rare. An elevated 24- hour urine vanillylmandelic acid of unknown origin is a previously unreported finding, to the best of our knowledge, associated with hyperthyroidism and pregnancy-induced hypertension.

  12. Hyperthyroid-associated osteoporosis is exacerbated by the loss of TSH signaling

    Science.gov (United States)

    The osteoporosis associated with human hyperthyroidism has traditionally been attributed to elevated thyroid hormone levels. There is evidence, however, that thyroid-stimulating hormone (TSH), which is low in most hyperthyroid states, directly affects the skeleton. Importantly, Tshr-knockout mice ar...

  13. BROMINATED-FLAME RETARDANTS (BFRS) IN CATS – POSSIBLE LINKAGE TO FELINE HYPERTHYROIDISM?

    Science.gov (United States)

    Coincident with global introduction of BFRs into house¬hold consumer products nearly 30 years ago, hyperthyroidism in cats has increased considerably. The etiopathogenesis of feline hyperthyroidism remains unknown. We hypothesized that increasing exposure of pet cats to BFRs such...

  14. Treatment of Hyperthyroidism in Down Syndrome: Case Report and Review of Literature.

    Science.gov (United States)

    Ali, Fawzi E.; Al-Busairi, Waleed A.; Al-Mulla, Fatema A.

    1999-01-01

    A case of an institutionalized adult male with Down syndrome and hyperthyroidism is reported. After treatment with radioactive iodine, he was found to be markedly hypothyroid when he was reviewed 11 weeks later. Three treatment options for hyperthyroidism in Down syndrome are reviewed: surgery, medical treatments, and radiotherapy. (Author/CR)

  15. Ambulatory blood pressure monitoring in patients with hyperthyroidism before and after control of thyroid function.

    Science.gov (United States)

    Iglesias, P; Acosta, M; Sánchez, R; Fernández-Reyes, M J; Mon, C; Díez, J J

    2005-07-01

    Thyroid hormones have pronounced effects on the cardiovascular system. Thyrotoxicosis affects blood pressure (BP), modifying both diastolic (DBP) and systolic (SBP) pressures. There are no studies examining BP with ambulatory blood pressure monitoring (ABPM) in hyperthyroidism before and after control of thyroid function. Our aims were (1) to analyse ABPM in a group of normotensive hyperthyroid patients before and after normalizing circulating thyroid hormones and (2) to compare these results with those obtained in a group of euthyroid subjects. We studied 20 normotensive hyperthyroid subjects [18 women; age (mean +/- SEM) 49.0 +/- 3.0 years] and 15 healthy subjects. Patients were evaluated by ABPM over 24 h, at diagnosis and after therapy (n = 18). The average 24-h, daytime and night-time SBP was significantly greater in hyperthyroid patients than in controls with no significant differences in DBP. Circadian BP rhythm, estimated by the difference between mean values of SBP, DBP and mean BP during daytime and night-time, was unchanged. The average 24-h and daytime SBP significantly decreased after normalizing thyroid function in the 18 hyperthyroid evaluated patients. Daytime SBP and DBP were higher than night-time values both before and after control of thyroid function. However, no differences in circadian BP rhythm were observed. Normotensive hyperthyroid patients exhibit higher ambulatory SBP throughout 24 h than normotensive euthyroid subjects. Control of hyperthyroidism decreases ambulatory SBP values. Mean nocturnal fall in BP is comparable in normotensive hyperthyroid patients and control subjects.

  16. BROMINATED-FLAME RETARDANTS (BFRS) IN CATS – POSSIBLE LINKAGE TO FELINE HYPERTHYROIDISM?

    Science.gov (United States)

    Coincident with global introduction of BFRs into house¬hold consumer products nearly 30 years ago, hyperthyroidism in cats has increased considerably. The etiopathogenesis of feline hyperthyroidism remains unknown. We hypothesized that increasing exposure of pet cats to BFRs such...

  17. Serum cytokine levels in autoimmune and non-autoimmune hyperthyroid states

    Directory of Open Access Journals (Sweden)

    L.S. Ward

    2000-01-01

    Full Text Available Although the role of interleukin-2 (IL-2 and interferon gamma (gIFN is still poorly understood in hyperthyroid diseases, it is reasonable to assume that these cytokines may be present at higher levels in Graves' disease (GD than in other primarily non-autoimmune thyroid diseases. In order to look for an easy method to distinguish GD from primarily non-autoimmune causes of hyperthyroidism, we compared 13 healthy individuals with 21 treated and untreated hyperthyroid GD patients and with 19 patients with hyperthyroidism due to other etiologies: 7 cases of multinodular goiter, 5 cases of excessive hormone replacement and 7 cases of amiodarone-associated hyperthyroidism. All patients presented low TSH levels and a dubious clinical thyroid state. We found a good correlation between TSH and serum IL-2 levels (r = 0.56; PgIFN (P<0.01 levels were lower in the hyperthyroid group of patients than in control subjects, suggesting a depressed TH1 pattern in the T-cell subset of hyperthyroid patients. GD had normal IL-2 levels, while patients with other forms of thyrotoxicosis presented decreased IL-2 levels (P<0.05. There was no difference between treated and untreated GD patients. We suggest that the direct measurement of serum IL-2 level may help to confirm hyperthyroidism caused by GD.

  18. Changing axis deviation and paroxysmal atrial flutter associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-10-08

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Rarely, it has also been reported intermittent changing axis deviation during atrial fibrillation and during atrial flutter. We present a case of paroxysmal atrial flutter and changing axis deviation associated with subclinical hyperthyroidism, in a 76-year-old Italian man. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  19. Acute myocardial infarction without significant coronary stenoses associated with endogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Sturiale, Mauro

    2012-04-05

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Nowadays, there is growing interest regarding endogenous sublinical hyperthyroidism and the cardiovascular system. We present a case of acute myocardial infarction without significant coronary stenoses in a 75-year-old Italian woman with endogenous subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of endogenous subclinical hyperthyroidism. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Dissociative disorder due to Graves' hyperthyroidism: a case report.

    Science.gov (United States)

    Mizutani, Kaoru; Nishimura, Katsuji; Ichihara, Atsuhiro; Ishigooka, Jun

    2014-01-01

    We report the case of a 20-year-old Japanese woman with no psychiatric history with apparent dissociative symptoms. These consisted of amnesia for episodes of shoplifting behaviors and a suicide attempt, developing together with an exacerbation of Graves' hyperthyroidism. Patients with Graves' disease frequently manifest various psychiatric disorders; however, very few reports have described dissociative disorder due to this disease. Along with other possible causes, for example, encephalopathy associated with autoimmune thyroid disease, clinicians should be aware of this possibility. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Current and emerging treatment options for Graves’ hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Prakash Abraham

    2009-12-01

    Full Text Available Prakash Abraham1, Shamasunder Acharya21Department of Endocrinology, Aberdeen Royal Infirmary, Aberdeen, UK; 2Department of Endocrinology, John Hunter Hospital, New Lambton NSW, AustraliaAbstract: Radioiodine, antithyroid drugs and surgery have been well established therapies for Graves’ hyperthyroidism for several decades. However there remain large variations in practice among physicians in the preferred modality and the method of administration. Patient choice and perceptions also play a big role in the choice of treatment. Radioiodine may be given using fixed high doses or by calculated doses following uptake studies. The risks of radioiodine including eye disease and the role of prophylactic steroid therapy are discussed. The commonly used antithyroid drugs include carbimazole, methimazole and propylthiouracil; however a number of other agents have been tried in special situations or in combination with these drugs. The antithyroid drugs may be given in high (using additional levothyroxine in a block–replace regimen or low doses (in a titration regimen. This review examines the current evidence and relative benefits for these options as well as looking at emerging therapies including immunomodulatory treatments such as rituximab which have come into early clinical trials. The use of antithyroid therapies in special situations is also discussed as well as clinical practice issues which may influence the choices.Keywords: Graves’ hyperthyroidism, radioiodine, antithyroid drugs, methimazole, propylthiouracil

  2. Mortality in patients treated for hyperthyroidism with iodine-131

    Energy Technology Data Exchange (ETDEWEB)

    Hall, P.; Lundell, G.; Holm, L.E. (Karolinska Hospital, Stockholm (Sweden))

    1993-03-01

    Causes of death were studied in 10552 Swedish hyperthyroid patients treated with [sup 131]I diagnosed between 1950 and 1975. The patients were followed for an average of 15 years and were matched with the Swedish cause of death register. A total of 5400 deaths were observed and the overall standardized mortality ratio was 1.47. The standardized mortality ratio for females was 1.50 compared to 1.31 in males. The most common cause of death was from cardiovascular diseases. Significantly elevated risks were also seen for tumours, diseases of the endocrine system, respiratory system, gastro-intenstinal system, and congenital malformations. In all causes of death, except tumours and trauma, decreasing standardized mortality ratios over time were seen. Patients followed for more than 10 years had significantly elevated risks for tumours, diseases of the endocrine, respiratory, and cardiovascular systems. Patients given higher [sup 131]I activity and younger patients had higher standardized mortality ratios than those given lower activity and older patients. The hyperthyroidism per se, rather than the [sup 131]I treatment, appeared to be the major explanation for the elevated mortality. 20 refs., 3 tabs.

  3. Grey matter abnormalities in untreated hyperthyroidism: A voxel-based morphometry study using the DARTEL approach

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Wei, E-mail: will.zhang.1111@gmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People' s Armed Police Forces, Leshan 614000 (China); Song, Lingheng, E-mail: songlh1023@hotmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Department of Radiology, No. 324 Hospital of PLA, Chongqing 400020 (China); Yin, Xuntao, E-mail: xuntaoyin@gmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Zhang, Jiuquan, E-mail: jiuquanzhang@yahoo.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Liu, Chen, E-mail: cqliuchen@foxmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Wang, Jian, E-mail: wangjian_811@yahoo.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Zhou, Daiquan, E-mail: zhoudq77@sina.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Chen, Bing, E-mail: chenbing3@medmail.com.cn [Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Lii, Haitao, E-mail: haitaolii023@gmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China)

    2014-01-15

    Objective: Hyperthyroidism is frequently associated with pronounced neuropsychiatric symptoms such as impulsiveness, irritability, poor concentration, and memory impairments. Functional neuroimaging has revealed changes in cerebral metabolism in hyperthyroidism, but regional changes in cortical morphology associated with specific neurological deficits have not been studied so far. To investigate the pathophysiology underlying hyperthyroid-associated neural dysfunction, we compared grey matter volume (GMV) between adult hyperthyroid patients and matched healthy controls using voxel-based morphometry (VBM). Materials and methods: High resolution 3D T1-weighted images were acquired by 3T MRI from 51 hyperthyroid patients and 51 controls. VBM analysis was performed using SPM8. Correlations between regional GMV and both serum free thyroid hormone (TH) concentrations and disease duration were assessed by multiple regression analysis. Results: Compared to controls, GM volumes in the bilateral hippocampus, parahippocampal gyrus, calcarine, lingual gyrus, and left temporal pole were lower and bilateral supplementary motor area GMV higher in hyperthyroid patients. Serum free triiodothyronine (FT3) concentration was negatively correlated with the normalized regional volume (NRV) of the left parahippocampal gyrus and serum free thyroxine (FT4) concentration negatively correlated with the NRV of the left hippocampus and right parahippocampal gyrus. Disease duration was negatively correlated with the NRV of the left hippocampus, bilateral parahippocampal gyrus, and left temporal pole. Conclusion: Hyperthyroid patients exhibited reduced GMV in regions associated with memory, attention, emotion, vision, and motor planning. Negative correlations between GMV and both free TH and disease duration suggest that chronic TH elevation induces abnormalities in the adult cortex.

  4. [Measurement and correlation analysis of plasma VEGF level in the patients of hyperthyroidism].

    Science.gov (United States)

    Zhao, Xiaoni; Wang, Guangrong; You, Jinhui

    2013-04-01

    Vascular endothelial growth factor (VEGF) is a glycoprotein that promotes endothelial regeneration, stimulates formation of collateral blood vessels and increases vascular permeability. The purpose of this study was to measure the peripheral blood plasma level of VEGF and FT3, FT4, TSH and to analyze the correlation of the level of VEGF and TSH, FT3, FT4, age and gender in the patients of hyperthyroidism. The relationship between hyperthyroidism and VEGF was investigated as well. The plasma level of VEGF in 45 hyperthyroidism patients and 27 healthy persons were measured by enzyme-linked immunosorbent assay (ELISA), while plasma FT3, FT4, TSH were detected by chemiluminescence. The result showed that the plasma level of VEGF in hyperthyroidism patients [(92.53 +/- 62.38) pg/mL] was significantly lower than that in the control group [(158.28 +/- 77.15) pg/mL] (P hyperthyroidism patients (P > 0.05). These results suggested that the peripheral blood plasma level of VEGF in hyperthyroidism patients was significantly lower than that in the control group. Further experimental investigations are needed to estimate the relationship between VEGF and hyperthyroidism.

  5. The evaluation of left ventricular hypertrophy in hypertensive patients with subclinical hyperthyroidism.

    Science.gov (United States)

    Tamer, Ismet; Sargin, Mehmet; Sargin, Haluk; Seker, Mesut; Babalik, Erhan; Tekce, Mustafa; Yayla, Ali

    2005-08-01

    The aim of this prospective cross-sectional study was to investigate the hypertrophic effects of endogenous subclinical hyperthyroidism on myocardium and early development of left ventricular hypertrophy (LVH) in essential hypertensive patients accompanied by endogenous subclinical hyperthyroidism. A total of 31 consecutive patients with stage I hypertension were included in the study. Sixteen of them also had endogenous subclinical hyperthyroidism that they were unaware before. The patients and the controls formed out of ten healthy subjects all underwent an investigation of thyroid functions and cardiologic evaluation. The mean wall thickness of the left ventricle in the stage I hypertensive group with endogenous subclinical hyperthyroidism (group I) was significantly increased as compared with both hypertensive patients without thyroid disease (group II) and the control subjects. The mean left ventricle mass was also significantly higher in group I than group II. Both of the patients' groups had an increased prevalence of LVH as compared with the controls. In this study, hypertensive patients with subclinical hyperthyroidism presented more increase in left ventricular mass, suggesting that subclinical hyperthyroidism may contribute to left ventricular hypertrophy forming a natural progression to hypertension. The hypertensive population should always be screened for endogenous subclinical hyperthyroidism, and should be examined for the criteria of left ventricular hypertrophy by echocardiography in early stages.

  6. Atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-11-05

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that sub-clinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Moreover increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. It has been also reported an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Furthermore it has been reported that at highly increased hematocrit levels patients may experience hyperviscosity symptoms. We present a case of atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  7. "LASER" EN MEDICINA Y CIRUGIA

    Directory of Open Access Journals (Sweden)

    Jaime Gómez Gonzalez

    1985-12-01

    Full Text Available

    El Laser es un instrumento de gran utilidad en diferentes campos de la medicina y la cirugía. Su aplicación se ha limitado en los países Latinoamericanos por el alto costo de la tecnología que representan estos equipos. En este artículo se presentan algunas de las aplicaciones del Laser en susdiversas modalidades.


    ABREVIATURAS: LF = Baja frecuencia; MF = Frecuencia media; HF = Frecuencia alta; TV= Televisión; VHF= Frecuencia muy alta; UHF = Frecuencia superalta; FM= Frecuencia modulada; FIR =Zona infrarroja lejana; NIR= Zona infrarroja cercana.


    La aplicación del Laser en la medicina y cirugía constituye uno de los grandes avances de la ciencia, pues con este instrumento se han podido realizar procedimientos imposibles de practicar con otros métodos. La posibilidad de cortar, coagular y vaporizar los tejidos sin tocarlos o con manipulación mínima se traduce en disminución del tiempo operatorio, reducción de la hemorragia (lo que permite intervenir enfermos con trastornos de coagulación, paso inocuo a través de zonas infectadas, acceso más fácil a las cavidades del cuerpo y cirugía prácticamente atraumática. El Laser fue producto de la aplicación práctica de las investigaciones básicas de Einstein, quien formuló la teoría foto-eléctrica merecedora del Premio Nobel en 1917. El primer Laser de Rubí fue construido por Maiman en 1960; poco después Patel desarrolló el Laser de CO2. En 1965 empezaron las investigaciones para sus múltiples aplicaciones en medicina y cirugía y a final de los afias setenta fue aprobado para uso clínico en los Estados Unidos, Europa y el Japón...

  8. [Treatment of hyperthyroidism due to Graves' disease: what is the recommended antithyroid drug during pregnancy?].

    Science.gov (United States)

    Caron, P

    2013-05-01

    Clinical hyperthyroidism during the first trimester of pregnancy due to Graves' disease can be associated with maternal, obstetrical and fetal complications, indicating an active treatment to restore normal thyroid function. Antithyroid drugs are the first line treatment in pregnant women with hyperthyroidism. Due to the increased congenital malformations reported in neonates after first-trimester carbimazole/methimazole treatment and propylthiouracil associated hepatotoxicity, the recommended treatment for pregnant women with hyperthyroid Graves' disease is propylthiouracil during the first trimester of pregnancy and following the first trimester, consideration should be given switching to carbimazole/methimazole during the second part of gestation.

  9. N-terminal-pro-B-type natriuretic peptide during pharmacological heart rate reduction in hyperthyroidism

    DEFF Research Database (Denmark)

    Schultz, M; Kistorp, C; Corell, P

    2009-01-01

    of pharmacologically induced heart rate reduction in untreated hyperthyroidism. We designed a noncontrolled interventional study. Eighteen women with newly diagnosed hyperthyroidism were evaluated (including an echocardiography) before and after pharmacological heart rate reduction with 360 mg verapamil daily for 6......; resting heart rate [from mean 97 to 80 beats per min (17.5%), p...-index decreased from median 319 to 315 arbitrary units (p=0.039) and free triiodothyronine-index increased from 8.6 to 9.9 arbitrary units (p=0.010). No changes in echocardiographic parameters were observed. A decrease in resting heart rate in untreated hyperthyroidism due to verapamil treatment did not result...

  10. Acute reaction to erroneous injection of adrenaline to the patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2014-01-01

    Hyperthyroidism is an important endocrine disorder that can be seen around the world.In this disorder, the patient is usually hyperstimulate and palpitation.The effect of thyroid hormone is the explanation.A similar effect can be seen due to adrenaline reaction.In general, the use of adrenaline in the case with hyperthyroidism has to be carefully done.In the present case study, the authors present a case of acute reaction to erroneous injection of adrenaline to the patients with hyperthyroidism.

  11. Management of hyperthyroidism due to Graves' disease: frequently asked questions and answers (if any).

    Science.gov (United States)

    Bartalena, L; Chiovato, L; Vitti, P

    2016-10-01

    Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Although progress has been made in our understanding of the pathogenesis of the disease, no treatment targeting pathogenic mechanisms of the disease is presently available. Therapies for Graves' hyperthyroidism are largely imperfect because they are bound to either a high rate of relapsing hyperthyroidism (antithyroid drugs) or lifelong hypothyroidism (radioiodine treatment or thyroidectomy). Aim of the present article is to offer a practical guidance to the reader by providing evidence-based answers to frequently asked questions in clinical practice.

  12. Pathophysiology and management of intracranial arterial stenosis around the circle of Willis associated with hyperthyroidism: case reports and literature review.

    Science.gov (United States)

    Matano, Fumihiro; Murai, Yasuo; Adachi, Koji; Kitamura, Takayuki; Teramoto, Akira

    2014-04-01

    Cases of moyamoya disease or intracranial arterial stenosis around the circle of Willis (M/IAS) associated with hyperthyroidism have been reported. However, most of these previous reports were of the ischemic form of M/IAS and primary hyperthyroidism. To the best of our knowledge, no studies have documented therapy for M/IAS associated with hyperthyroidism. We discuss four previously unreported cases, including those involving the intracerebral hemorrhage form and thyroid-stimulating hormone (TSH) secretion from a pituitary adenoma (secondary hyperthyroidism). We analyzed data from 52 previously reported cases, including the 4 cases presented here, and discuss M/IAS associated with hyperthyroidism, treatment options, pathophysiology, the ischemic and hemorrhagic forms, secondary hyperthyroidism, and the relevant literature. Hyperthyroidism results in thyrotoxicosis and the stimulation of the superior cervical ganglion by TSH antibodies and f-T3/f-T4. Consequently, hypercoagulability and stenosis of the cerebral artery can occur. There are many reports of ischemic M/IAS associated with hyperthyroidism. A conservative approach to treatment is important in such cases; for example, antithyroid therapy should be the first choice to treat ischemic M/IAS. There have been only a limited number of reports on hemorrhagic M/IAS. We presume that hemorrhagic M/IAS tears the weakened vasculature in a manner similar to that of normal M/IAS (with no complicating hyperthyroidism). The authors also reported M/IAS associated with secondary hyperthyroidism due to pituitary thyroid secreting hormone secreting adenoma.

  13. Influencing factors of radioiodine therapy in hyperthyroidism in adults

    Institute of Scientific and Technical Information of China (English)

    XU Jiehua; ZHANG Zikang; CHENG Muhua; WANG Ping; WU Chunxing; SHAN Hong

    2007-01-01

    The study was to evaluate factors affecting outcome of 131I therapy in hyperthyroidism for optimizing the method. Data from 213 patients who received 131I treatment from July 2003 to July 2005 in our department were retrospectively analyzed. Factors possibly contributing to the outcome of the 131I therapy were analyzed, including gender, age, history of antithyroid drug, thyroid volume, duration of disease and radioactive iodine uptake rate. Multivariate analysis was done. The rates of euthyroidism and hypothyroidism were 69% and 8.5%, respectively, after one time 131I therapy. Multivariate analysis of the patients showed no statistically significant factors affecting the outcome of 131I therapy. The study showed that 131I dose can be directly calculated, and this simplifies the dose-determined method and individualizes the therapy.

  14. Fetal Hyperthyroidism: Intrauterine Treatment with Carbimazole in Two Siblings.

    Science.gov (United States)

    Batra, Chandar Mohan; Gupta, Vidya; Gupta, Nomeeta; Menon, P S N

    2015-10-01

    Hyperthyroidism can manifest very early in fetal life (fetal thyrotoxicosis) or immediately after birth (neonatal thyrotoxicosis). The authors describe outcome of pregnancies in a woman with Graves' disease who received medical management and underwent subtotal thyroidectomy. The first pregnancy resulted in macerated stillbirth at 32 wk. Fetal tachycardia was followed by intrauterine death at 30 wk in the second pregnancy and macerated stillbirth at 26 wk in the third pregnancy. Fetal tachycardia was detected at 17 wk in the fourth pregnancy. Treatment with carbimazole along with thyroxine was followed by a live birth at 35 wk; but the baby developed severe fatal neonatal thyrotoxicosis with crisis on day 9 and died on day 12. Fetal tachycardia was noted in the fifth pregnancy as well and she was treated with carbimazole and thyroxine. She delivered a male baby at 37 wk. He developed neonatal hypothyroidism on day 8 which was controlled with thyroxine.

  15. Should we treat mild subclinical/mild hyperthyroidism? Yes.

    Science.gov (United States)

    Wiersinga, Wilmar M

    2011-08-01

    Whether or not subclinical hyperthyroidism (SCH) should be treated, remains a matter of debate because there are no randomized clinical trials answering the question if treatment improves long-term health outcomes. Cross-sectional and longitudinal population-based sudies demonstrate clear associations between SCH and risk on atrial fibrillation and fractures; associations with cardiovascular and overall mortality and mental health are less consistent. Associations with adverse outcomes of cardiovascular and bone health are in all likelihood causally related to SCH in view of an observed dose-response relationship and the existence of a plausible biologic mechanism. Short-term intervention studies show improvement of surrogate outcome measurements. Against this background treatment of both endogenous and exogenous SCH is recommended when TSH is 0.1 mU/l or lower. At TSH values>0.1-65 years, post menopause, osteoporosis, cardiac disease).

  16. Is the thyorid malignancy associated with hyperthyroidism really so rare

    Energy Technology Data Exchange (ETDEWEB)

    Budihna, N.; Zupanc, M.; Porenta, M. (University Clinic for Nuclear Medicine, Ljubljana (Yugoslavia))

    1990-01-01

    To appraise the risk of associated malignancy in patients designed for radioiodine therapy ultrasound guided fine needle biopsy of scintigraphically hot and representative cold nodules was performed in 102 hyperthyroid patients. The average patients' age was 64{+-}11 years. {sup 99m}Tc-pertechnetate and {sup 131}I scans, showed similar distribution of radioactivity: 44 solitary, 26 double and 32 multiple hot spots were delineated. Among them 138 nodules were examined. Cytologically atypism was found in four patients (3.9%). Two of these patients had follicular carcinomas, verified histologically and two suspect Huerthle cell tumors. Conclusion: because of significant incidence of malignancy in the autonomous goiter, fine needle biopsy is warranted in every patients before radioiodine therapy in all nodules irrespective of their scintigraphic or acoustic characteristics before radioiodine therapy. (orig.).

  17. Development of Hyperthyroidism Following Primary Hypothyroidism: A Case Report

    Directory of Open Access Journals (Sweden)

    Yueh-Hua Chung

    2004-04-01

    Full Text Available Development of hyperthyroidism following primary hypothyroidism is uncommon, and only a few documented cases have been reported. Alterations in thyroid-stimulating hormone receptor antibodies in serum are currently considered to play the main role in the pathophysiology, but the exact mechanism is still unknown. Here, we report the case of a 60-year-old man with disturbed consciousness due to hyponatremia. Thyroid function tests showed primary hypothyroidism with a high anti-microsomal antibody titer (1:6,400. The patient experienced weight loss and exophthalmos 6 years later. Serum thyroid hormone levels were increased and thyroxine treatment was discontinued, but the patient remained thyrotoxic 2 months later. 131I thyroid uptake was 40.9% at 24 hours, and bilateral thyroid lobes were not enlarged with diffuse radioactivity. Six months later, the patient was still thyrotoxic and therapy with methimazole 10 mg/day was started. He is now taking methimazole and is euthyroid.

  18. Vertebral Compression Fracture in a Patient with Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Ayhan Kul

    2016-12-01

    Full Text Available Osteoporosis in men is an important public health problem, and its prevalence is increasing as the population ages. Although it is traditionally considered as a women’s health issue, osteoporosis-related mortality and morbidity rates are higher in men. Although the lifetime risk of the hip fracture is lower in men than women, men are twice as likely to die after a hip fracture. All men diagnosed with osteoporosis should be evaluated for secondary causes of bone loss, such as hypogonadism, the use of corticosteroid, smoking, excessive alcohol consumption, low calcium intake, vitamin D deficiency and hypothyroidism. Here, we aimed to present a male patient in whom osteoporotic a vertebral fracture was detected and who was diagnosed with hyperthyroidism.

  19. Paralysis as a Presenting Symptom of Hyperthyroidism in an Active Duty Soldier.

    Science.gov (United States)

    Jennette, John; Tauferner, Dustin

    2015-01-01

    Thyrotoxic periodic paralysis (TPP) is an endocrine disorder presenting with proximal motor weakness, typically greatest in the lower extremities, hypokalemia, and signs or laboratory findings consistent with hyperthyroidism. The incidence of TPP is highest in Asian males. This is a case report of a 30-year-old male active duty Soldier who presented to the emergency department complaining of several recent episodes of lower extremity paralysis. The patient underwent a workup which included serum and cerebrospinal fluid studies, and was found to be hypokalemic and hyperthyroid. Following consultation with neurology, the patient was admitted to the medicine service and treated for thyrotoxic periodic paralysis with potassium replacement and treatment of his hyperthyroidism. Since achieving a euthyroid state, he has had no recurrences of TPP. This disease should be considered in patients presenting with symmetric motor weakness and hypokalemia, whether or not symptoms of hyperthyroidism are elicited during the review of systems.

  20. [Supra-His complete atrioventricular block in a patient with subclinical hyperthyroidism].

    Science.gov (United States)

    Amasyalı, Basri; Barçın, Cem; Kılıç, Ayhan

    2011-12-01

    Subclinical hyperthyroidism is a difficult entity to diagnose because of silent clinical features and it may be easily underdiagnosed unless it is suspected and thyroid hormone levels are examined. Although atrioventricular (AV) conduction abnormalities such as complete heart block may occasionally be seen in hyperthyroidism, its association with subclinical hyperthyroidism has not been reported previously. We report on a 50-year-old female patient who did not have any systemic or cardiovascular disease or history of drug use that could affect AV conduction and presented with presyncope and complete heart block with narrow QRS complexes. Thyroid function tests showed subclinical hyperthyroidism and an electrophysiological study showed the supra-His level as the site of complete AV block. After initiation of antithyroid treatment (propylthiouracil), the patient's rhythm improved to second-degree AV block on the third day and returned to normal sinus rhythm on the fourth day.

  1. The 2015 european thyroid association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism

    DEFF Research Database (Denmark)

    Biondi, B.; Bartalena, L.; Cooper, D. S.

    2015-01-01

    Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective...

  2. Improved quality of life in hyperthyroidism patients after surgery.

    Science.gov (United States)

    Bukvic, Branka; Zivaljevic, Vladan; Sipetic, Sandra; Diklic, Aleksandar; Tausanovic, Katarina; Stojanovic, Dragos; Stevanovic, Dejan; Paunovic, Ivan

    2015-02-01

    The most common causes of hyperthyroidism are Graves disease (GD) and toxic nodular goiter (TNG). GD and TNG might influence patients' quality of life (QoL). The aim of our study was to analyze and compare the QoL of patients with GD with that of TNG patients and to evaluate the influence of surgical treatment on their QoL. A prospective case-control study was conducted at the Center for Endocrine surgery in Belgrade, Serbia. The ThyPRO questionnaire was used in the QoL assessment of the GD and TNG patients (31 and 28, respectively) pre- and post-operatively. All patients were receiving antithyroid drugs, and none of the patients were overtly hyperthyroid at the time of completing the preoperative questionnaire. The QoL of the GD patients was worse than that of the TNG patients, with significant differences in eye symptoms, anxiety, and sex life domains (P < 0.001, P = 0.005, and P = 0.004, respectively), preoperatively, and in eye symptoms, anxiety, emotional susceptibility, and overall QoL (P = 0.001, P = 0.027, P = 0.005 and P = 0.013, respectively), postoperatively. The improvement in QoL in the GD patients was significant after surgical treatment in all ThyPRO domains. In the TNG patients, the improvement was significant in all but one ThyPRO domain, sex life (P = 0.066). The QoL of GD patients is worse than those of TNG patients. Surgery may improve QoL in patients with GD and TNG even if they have achieved satisfying thyroid status with medication treatment, preoperatively. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism

    OpenAIRE

    Yeliz Yilmaz; Kemal Erdinc Kamer; Orhan Ureyen; Erdem Sari; Turan Acar; Onder Karahalli

    2016-01-01

    Aim: To investigate the effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism. Material and methods: This controlled, randomized, prospective cohort was carried out on 40 patients who admitted for surgery due to hyperthyroidism. Cases were randomly assigned to receive either preoperative treatment with Lugol solution (Group 1) or no preoperative treatment with Lugol solution (Group 2). Group 3 (n = 10) consisted of healthy adults with no known hi...

  4. Apolipoprotein(a) phenotypes and lipoprotein(a) concentrations in patients with hyperthyroidism

    DEFF Research Database (Denmark)

    Klausen, I C; Hegedüs, L; Hansen, P S

    1995-01-01

    and determined apo(a) phenotypes in 31 patients with hyperthyroidism, before and after the patients had become euthyroid by treatment. The mean concentration of LDL cholesterol rose from 2.67 to 3.88 mmol/l (P ....01) and in patients with low molecular weight apo(a) phenotypes (n = 16; P hyperthyroidism may result from increased LDL receptor activity. The increase in Lp(a) levels were not correlated...

  5. Modulation of central glucocorticoid receptors in short- and long-term experimental hyperthyroidism.

    Science.gov (United States)

    Nikolopoulou, Elena; Mytilinaios, Dimitrios; Calogero, Aldo E; Kamilaris, Themis C; Troupis, Theodore; Chrousos, George P; Johnson, Elizabeth O

    2015-08-01

    Hyperthyroidism is associated with a significant increase in circulating glucocorticoid levels and hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. The aim of this study was to examine whether the HPA axis hyperactivity observed in hyperthyroidism may be explained by a disturbed feedback inhibition of endogenous glucocorticoids through two specific intracellular receptors in the brain: the high affinity mineralocorticoid receptor (MR) and the lower affinity glucocorticoid receptor (GR). Cytosolic receptor binding and gene expression was assessed in rats with short (7 days) and long standing (60 days) eu- and hyperthyroidism. Glucocorticoid receptor number and binding affinity (Kd) in the hippocampus were measured using [(3)H2]-dexamethasone radioreceptor assay. In situ hybridization was employed to examine the effects of hyperthyroidism on the GR and MR mRNA levels in the hippocampus and the pituitary. Both short- and long-term hyperthyroid rats showed pronounced reduction in the concentration of cytosolic GR in the hippocampus, without changes in binding affinity or changes in GR expression. In contrast, GR mRNA in the pituitary increased after 7 days and decreased after 60 days of thyroxin treatment. MR mRNA was moderately affected. Hyperthyroidism is associated with significant decreases in hippocampal GR levels supporting the hypothesis that hyperactivity of the HPA axis observed in experimentally induced hyperthyroidism may be attributed, at least in part, to decreased negative feedback at the level of the hippocampus. These findings further support the notion that a central locus is principally responsible for the hyperactivity of the HPA axis observed in hyperthyroidism.

  6. Multicompartmental model for iodide, thyroxine, and triiodothyronine metabolism in normal and spontaneously hyperthyroid cats

    Energy Technology Data Exchange (ETDEWEB)

    Hays, M.T.; Broome, M.R.; Turrel, J.M.

    1988-06-01

    A comprehensive multicompartmental kinetic model was developed to account for the distribution and metabolism of simultaneously injected radioactive iodide (iodide*), T3 (T3*), and T4 (T4*) in six normal and seven spontaneously hyperthyroid cats. Data from plasma samples (analyzed by HPLC), urine, feces, and thyroid accumulation were incorporated into the model. The submodels for iodide*, T3*, and T4* all included both a fast and a slow exchange compartment connecting with the plasma compartment. The best-fit iodide* model also included a delay compartment, presumed to be pooling of gastrosalivary secretions. This delay was 62% longer in the hyperthyroid cats than in the euthyroid cats. Unexpectedly, all of the exchange parameters for both T4 and T3 were significantly slowed in hyperthyroidism, possibly because the hyperthyroid cats were older. None of the plasma equivalent volumes of the exchange compartments of iodide*, T3*, or T4* was significantly different in the hyperthyroid cats, although the plasma equivalent volume of the fast T4 exchange compartments were reduced. Secretion of recycled T4* from the thyroid into the plasma T4* compartment was essential to model fit, but its quantity could not be uniquely identified in the absence of multiple thyroid data points. Thyroid secretion of T3* was not detectable. Comparing the fast and slow compartments, there was a shift of T4* deiodination into the fast exchange compartment in hyperthyroidism. Total body mean residence times (MRTs) of iodide* and T3* were not affected by hyperthyroidism, but mean T4* MRT was decreased 23%. Total fractional T4 to T3 conversion was unchanged in hyperthyroidism, although the amount of T3 produced by this route was increased nearly 5-fold because of higher concentrations of donor stable T4.

  7. Hyperthyroidism-Associated Insulin Resistance Is Not Mediated by Adiponectin Levels

    Directory of Open Access Journals (Sweden)

    Chih-Hsun Chu

    2011-01-01

    values were significantly decreased after management of hyperthyroidism. Pearson's correlation revealed that insulin and HOMA-IR values positively correlated with triiodothyronine (T3 and free thyroxine (FT4 levels. However, adiponectin did not correlate with T3, FT4, insulin, HOMA-IR and thyrotropin receptor autoantibody (TRAb levels. In conclusion, insulin resistance associated with hyperthyroidism is not mediated by the levels of plasma adiponectin.

  8. Spontaneous Abortion, Stillbirth and Hyperthyroidism: A Danish Population-Based Study

    Science.gov (United States)

    Andersen, Stine Linding; Olsen, Jørn; Wu, Chun Sen; Laurberg, Peter

    2014-01-01

    Objectives Pregnancy loss in women suffering from hyperthyroidism has been described in case reports, but the risk of pregnancy loss caused by maternal hyperthyroidism in a population is unknown. We aimed to evaluate the association between maternal hyperthyroidism and pregnancy loss in a population-based cohort study. Study Design All pregnancies in Denmark from 1997 to 2008 leading to hospital visits (n = 1,062,862) were identified in nationwide registers together with information on maternal hyperthyroidism for up to 2 years after the pregnancy [hospital diagnosis/prescription of antithyroid drug (ATD)]. The Cox proportional hazards model was used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI) for spontaneous abortion (gestational age hyperthyroidism was diagnosed before/during the pregnancy (n = 5,229), spontaneous abortion occurred more often both in women treated before the pregnancy alone [aHR 1.28 (95% CI 1.18-1.40)] and in women treated with ATD in early pregnancy [1.18 (1.07-1.31)]. When maternal hyperthyroidism was diagnosed and treated for the first time in the 2-year period after the pregnancy (n = 2,361), there was a high risk that the pregnancy under study had terminated with a stillbirth [2.12 (1.30-3.47)]. Conclusions Both early (spontaneous abortion) and late (stillbirth) pregnancy loss were more common in women suffering from hyperthyroidism. Inadequately treated hyperthyroidism in early pregnancy may have been involved in spontaneous abortion, and undetected high maternal thyroid hormone levels present in late pregnancy may have attributed to an increased risk of stillbirth. PMID:25538898

  9. Relationship Among Pulmonary Hypertension, Autoimmunity, Thyroid Hormones and Dyspnea in Patients With Hyperthyroidism.

    Science.gov (United States)

    Zuhur, Sayid Shafi; Baykiz, Derya; Kara, Sonat Pinar; Sahin, Ertan; Kuzu, Idris; Elbuken, Gulsah

    2017-04-01

    Previous studies have reported conflicting results regarding the mechanisms underlying the pathophysiology of pulmonary hypertension (PHT) in patients with hyperthyroidism. Therefore, in this study, we investigated the association between PHT and thyroid-stimulating hormone (TSH) receptor antibody, thyroid peroxidase antibody, thyroglobulin antibody, TSH, fT3, fT4 and dyspnea during daily activities in a large population of patients with hyperthyroidism. A total of 129 consecutive patients with hyperthyroidism, 37 with hypothyroidism and 38 euthyroid controls were enrolled in this study. The modified medical research council scale was used for the assessment of dyspnea in daily activities. All the patients and euthyroid controls underwent transthoracic echocardiography for the assessment of PHT. Mild PHT was present in 35%, 36%, 13.5% and 5% of the patients with Graves׳ disease, toxic multinodular goiter, hypothyroidism and euthyroid controls, respectively. Pulmonary vascular resistance (PVR) was higher in hyperthyroid patients with PHT than in those without PHT. Moreover, a significant positive correlation was found between modified medical research council scale and pulmonary artery systolic pressure as well as PVR in patients with hyperthyroidism. No association was found between PHT and serum TSH receptor antibody, thyroid peroxidase antibody, thyroglobulin antibody, TSH, fT3 and fT4 levels. Mild PHT is present in a significant proportion of patients with hyperthyroidism, regardless of etiology. PVR appears to be the main cause of PHT in patients with hyperthyroidism, and neither autoimmunity nor thyroid hormones are associated with PHT in these patients. Mild dyspnea during daily activities in patients with hyperthyroidism may be related to PHT; however, severe dyspnea requires further evaluation. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  10. EVALUATION OF ISCHEMIA MODIFIED ALBUMIN AND NITRIC OXIDE LEVELS AND THEIR INTER - RELATIONSHIP IN HYPERTHYROIDISM

    Directory of Open Access Journals (Sweden)

    Rangaswamy

    2014-02-01

    Full Text Available BACKGROUND: Ischemia Modified Albumin (IMA is an ischemia/reperfusion injury marker which has been considered to be formed under oxidative stress conditions. Endothelial L - Arginine/NO pathway dysfunction can lead to oxidative stress which has deleterious effects seen on the vascular wall causing ischemia. AIM: 1 The study was conducted to estimate the levels of IMA and NO in hyperthyroidism patients. 2 To evaluate the relationship bet ween IMA and NO levels in hyperthyroidism. MATERIALS AND METHODS: A cross sectional study was done with 30 newly diagnosed hyperthyroid patients as cases and 30 age and sex matched healthy controls. Serum levels of IMA and NO were estimated by colorimetric methods and thyroid profile was done by ELIFA methodology. STATISTICAL ANALYSIS: Data were analyzed using SPSS. Values were expressed as Mean±SD. RESULTS: Nitric Oxide levels were significantly decreased in hyperthyroid patients (7.08±1.57μmol/L as compa red to healthy controls (39.76±4.98μmol/L (p=0.001. Ischemia Modified Albumin levels were found to be significantly increased in hyperthyroid patients (0.73±0.10 ODU when compared to healthy controls (0.28±0.01 ODU (p=0.001. CONCLUSION: In our study t here was increase in IMA levels with decreased NO levels which could be due to the consequence of oxidative stress and ischemia which is present in hyperthyroidism

  11. Evaluation of Body Weight, Body Condition, and Muscle Condition in Cats with Hyperthyroidism.

    Science.gov (United States)

    Peterson, M E; Castellano, C A; Rishniw, M

    2016-11-01

    The contribution of fat loss versus muscle wasting to the loss of body weight seen in hyperthyroid cats is unknown. To investigate body weight, body condition score (BCS), and muscle condition score (MCS) in hyperthyroid cats. Four hundred sixty-two cats with untreated hyperthyroidism, 117 of which were reevaluated after treatment. Prospective cross-sectional and before-after studies. Untreated hyperthyroid cats had body composition evaluated (body weight, BCS, and MCS). A subset of these cats were reevaluated 3-12 months after treatment when euthyroid. Pretreatment body weight (median, 4.36 kg; IQR, 3.5 to 5.2 kg) was lower than premorbid weight (5.45 kg; IQR, 4.6 to 6.4 kg, P weight (median, 4.1 kg to 5.0 kg), BCS (median, 3/5 to 3.5/5), and MCS (2/3 to 3/3) after treatment (P weight but maintain an ideal or overweight BCS, with only a third being underweight. As in human hyperthyroid patients, this weight loss is associated with muscle wasting, which affects >75% of hyperthyroid cats. Successful treatment leads to weight gain and increase of BCS in most cats, but almost half fail to regain normal muscle mass. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  12. The effect of hyperthyroidism on opiate receptor binding and pain sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Edmondson, E.A. (Baylor College of Medicine, Houston, TX (USA)); Bonnet, K.A.; Friedhoff, A.J. (New York Univ. School of Medicine, NY (USA))

    1990-01-01

    This study was conducted to determine the effect of thyroid hormone on opiate receptor ligand-binding and pain sensitivity. Specific opiate receptor-binding was performed on brain homogenates of Swiss-Webster mice. There was a significant increase in {sup 3}H-naloxone-binding in thyroxine-fed subjects (hyperthyroid). Scatchard analysis revealed that the number of opiate receptors was increased in hyperthyroid mice (Bmax = 0.238 nM for hyperthyroid samples vs. 0.174 nM for controls). Binding affinity was unaffected (Kd = 1.54 nM for hyperthyroid and 1.58 nM for control samples). When mice were subjected to hotplate stimulation, the hyperthyroid mice were noted to be more sensitive as judged by pain aversion response latencies which were half that of control animals. After morphine administration, the hyperthyroid animals demonstrated a shorter duration of analgesia. These findings demonstrate that thyroxine increases opiate receptor number and native pain sensitivity but decreases the duration of analgesia from morphine.

  13. Elevated levels of circulating thyroid hormone do not cause the medical sequelae of hyperthyroidism.

    Science.gov (United States)

    Kelly, Tammas; Denmark, Lawrence; Lieberman, Daniel Z

    2016-11-03

    Clinicians have been reluctant to use high dose thyroid (HDT) to treat affective disorders because high circulating levels of thyroid hormone have traditionally been equated with hyperthyroidism, and understood as the cause of the medical sequelae of hyperthyroidism, such as osteoporosis and cardiac abnormalities. This conclusion is not supported by (HDT) research. A literature review of research related to the morbidity and mortality of HDT treatment was performed. There exists a large body of research involving the use of HDT treatment to prevent the recurrence of differentiated thyroid cancer and to treat affective disorders. A review of this literature finds a lack of support for HDT as a cause of osteoporosis, nor is there support for an increase in morbidity or mortality associated with HDT. This finding contrasts with the well-established morbidity and mortality associated with Graves' disease, thyroiditis, and other endogenous forms of hyperthyroidism. The lack of evidence that exogenous HDT causes osteoporosis, cardiac abnormalities or increases mortality compared with the significant morbidity and mortality of hyperthyroidism requires an alternative cause for the medical sequelae of hyperthyroidism. One possibility is an autoimmune mechanism. High circulating levels of thyroid hormone is not the cause of the sequela of hyperthyroidism. The reluctance to using high dose thyroid is unwarranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Concurrent sympathetic activation and vagal withdrawal in hyperthyroidism: Evidence from detrended fluctuation analysis of heart rate variability

    Science.gov (United States)

    Chen, Jin-Long; Shiau, Yuo-Hsien; Tseng, Yin-Jiun; Chiu, Hung-Wen; Hsiao, Tzu-Chien; Wessel, Niels; Kurths, Jürgen; Chu, Woei-Chyn

    2010-05-01

    Despite many previous studies on the association between hyperthyroidism and the hyperadrenergic state, controversies still exist. Detrended fluctuation analysis (DFA) is a well recognized method in the nonlinear analysis of heart rate variability (HRV), and it has physiological significance related to the autonomic nervous system. In particular, an increased short-term scaling exponent α1 calculated from DFA is associated with both increased sympathetic activity and decreased vagal activity. No study has investigated the DFA of HRV in hyperthyroidism. This study was designed to assess the sympathovagal balance in hyperthyroidism. We performed the DFA along with the linear analysis of HRV in 36 hyperthyroid Graves’ disease patients (32 females and 4 males; age 30 ± 1 years, means ± SE) and 36 normal controls matched by sex, age and body mass index. Compared with the normal controls, the hyperthyroid patients revealed a significant increase ( Pexercise intolerance among hyperthyroid patients.

  15. Hyperthyroidism-associated coronary spasm: A case of non-ST segment elevation myocardial infarction with thyrotoxicosis

    Institute of Scientific and Technical Information of China (English)

    Xiao-Hu Kuang; Shu-Yang Zhang

    2011-01-01

    Hyperthyroidism is associated with many heart diseases.Thyrotoxic state has a relationship with coronary spasm.We present a case of a non-menopausal woman with hyperthyroidism who complained of chest pain.The diagnosis of coronary spasm was confirmed by coronary angiography (CAG).She is treated well with anti-thyrotoxicosis and anti-anginal medication.We recommend not use CAG as the first diagnostic choice among the patients with medication-uncontrolled hyperthyroidism and chest pain.

  16. Hepatoprotective Effect of Satureja Khuzestanica Essential Oil and Vitamin E in Experimental Hyperthyroid Rats: Evidence for Role of Antioxidant Effect

    Directory of Open Access Journals (Sweden)

    Raheleh Assaei

    2014-09-01

    Full Text Available Background: Hyperthyroidism is associated with liver oxidative stress causing liver dysfunction in many hyperthyroid patients. The hepatoprotective effect of Satureja Khuzestanica Essential Oil (SKEO, as herbal origin antioxidant and anti-inflammatory agent on the hyperthyroidism induced hepatotoxicity and oxidative stress is investigated. Methods: Adult male sprague dawley rats were divided into categories of; control (group C, hyperthyroid (group H, hyperthyroid with olive oil (group H+O, hyperthyroid with vitamin E (group H+E, hyperthyroid with SKEO (group H+S, combination of hyperthyroid with vitamin E and SKEO (group H+S+E. Hepatoprotective and antioxidant properties of SKEO with or without vitamin E in hyperthyroid rats were then investigated. Results: Serum Aspartate Transaminase (AST and Alanine Transaminase (ALT activities reduced significantly in H+O, H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. Enzymes activities returned to normal in H+S+E group. Hepatic Malondialdehyde (MDA was reduced in H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. The most significant MDA reduction was in the H+S+E group. Glutathione Peroxidase (GPx and Glutathione Reductase (GR activities increased in H+E, H+S and H+S+E groups in comparison with group H. The largest increment in GPx and GR activities were in the H+S+E group. Glutathione level did not change in any group in comparison with the control group. Conclusion: Administration of SKEO has hepatoprotective effect in hyperthyroid rats and is more effective when used in combination with vitamin E.

  17. History of hyperthyroidism and long-term outcome of catheter ablation of drug-refractory atrial fibrillation.

    Science.gov (United States)

    Wongcharoen, Wanwarang; Lin, Yenn-Jiang; Chang, Shih-Lin; Lo, Li-Wei; Hu, Yu-Feng; Chung, Fa-Po; Chong, Eric; Chao, Tze-Fan; Tuan, Ta-Chuan; Chang, Yao-Ting; Lin, Chin-Yu; Liao, Jo-Nan; Lin, Yi-Chun; Chen, Yun-Yu; Chen, Shih-Ann

    2015-09-01

    Hyperthyroidism is a known reversible cause of atrial fibrillation (AF). However, some patients remain in AF despite restoration of euthyroid status. The purpose of this study was to compare the electrophysiologic characteristics and long-term ablation outcome in AF patients with and without history of hyperthyroidism. The study enrolled 717 consecutive patients with AF who underwent first AF ablation, which involved pulmonary vein (PV) isolation in paroxysmal AF and additional substrate modification in nonparoxysmal AF patients. Eighty-four patients (12%) with hyperthyroidism history were compared to those without. Euthyroid status was achieved for ≥3 months before ablation in hyperthyroid patients. Patients with hyperthyroid history were associated with older age, more female gender, lower mean right atrial voltage, higher number of PV ectopic foci (1.3 ± 0.4 vs 1.0 ± 0.2, P hyperthyroid patients (7.1% vs 1.6%, P hyperthyroidism was an independent predictor of AF recurrence after single procedure (hazard ratio 2.07, 95% confidence interval 1.27-3.38). AF recurrence rates after multiple procedures were not different between patients with and those without hyperthyroid history. Patients with hyperthyroid history had a significantly higher number of PV ectopies and higher prevalence of non-PV ectopic foci compared to euthyroid patients, which resulted in a higher AF recurrence rate after a single procedure. Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  18. Potential Involvement of P2 Receptors in the Pathological Processes of Hyperthyroidism: A Pilot Study.

    Science.gov (United States)

    Hong, Wu; Li, Guodong; Nie, Yijun; Zou, Lifang; Zhang, Xi; Liu, Shuangmei; Li, Guilin; Xu, Hong; Zhang, Chun-Ping; Liang, Shangdong

    2016-05-01

    Symptoms of hyperthyroidism manifest mainly as changes in the nervous and metabolic systems. Whether P2X receptors (ionotropic ATP purinergic receptors, including P2X3 receptor and P2X7 receptor) are involved in the alterations of these disorders still remains unclear. Thus, this study aimed to assess the association of hyperthyroidism with the expression of P2X3 and P2X7 receptors and the concentrations of ATP in blood leukocytes and catecholamine. Twelve healthy subjects and twelve patients diagnosed with hyperthyroidism were recruited. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels had been detected by chemiluminescence method. Meanwhile, the catecholamine levels (including adrenaline, noradrenaline, and dopamine) in plasma, ATP level and P2X receptors (including P2X3 receptor and P2X7 receptor) in peripheral blood had been detected by high performance liquid chromatography, bioluminescence method, and reverse transcription polymerase chain reaction, respectively. Levels of epinephrine and norepinephrine were significantly higher in the hyperthyroidism group compared with the control group. The concentration of ATP in the hyperthyroidism group was significantly higher than its in the control group. The expression of P2X3 mRNA and P2X7 mRNA in hyperthyroidism group were significantly increased compared with those in control group. In a conclusion, there is a relationship between the elevated expression of P2X3 receptor and P2X7 receptor in peripheral blood leukocytes and high serum epinephrine and norepinephrine levels in hyperthyroidism patients.

  19. Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J.J.; Ladenson, P.W.

    1986-07-01

    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or /sup 131/I treatment for hyperthyroid Graves' disease. To determine the frequency of combined high serum T3 and low serum T4 concentrations during such treatment and to assess the clinical significance of its recognition, we reviewed 60 patients treated for hyperthyroid Graves' disease with antithyroid drugs (n = 43) or radioactive iodine (n = 17). Six of these patients (10%) were found to have high serum T3 and low serum T4 concentrations during therapy. Four were receiving antithyroid drugs, and 2 had received radioactive iodine. At the time this abnormality occurred, 4 patients were euthyroid, 1 was hypothyroid, and 1 was hyperthyroid. The serum TSH concentration was increased in 2, at the upper limit of normal in 1, and undetectable in 3 patients. After discontinuation or reduction in the dose of antithyroid drug, clinical and chemical euthyroidism was restored in 2 additional patients with previously elevated TSH levels. In 2 patients, both of whom previously had undetectable serum TSH levels, clinical hyperthyroidism persisted or recurred, and additional therapy was required. No patient developed permanent hypothyroidism during the period of follow-up (1-22 months). An additional 19 of the 60 patients (32%) had an elevated serum T3 level with a normal serum T4 concentration during the course of follow-up. Among the 19 patients, the magnitude of serum T3 elevation was not different between clinically euthyroid (n = 13) and hyperthyroid (n = 6) patients. We conclude that discordance of serum T4 and T3 concentrations is frequently encountered in patients with hyperthyroid Graves' disease during or after therapy. The low serum T4 level does not predict hypothyroidism, nor does a high serum T3 level predict hyperthyroidism.

  20. Two unusual cases of intractable hyperthyroidism responsive to octreotide: Munchausen syndrome or not?

    Science.gov (United States)

    Liu, Jian-Min; Gu, Li-Qun; Zhao, Lin; Tang, Zheng-Yi; Sun, Li-Hao; Hong, Jie; Wang, Wei-Qing; Luo, Bang-Yao; Zhao, Yong-Ju; Xu, Man-Yin; Chen, Xi; Jiang, Xu-Feng; Zhu, Chen-Mo; Jin, Xiao-Long; Chen, Hong-Zhuan; Tan, Yu-Yan; Ning, Guang; Chen, Jia-Lun

    2011-05-12

    The effective treatment for patients with resistant hyperthyroidism is difficult. In this case report with 4-year follow-up data, we present 2 unusual cases of hyperthyroidism that were unresponsive to almost all antithyroid treatments including total thyroidectomy, but both were controlled with octreotide. Cases 1 and 2 were both middle-aged women. They presented thyrotoxicosis with a low serum concentration of TSH and thyroidal radioactive iodine uptake (RAIU). The underlying causes, such as thyroiditis, metastatic thyroid cancer and struma ovarii were explored. Iodine-induced hyperthyroidism, particularly factitious hyperthyroidism was highly suspected, but there was no direct evidence to establish these diagnoses. In spite of good compliance, their thyrotoxicosis could not be controlled with large doses of PTU or MMI. β-blocker, methylprednisolone, radio-iodine therapy and even thyroidectomy were all attempted and failed. Short-acting octreotide was first administered to case 1 and then to case 2. Thyroid function improved greatly within 3 days in both cases. The doses of octreotide were tapered down to twice a week with consistent efficacy. During the follow-up periods, case 1 required octreotide 0.1mg twice per week and case 2 is on thyroid replacement therapy due to hypothyroidism. The recurrences of hyperthyroidism in both cases were again rapidly controlled with the increased dose of octreotide in case 1 and re-started the usage of octreotide in case 2. The etiology of thyrotoxicosis in these 2 cases is not clear. In the absence of struma ovarii or wide-spread follicular thyroid cancer, factitious hyperthyroidism due to Munchausen syndrome should be considered first. The efficacy of the off-label use of octreotide in hyperthyroidism was highly effective (only) in these 2 cases. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Melatonin alleviates hyperthyroidism induced oxidative stress and neuronal cell death in hippocampus of aged female golden hamster, Mesocricetus auratus.

    Science.gov (United States)

    Rao, Geeta; Verma, Rakesh; Mukherjee, Arun; Haldar, Chandana; Agrawal, Neeraj Kumar

    2016-09-01

    Oxidative stress is a well known phenomenon under hyperthyroid condition that induces various physiological and neural problems with a higher prevalence in females. We, therefore investigated the antioxidant potential of melatonin (Mel) on hyperthyroidism-induced oxidative stress and neuronal cell death in the hippocampus region of brain (cognition and memory centre) of aged female golden hamster, Mesocricetus auratus. Aged female hamsters were randomly divided into four experimental groups (n=7); group-I: control, group-II: Melatonin (5mgkg(-1)day(-1), i.p., for one week), group-III: Hyperthyroid (100μg kg(-1)day(-1), i.p., for two weeks) and group-IV- Hyper+Mel. Hormonal profiles (thyroid and melatonin), activity of antioxidant enzymes (SOD, CAT and GPX), lipid peroxidation level (TBARS) and the specific apoptotic markers (Bax/Bcl-2 ratio and Caspase-3) expression were evaluated. A significant increase in the profile of total thyroid hormone (tT3 and tT4) in hyperthyroidic group as compared to control while tT3 significantly decreased in melatonin treated hyperthyroidic group. However, Mel level significantly decreased in hyperthyroidic group but increased in melatonin treated hyperthyroidic group. Further, the number of immune-positive cells for thyroid hormone receptor-alpha (TR-α) decreased in the hippocampus of hyperthyroidic group and increased in melatonin treated hyperthyroidic group. Profiles of antioxidant enzymes showed a significant decrease in hyperthyroidic group with a simultaneous increase in lipid peroxidation (TBARS). Melatonin treatment to hyperthyroidic group lead to decreased TBARS level with a concomitant increase in antioxidant enzyme activity. Moreover, increased expression of Bax/Bcl-2 ratio and Caspase-3, in hyperthyroidic group had elevated neuronal cell death in hippocampal area and melatonin treatment reduced its expression in hyperthyroidic group. Our findings thus indicate that melatonin reduced the hyperthyroidism

  2. Subclinical hyperthyroidism and cardiovascular manifestations: a reevaluation of the association.

    Science.gov (United States)

    Carpi, Angelo; Cini, Giuseppe; Russo, Matteo; Antonelli, Alessandro; Gaudio, Carlo; Galetta, Fabio; Franzoni, Ferdinando; Rossi, Giuseppe

    2013-04-01

    Subclinical hyperthyroidism (SH) has been reported associated with atrial fibrillation (AF), heart failure (HF) and coronary heart disease events, including mortality. An expert opinion indicates that AF is the possible link between SH and the other important cardiovascular (CV) manifestations. We analyzed the data of three recent studies including 60,883 subjects of whom 2,284 SH patients. In these subjects, the ratio between the AF events and each of the other above reported CV events varied from 0.14 to 0.4 in SH and from 0.2 to 2.4 in euthyroidism (ET). The general pattern of this ratio in 6 comparisons performed was not significantly higher for SH than ET. This data suggest that AF is not the major link between SH and the related CV manifestations. We suggest that a further link to be considered is the higher frequency of the early atherosclerosis manifestations such as carotid intima media thickness or carotid integrated back scatter, observed in SH. This atherogenic effect of SH can affect the occurrence of all the above clinical CV manifestations.

  3. Lower prevalence of mild hyperthyroidism related to a higher iodine intake in the population: prospective study of a mandatory iodization programme

    DEFF Research Database (Denmark)

    Vejbjerg, Pernille; Knudsen, Nils; Perrild, Hans

    2009-01-01

    -2 center dot 66) before iodization. The difference was found in both regions and across age groups. There was a lower prevalence of mild hyperthyroidism and a tendency towards a lower prevalence of overt hyperthyroidism. The prevalence of mild hypothyroidism increased, most pronounced among young women...... of thyroid dysfunction was seen in relation to mandatory iodization of salt. There was no rise in the prevalence of hyperthyroidism and the prevalence of mild hyperthyroidism was halved. Conversely, prevalence of hypothyroidism increased....

  4. Measurement of thyrotropin in clinical and subclinical hyperthyroidism using a new chemiluminescent assay.

    Science.gov (United States)

    Ross, D S; Ardisson, L J; Meskell, M J

    1989-09-01

    A new commercially available chemiluminescent TSH assay demonstrates an 8- to 10-fold increase in sensitivity over a sensitive immunoradiometric assay, allowing increased ability to distinguish partial from more complete thyrotroph suppression. Sera were analyzed from 145 patients who had TSH concentrations below 0.08 mU/L in the immunoradiometric assay. Most patients with overt hyperthyroidism had undetectable TSH concentrations in the chemiluminescent assay. Three groups of patients were identified, in which a large subgroup had undetectable values in the immunoradiometric assay and detectable values in the chemiluminescent assay (12 of 17 patients under treatment for hyperthyroidism who had recently normalized their serum thyroid hormone levels, 33 of 68 patients taking L-T4, and 4 of 8 patients with endogenous subclinical hyperthyroidism). In addition, several patients with undetectable basal and detectable TRH-stimulated TSH values in the immunoradiometric assay had detectable basal TSH values in the chemiluminescent assay. The utility of first generation TSH immunometric assays was their ability to distinguish hyperthyroidism from euthyroidism. The clinical utility of increasingly sensitive TSH assays will be to distinguish degrees of thyrotroph suppression in subclinical hyperthyroidism.

  5. Animal models of disease: feline hyperthyroidism: an animal model for toxic nodular goiter.

    Science.gov (United States)

    Peterson, Mark E

    2014-11-01

    Since first discovered just 35 years ago, the incidence of spontaneous feline hyperthyroidism has increased dramatically to the extent that it is now one of the most common disorders seen in middle-aged to senior domestic cats. Hyperthyroid cat goiters contain single or multiple autonomously (i.e. TSH-independent) functioning and growing thyroid nodules. Thus, hyperthyroidism in cats is clinically and histologically similar to toxic nodular goiter in humans. The disease in cats is mechanistically different from Graves' disease, because neither the hyperfunction nor growth of these nodules depends on extrathyroidal circulating stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells, but iodine deficiency, other nutritional goitrogens, or environmental disruptors may play a role in the disease pathogenesis. Clinical features of feline toxic nodular goiter include one or more palpable thyroid nodules, together with signs of hyperthyroidism (e.g. weight loss despite an increased appetite). Diagnosis of feline hyperthyroidism is confirmed by finding the increased serum concentrations of thyroxine and triiodothyronine, undetectable serum TSH concentrations, or increased thyroid uptake of radioiodine. Thyroid scintigraphy demonstrates a heterogeneous pattern of increased radionuclide uptake, most commonly into both thyroid lobes. Treatment options for toxic nodular goiter in cats are similar to that used in humans and include surgical thyroidectomy, radioiodine, and antithyroid drugs. Most authorities agree that ablative therapy with radioiodine is the treatment of choice for most cats with toxic nodular goiter, because the animals are older, and the disease will never go into remission.

  6. Change of oxygen free radical metabolism and free amino acids of patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Hua-Ling Ruan; Li Zhao; Kun-Quan Guo; Kun Yang; Lin-Xiu Ye; Xue Sun

    2016-01-01

    Objective:To study the change situation of oxygen free radical metabolism and free amino acids of patients with hyperthyroidism.Methods:Eighty-one patients with hyperthyroidism who were treated in our hospital from May 2013 to October 2014 were selected as the observation group, while 81 healthy persons with health examination at the same period were the control group. Then, the serum oxygen free radical indexes and free amino acids of the two groups were respectively detected and compared, and the detection results of patients in the observation group with different etiologic types and basal metabolic rate were also compared. Results:The serum oxygen free radical related indexes of the observation group were all higher than those of the control group; the serum antioxidant related indexes were all lower than those of the control group; and the serum free amino acids levels were all obviously lower than those of the control group. Besides, the detection results of patients with severe hyperthyroidism in the observation group were worse than those of patients with mild and moderate disease, while the detection results of the observation group with different types of hyperthyroidism had no significant differences.Conclusions:The fluctuation of oxygen free radical metabolism and free amino acids of patients with hyperthyroidism are obvious, and the detection results of patients with different basal metabolic rates are also quite obvious.

  7. The results of therapeutic plasma exchange in patients with severe hyperthyroidism: a retrospective multicenter study.

    Science.gov (United States)

    Keklik, Muzaffer; Kaynar, Leylagul; Yilmaz, Mehmet; Sivgin, Serdar; Solmaz, Musa; Pala, Cigdem; Aribas, Sulbiye; Akyol, Gulsah; Unluhizarci, Kursat; Cetin, Mustafa; Eser, Bulent; Unal, Ali

    2013-06-01

    Hyperthyroidism characterized by elevated serum levels of circulating thyroid hormones. The aim of hyperthyroidism treatment is to achieve a euthyroid state as soon as possible and to maintain euthyroid status. However, drug withdrawal and utilization of alternative therapies are needed in cases in which leucopenia or impairment in liver functions is observed during medical therapy. In the present study, we aimed to present our cases which underwent therapeutic plasma exchange (TPE) due to severe hyperthyroidism. The results of 22 patients who underwent therapeutic plasma exchange due to hyperthyroidism in Apheresis Units of Erciyes University and Gaziantep University, between 2006 and 2012, were retrospectively reviewed. These cases had severe thyrotoxic values despite anti-thyroid drug use. After TPE, we observed a significant decrease in free thyroxin (FT4) (phyperthyroidism by TPE in 20 cases (91%). Both FT3 and FT4 levels remained above the normal limits in two of 22 patients. TPE should be considered as an effective and safe therapeutic option to achieve euthyroid state before surgery or radioactive iodine treatment. TPE is a useful option in cases with severe hyperthyroidism unresponsive to anti-thyroid agents and in those with clinical manifestations of cardiac failure and in patients with severe adverse events during anti-thyroid therapy.

  8. Brain perfusion SPECT and FDG PET findings in a patient with ballism associated with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Sang Kyun; Kim, Sang Jin [Pusan Paik Hospital, Pusan (Korea, Republic of)

    2007-07-01

    Ballism is a very rare presentation in association with hyperthyroidism. We describe a 22-year-old lady with episodes of recurrent ballism and hyperthyroidism. A 22-year-old lady was admitted to Neurology department because of sudden development of vigorous involuntary movement and dysarthria. She was diagnosed as hyperthyroidism at the age 12 and treated irregularly. She arrived at the emergency room because of sudden onset of involuntary movement. Computed tomography (CT) scan and Magnetic Resonance Imaging (MRI) of brain was normal. Serum levels of thyroid hormone were increased (Free T4 3.15 ng/dl; normal range 0.93-1.71 ng/dl), whereas thyroid-stimulating hormone (TSH) was undetectable. The thyroid gland was diffusely enlarged and exophthalmos was found. She had been given antithyroid medication from local clinic but medicated irregularly. Technetium thyroid scan reveals diffusely enlarged thyroid with increased radioactivity. Radioiodine uptake in 24 hours was 71 %. Brain perfusion SPECT using Tc-99m ECD reveals asymmetrical perfusion pattern in basal ganglia. Brain PET using F-18 FDG reveals increased metabolism at both caudate nucleus and putamen. She was treated with radioiodine and involuntary movement was improved. There is only few report on ballism associated with hyperthyroidism and no report on functional brain imaging. Brain perfusion SPECT and FDG PET may give useful information about functional status of brain in patients with ballism associated with hyperthyroidism in case of normal anatomical finding on CT/MRI.

  9. Recurrent acute pulmonary embolism and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Currò, Alessio; Cimino, Claudia

    2010-07-09

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Elevated D-dimer levels have been reported in acute pulmonary embolism and it has also been reported that right ventricular overload and hypoxia in acute pulmonary embolism may lead to right ventricular myocardium injury reflected by elevated cardiac troponin levels too. We present a case of recurrent pulmonary embolism associated with subclinical hyperthyroidism, in an 81-year-old Italian woman. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism.

  10. Efficacy of protocols for induction of chronic hyperthyroidism in male and female mice.

    Science.gov (United States)

    Engels, Kathrin; Rakov, Helena; Zwanziger, Denise; Hönes, Georg Sebastian; Rehders, Maren; Brix, Klaudia; Köhrle, Josef; Möller, Lars Christian; Führer, Dagmar

    2016-10-01

    Protocols for induction of hyperthyroidism in mice are highly variable and mostly involve short-term thyroid hormone (TH) treatment. In addition, little is known about a possible influence of sex on experimental TH manipulation. Here we analyzed the efficacy of intraperitoneal vs. oral levothyroxine (T4) administration to induce chronic hyperthyroidism in male and female mice and asked which T4 dosing intervals are required to achieve stable organ thyrotoxicosis. T4 was administered intraperitoneally or orally over a period of 6/7 weeks. Assessment included monitoring of body weight, TH serum concentrations, and serial quantitative TH target gene expression analysis in liver and heart. Our results show that both intraperitoneal and oral T4 treatment are reliable methods for induction of chronic hyperthyroidism in mice. Thereby T4 injection intervals should not exceed 48 h and oral levothyroxine should be administered continuously during experiments and up to sacrifice to ensure a hyperthyroid organ state. Furthermore, we found a sex-dependent variation in levothyroxine-induced TH serum state, with significantly higher T4 concentrations in female mice, while expression of investigated classical TH responsive genes in liver and heart did not vary with animal's sex. In summary, our study shows that common approaches for rendering rodents thyrotoxic can also be used for induction of chronic hyperthyroidism in male and female mice. Thereby T4 dosing intervals are critical as are read-out parameters to verify a chronic thyrotoxic organ state.

  11. Cardioprotective properties of citicoline against hyperthyroidism-induced reperfusion damage in rat hearts.

    Science.gov (United States)

    Hernández-Esquivel, Luz; Pavón, Natalia; Buelna-Chontal, Mabel; González-Pacheco, Héctor; Belmont, Javier; Chávez, Edmundo

    2015-06-01

    Hyperthyroidism represents an increased risk factor for cardiovascular morbidity, especially when the heart is subjected to an ischemia/reperfusion process. The aim of this study was to explore the possible protective effect of the nucleotide citicoline on the susceptibility of hyperthyroid rat hearts to undergo reperfusion-induced damage, which is associated with mitochondrial dysfunction. Hence, we analyzed the protective effect of citicoline on the electrical behavior and on the mitochondrial function in rat hearts. Hyperthyroidism was established after a daily i.p. injection of triiodothyronine (at 2 mg/kg of body weight) during 5 days. Thereafter, citicoline was administered i.p. (at 125 mg/kg of body weight) for 5 days. In hyperthyroid rat hearts, citicoline protected against reperfusion-induced ventricular arrhythmias. Moreover, citicoline maintained the accumulation of mitochondrial Ca(2+), allowing mitochondria to reach a high transmembrane electric gradient that protected against the release of cytochrome c. It also preserved the activity of the enzyme aconitase that inhibited the release of cytokines. The protection also included the inhibition of oxidative stress-induced mDNA disruption. We conclude that citicoline protects against the reperfusion damage that is found in the hyperthyroid myocardium. This effect might be due to its inhibitory action on the permeability transition in mitochondria.

  12. Beneficial role of ascorbic and folic acids antioxidants against thyroxin-induced testicular dysfunction in hyperthyroid rats.

    Science.gov (United States)

    Beltagy, Doha M; Mohamed, Tarek M; El Said, Ahmed S; Tousson, Ehab

    2016-09-01

    Thyroid hormones play a fundamental role in the regulation of metabolism of almost all mammalian tissue including the reproductive system. Hyperthyroidism in early life may cause delayed sexual maturation, although physical development is normal and skeletal growth may be accelerated. Hyperthyroidism after puberty influences reproductive functions and increases testosterone level. The aim of this work is to study the effect of induced hyperthyroidism by L-thyroxine sodium administration on the testis of rats and to evaluate the ameliorating role of different antioxidants as ascorbic acid and folic acid on the hyperthyroid state via the assessment of different biochemical markers, histopathological and immunochemical sections. DNA analysis of the D1 deiodinase was performed to determine genetic mutation due to hyperthyroidism. The results showed partially disrupted in the measured biochemical parameters and spermatogenesis in hyperthyroid rats. Post-administration of both folic and ascorbic acids together in hyperthyroid rats showed the best ameliorating effects on the thyroid hormones, testosterone, testicular GGT and ALP, and all oxidative stress markers. There is no genetic mutations that occurred in D1 deiodinase due to hyperthyroidism. These findings were indicated by the proliferating cell nuclear antigen (PCNA) studies of testes.

  13. Liver volume, portal vein flow, and clearance of indocyanine green and antipyrine in hyperthyroidism before and after antithyroid treatment

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Sonne, J; Court-Payen, M

    1999-01-01

    The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment.......The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment....

  14. Effects of hyperthyroidism on expression of vascular endothelial growth factor (VEGF) and apoptosis in fetal adrenal glands.

    Science.gov (United States)

    Karaca, T; Hulya Uz, Y; Karabacak, R; Karaboga, I; Demirtas, S; Cagatay Cicek, A

    2015-11-26

    This study investigated the expression of vascular endothelial growth factor (VEGF), vascular density, and apoptosis in fetal rat adrenal glands with hyperthyroidism in late gestation. Twelve mature female Wistar albino rats with the same biological and physiological features were used for this study. Rats were divided into two groups: control and hyperthyroidism. Hyperthyroidism was induced by daily subcutaneous injections of L-thyroxine (250 μg/kg) before pregnancy for 21 days and during pregnancy. Rats in the control and hyperthyroidism groups were caged according to the number of male rats. Zero day of pregnancy (Day 0) was indicated when the animals were observed to have microscopic sperm in vaginal smears. Pregnant rats were sacrificed on the 20th day of pregnancy; blood from each animal was collected to determine the concentrations of maternal adrenocorticotropic hormone and thyroxine. Rat fetuses were then quickly removed from the uterus, and the adrenal glands of the fetuses were dissected. VEGF expression, vascular density, and apoptosis were analyzed in fetal rat adrenal glands. Maternal serum levels of the adrenocorticotropic hormone and free thyroxine were significantly higher in the hyperthyroidism group than in the control group. Immunohistochemistry revealed that the number of VEGF positive cells and vessel density significantly increased in the hyperthyroidism rat fetal adrenal group compared with the control group. Hyperthyroidism did not change the fetal and placental weights and the number of fetuses. This study demonstrates that hyperthyroidism may have an effect on the development of rat adrenal glands mediated by VEGF expression, angiogenesis, and apoptosis.

  15. Liver volume, portal vein flow, and clearance of indocyanine green and antipyrine in hyperthyroidism before and after antithyroid treatment

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Sonne, J; Court-Payen, M

    1999-01-01

    The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment.......The aim of the study was to examine liver volume, portal vein flow, and indocyanine green (ICG) and antipyrine clearance in hyperthyroidism before and after antithyroid drug treatment....

  16. Low incidence rate of overt hypothyroidism compared with hyperthyroidism in an area with moderately low iodine intake

    DEFF Research Database (Denmark)

    Laurberg, P; Bülow Pedersen, I; Pedersen, K M

    1999-01-01

    In areas with relatively high iodine intake, the incidence rate of hypothyroidism is several-fold higher than that of hyperthyroidism. Recently, we found a similarly high prevalence rate of subclinical hypothyroidism compared with hyperthyroidism in a high iodine intake area, while a relatively low...... prevalence of subclinical hypothyroidism was observed in a low iodine intake area. In the present study we compared the incidence rate (newly diagnosed in primary care and at hospital) of overt hypothyroidism with that of hyperthyroidism in a well-defined geographical area in Jutland, Denmark, with an iodine...... intake around 60 microg/day. The number of personsxyears studied was 569,108. Data on hyperthyroidism have been published previously. The overall incidence of hypothyroidism was 13.5/100,000 per year (F/M 22.9/3.6), hyperthyroidism 38.7/100.000 per year (F/M 63.0/13.0). The incidence of hypothyroidism...

  17. Radioiodine therapy in hyperthyroid disease: poorer outcome in patients with high 24 hours radioiodine uptake

    DEFF Research Database (Denmark)

    Kristoffersen, Ulrik Sloth; Hesse, Birger; Rasmussen, Ase Krogh

    2006-01-01

    PURPOSE: To evaluate the importance of 24 h radioiodine uptake (24 h RIU) for the outcome of radioiodine treatment of hyperthyroidism. METHODS: Retrospective analysis of 72 patients who underwent radioiodine treatment for toxic goiter at our outpatient clinic [29 diffuse goiters (DG), 30 toxic...... multinodular goiters (TMG) and 13 toxic adenomas (TA)]. Thyroid status was determined by TSH, fT3 and fT4 levels, and outcome was rendered successful when hyperthyroidism was absent. Relation between low 24 h RIU (below median) or high 24 h RIU (above or equal to median) and outcome was evaluated. RESULTS......: Of patients with DG and low 24 h RIU, 15% remained hyperthyroid, as opposed to 56% of patients with DG and high 24 h RIU (Phyperthyroid, as opposed to 44% of patients with TMG and high 24 h RIU (P

  18. Hyperthyroidism with dome-and-dart T wave: A case report

    Science.gov (United States)

    Lai, Ping; Yuan, Jing-ling; Xue, Jin-hua; Qiu, Yue-qun

    2017-01-01

    Abstract Rationale: Dome-and-dart T waves (or bifid T waves) are a rare phenomenon in the surface electrocardiogram. These wave forms are mainly observed in patients with congenital heart disease such as atrial septal defect and ventricular septal defect. And hyperthyroidism who presented with an electrocardiogram that had dome-and-dart T waves in a precordial lead is never been reported. Patient concerns: The patient presented with continuous tachycardia, palpitations, chest tightness, and headache for 4 days, and aggravated for 1 day. Diagnoses: Hyperthyroidism. Interventions: Methimazole. Outcomes: All symptoms were alleviated. Lessons: Dome-and-dart or bifid T waves have been reported in the conventional 12-lead electrocardiograms in some patients with congenital heart disease. The case illustrated here, to the best of our knowledge, dome-and-dart or bifid T waves may associate with hyperthyroidism patients. PMID:28178156

  19. Current opinions on the radioiodine treatment of Graves' hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Woo; Lee, Jae Tae [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

    2003-12-01

    Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainty and debate. Early side effects are uncommon and readily manageable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

  20. Intermittent changing axis deviation with intermittent left anterior hemiblock during atrial flutter with subclinical hyperthyroidism.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2009-06-26

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias including atrial fibrillation and atrial flutter. Intermittent changing axis deviation during atrial fibrillation has also rarely been reported. We present a case of intermittent changing axis deviation with intermittent left anterior hemiblock in a 59-year-old Italian man with atrial flutter and subclinical hyperthyroidism. To our knowledge, this is the first report of intermittent changing axis deviation with intermittent left anterior hemiblock in a patient with atrial flutter.

  1. Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Hyperaldosternoism: A Case Report.

    Science.gov (United States)

    Hsiao, Yu-Hsin; Fang, Yu-Wei; Leu, Jyh-Gang; Tsai, Ming-Hsein

    2017-01-04

    BACKGROUND Thyrotoxic periodic paralysis (TPP) is commonly observed in patients with acute paralysis and hyperthyroidism. However, there is a possibility of secondary causes of hypokalemia in such a setting. CASE REPORT Herein, we present the case of a 38-year-old woman with untreated hypertension and hyperthyroidism. She presented with muscle weakness, nausea, vomiting, and diarrhea since one week. The initial diagnosis was TPP. However, biochemistry tests showed hypokalemia with metabolic alkalosis and renal potassium wasting. Moreover, a suppressed plasma renin level and a high plasma aldosterone level were noted, which was suggestive of primary aldosteronism. Abdominal computed tomography confirmed this diagnosis. CONCLUSIONS Therefore, it is imperative to consider other causes of hypokalemia (apart from TPP) in a patient with hyperthyroidism but with renal potassium wasting and metabolic alkalosis. This can help avoid delay in diagnosis of the underlying disease.

  2. Subclinical hyperthyroidism and dementia: the Sao Paulo Ageing & Health Study (SPAH

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    Lotufo Paulo A

    2010-06-01

    Full Text Available Abstract Background Several epidemiologic studies have shown a possible association between thyroid function and cognitive decline. Our aim was to evaluate the association of subclinical hyperthyroidism and dementia in a population sample of older people Methods A cross-sectional study - São Paulo Ageing & Health Study (SPAH - in a population sample of low-income elderly people ≥ 65 years-old to evaluate presence of subclinical thyroid disease as a risk factor for dementia. Thyroid function was assessed using thyrotropic hormone and free-thyroxine as well as routine use of thyroid hormones or antithyroid medications. Cases of dementia were assessed using a harmonized one-phase dementia diagnostic procedure by the "10/66 Dementia Research Group" including Alzheimer's disease and vascular dementia. Logistic regression models were used to test a possible association between subclinical hyperthyroidism and dementia. Results and discussion Prevalence of dementia and of subclinical hyperthyroidism were respectively of 4.4% and 3.0%. After age adjustment, we found an association of subclinical hyperthyroidism and any type of dementia and vascular dementia (Odds Ratio, 4.1, 95% Confidence Interval [95% CI] 1.3-13.1, and 5.3 95% CI, 1.1-26.4; respectively. Analyzing data by gender, we found an association of subclinical hyperthyroidism with dementia and Alzheimer's disease only for men (OR, 8.0; 95% CI, 1.5-43.4; OR, 12.4; 95% CI, 1.2-128.4; respectively. No women with subclinical hypothyroidism presented Alzheimer's disease in the sample. Conclusion The results suggest a consistent association among people with subclinical hyperthyroidism and dementia.

  3. Effect of a Limited Iodine Diet on Iodine Uptake by Thyroid Glands in Hyperthyroid Cats.

    Science.gov (United States)

    Scott-Moncrieff, J C; Heng, H G; Weng, H Y; Dimeo, D; Jones, M D

    2015-01-01

    The effect of feeding a limited iodine diet on radioactive iodine uptake in the thyroid glands of hyperthyroid cats is unknown. To determine how feeding limited dietary iodine affects radioactive iodine uptake by the thyroid glands of hyperthyroid cats. Eight geriatric cats with spontaneous hyperthyroidism. Prospective study of eight client owned hyperthyroid cats fed a commercially available iodine limited diet for 6 months. Clinical signs were evaluated and TT4 and fT4 were measured during consumption of the diet. Uptake of (123)I was determined before and 8-16 weeks after exclusive consumption of the diet. Clinical signs of hyperthyroidism resolved in all cats, but there was no significant increase in body weight. TT4 and fT4 decreased into the reference range by 8-16 weeks in all cats. Mean TT4 before consumption of the diet was 9.7 μg/dL (SD 5.2) and after consumption of the diet was 3.1 μg/dL (SD 0.9). Scintigraphy revealed unilateral uptake of isotope in 5 cats and bilateral uptake in 3 cats. Mean percentage uptake of (123)I by the thyroid gland at 8 hours after isotope administration was 16.2 (SD 11.8) before diet consumption and 34.6 (SD 11.7) 8-16 weeks after exclusive consumption of the diet. The percentage increase was variable between cats (38-639%). Limited iodine diets increase iodine uptake in the autonomous thyroid glands of hyperthyroid cats. Further studies are necessary to determine if consumption of a limited iodine diet changes sensitivity of the thyroid gland to (131)I treatment. Copyright © 2015 by the American College of Veterinary Internal Medicine.

  4. Advanced glycation end products (AGEs) and its receptors in the pathogenesis of hyperthyroidism.

    Science.gov (United States)

    Caspar-Bell, Gudrun; Dhar, Indu; Prasad, Kailash

    2016-03-01

    Oxidative stress has been implicated in the pathogenesis of hyperthyroidism and its complications. Interaction of advanced glycation end products (AGEs) with receptor RAGE (receptor for AGEs) generates reactive oxygen species. Soluble receptor for AGEs (sRAGE) competes with RAGE for binding with AGEs and attenuates the generation of ROS. Low levels sRAGE and high levels AGEs would generate more ROS leading to hyperthyroidism and its complications. The objectives are to determine if levels of serum sRAGE are low and the levels of AGEs and AGEs/sRAGE are high in patients with hyperthyroidism. The study subjects comprised of 33 patients with hyperthyroidism and 20 controls. Levels of serum sRAGE were lower, while that of AGEs and AGEs/sRAGE were higher in patients compared to controls, being significant only for sRAGE and AGEs/sRAGE. When the levels of sRAGE, AGEs, and AGEs/sRAGE were assessed for hyperthyroidism associated with different diseases, the levels of sRAGE were lower in Hashimoto disease, and levels of AGEs were higher in patients with Graves' disease compared to control. The levels of AGEs/sRAGE were elevated in an all except patients with Hashimoto disease. The levels of AGEs, sRAGE, or AGEs/RAGE were not correlated with age, weight, and blood pressures except systolic pressure which was inversely correlated with sRAGE. The levels of sRAGE were negatively correlated with AGEs and AGEs/sRAGE. The levels of AGEs/sRAGE were positively correlated with AGEs. In conclusion, low levels of sRAGE, and high levels of AGEs and AGEs/sRAGE are risk biomarkers in the pathogenesis hyperthyroidism and its complications.

  5. Management and monitoring of hyperthyroid cats: a survey of Australian veterinarians.

    Science.gov (United States)

    Kopecny, Lucy; Higgs, Paul; Hibbert, Angie; Malik, Richard; Harvey, Andrea M

    2017-06-01

    Objectives This study sought to evaluate how Australian veterinarians approach management and monitoring of feline hyperthyroidism and compare these results with a similar survey recently performed in the UK. Methods An invitation to complete an online survey was sent to veterinarians in all states and territories of Australia. The survey comprised questions relating to management of hyperthyroidism, use of antithyroid drugs vs radioiodine treatment vs surgical thyroidectomy, in addition to demographic information for respondents. Results A total of 546 clinicians completed the survey. The most commonly preferred treatments for long-term management of feline hyperthyroidism were antithyroid medications (305/546; 56%) and radioiodine (210/546; 38%), with substantially more respondents selecting radioiodine when cost was removed as a consideration (425/546; 78%). However, most respondents had treated or referred few cases for radioiodine (median 2). Most veterinarians (500/546; 92%) used antithyroid medications either long term or prior to definitive treatment of hyperthyroidism. For medical management, 45% (244/546) of veterinarians used twice-daily carbimazole. Half of respondents (274/546) aimed to maintain the total thyroxine concentration anywhere within the laboratory reference interval in hyperthyroid cats without chronic kidney disease. Blood pressure monitoring was uncommon. Surgical thyroidectomy was rarely performed. Conclusions and relevance Radioiodine was more frequently preferred by Australian veterinarians compared with those in the UK, likely associated with greater availability, reduced cost and shorter hospitalisation times in this jurisdiction, although antithyroid medications were the most frequently used treatment modality. Barriers remain to its utilisation, however, including perceived cost, misconceptions with regard to expected success rate and accessibility. Recent changes to recommendations on the management and monitoring of hyperthyroid

  6. The Effects of Maternal Hyperthyroidism on Histologic Changes in Parietal Lobe in Rat Embryos

    Directory of Open Access Journals (Sweden)

    Fatemeh Mirsafi

    2017-05-01

    Full Text Available Background Maternal hyperthyroidism causes developmental defects on the nervous system of fetuses. Objectives The present study was designed to study the effects of maternal hyperthyroidism on the development of the parietal lobe in the brain of rat embryos. Methods In this experimental study, thirty Sprague-Dawley rats were randomly divided into three groups. The control group received no injections, the sham group received intraperitoneal injections of distilled water solution containing salt and polysorbate (solvent of levothyroxine, and the experimental group received once-daily, intraperitoneal injections of 0.5 mg/kg levothyroxine for a 10-day period to become hyperthyroid rats. The hyperthyroid rats were then mated, and all pregnant rats were killed on the 20th day of gestation. Fetuses were removed, fixed, and processed for histological procedures. The fetuses were sagitally sectioned at 5 µ thickness and stained with hematoxylin-eosin (H and E technique. The sections were examined using a light microscope and Motic software. Results The results showed no significant difference in the studied variables between the sham and control groups. A significantly increase in body weight and a significant decrease in crown-rump length of embryos was observed in the experimental group when compared to the control group. The mean total thickness of the parietal cortex, ventricular layer, and intermediate layer of embryos showed a significant decrease in the experimental group compared to the control and sham groups. The mean number of cells also showed a significant decrease in the intermediate and ventricular layers in the experimental group compared to the control and sham groups. Conclusions This study showed that maternal hyperthyroidism leads to a reduction in development of the parietal cortex in embryos. Maternal hyperthyroidism can disturb the growth and development of embryos.

  7. A critical review and meta-analysis of the association between overt hyperthyroidism and mortality.

    Science.gov (United States)

    Brandt, Frans; Green, Anders; Hegedüs, Laszlo; Brix, Thomas H

    2011-10-01

    Overt hyperthyroidism has been associated with cardiac arrhythmias, hypercoagulopathy, stroke, and pulmonary embolism, all of which may increase mortality. Some, but not all, studies show an increased mortality in patients with hyperthyroidism. This inconsistency may be due to differences in study design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis. Based on an electronic PubMed search, using the Medical Subject Heading words such as hyperthyroidism, thyrotoxicosis, and mortality or survival, case-control and cohort studies were selected and reviewed. Using meta-analysis, an overall relative risk (RR) of mortality was calculated. Eight studies fulfilled the inclusion criteria, six of which showed an increased all-cause mortality; seven studies, including 31,138 patients and 400,000 person years at risk, allowed calculation of mortality in a meta-analysis. Based on this, the RR of overall mortality was 1.21 (95% confidence interval: 1.05-1.38). Analyses including studies considering setting, treatment, and control for co-morbidity did not significantly alter this finding. As the measured heterogeneity (I(2)) ranges from 89.1 to 98.3%, which is much higher than the 50% generally viewed on as a threshold, the statistical heterogeneity is very pronounced in the included studies. In patients diagnosed with hyperthyroidism, mortality is increased by ∼ 20%. Future studies need to address the cause of hyperthyroidism, impact of type of therapy, time dependency, as well as the potential influence of confounding or genetic susceptibility before the question of causality can be answered.

  8. [Effect of preoperative administration of Lugol's solution on thyroid blood flow in hyperthyroidism].

    Science.gov (United States)

    Rodier, J F; Janser, J C; Petit, H; Schneegans, O; Ott, G; Kaissling, A; Grob, J C; Velten, M

    1998-01-01

    A study of 50 patients with hyperthyroidism was conducted to evaluate the effect of preoperative administration of Lugol's iodine solution on thyroid blood flow. Highly significant reductions in diameter, time-averaged velocity, and volume flow of the superior thyroid artery were demonstrated after administration of Lugol's solution. The Duplex ultrasound scanning used in this study is a noninvasive, inexpensive, accurate, and reproducible technique suitable for analysis of thyroid blood flow in hyperthyroidism. On the basis of current ultrasonographic results and low postoperative morbidity in patients, Lugol's solution is well tolerated and may be recommended for use before thyroidectomy, especially for diffuse toxic goiters and Graves disease.

  9. [Fucus vesiculosus induced hyperthyroidism in a patient undergoing concomitant treatment with lithium].

    Science.gov (United States)

    Arbaizar, Beatriz; Llorca, Javier

    2011-01-01

    Fucus vesiculosus is a marine alga rich in iodine, which is being used in alternative medicine as a laxative, diuretic, and as a complement for weight loss diets. We report the case of a 60-year old male patient, diagnosed with bipolar disorder and under treatment with lithium concomitantly with a herbal preparation, including Fucus vesiculosus, as a laxative. He developed hyperthyroidism that remitted once the herbal preparation was withdrawn. Fucus vesiculosus may cause hyperthyroidism given its high iodine content. Herbal preparations should be taken in account when treating a patient due to the possibility of adverse effects and interactions with other drugs.

  10. Longstanding hyperthyroidism is associated with normal or enhanced intrinsic cardiomyocyte function despite decline in global cardiac function.

    Directory of Open Access Journals (Sweden)

    Nathan Y Weltman

    Full Text Available Thyroid hormones (THs play a pivotal role in cardiac homeostasis. TH imbalances alter cardiac performance and ultimately cause cardiac dysfunction. Although short-term hyperthyroidism typically leads to heightened left ventricular (LV contractility and improved hemodynamic parameters, chronic hyperthyroidism is associated with deleterious cardiac consequences including increased risk of arrhythmia, impaired cardiac reserve and exercise capacity, myocardial remodeling, and occasionally heart failure. To evaluate the long-term consequences of chronic hyperthyroidism on LV remodeling and function, we examined LV isolated myocyte function, chamber function, and whole tissue remodeling in a hamster model. Three-month-old F1b hamsters were randomized to control or 10 months TH treatment (0.1% grade I desiccated TH. LV chamber remodeling and function was assessed by echocardiography at 1, 2, 4, 6, 8, and 10 months of treatment. After 10 months, terminal cardiac function was assessed by echocardiography and LV hemodynamics. Hyperthyroid hamsters exhibited significant cardiac hypertrophy and deleterious cardiac remodeling characterized by myocyte lengthening, chamber dilatation, decreased relative wall thickness, increased wall stress, and increased LV interstitial fibrotic deposition. Importantly, hyperthyroid hamsters demonstrated significant LV systolic and diastolic dysfunction. Despite the aforementioned remodeling and global cardiac decline, individual isolated cardiac myocytes from chronically hyperthyroid hamsters had enhanced function when compared with myocytes from untreated age-matched controls. Thus, it appears that long-term hyperthyroidism may impair global LV function, at least in part by increasing interstitial ventricular fibrosis, in spite of normal or enhanced intrinsic cardiomyocyte function.

  11. Subclinical hyperthyroidism seems not to have a significant impact on systemic anticoagulation in patients with coumarin therapy.

    Science.gov (United States)

    Bucerius, Jan; Naubereit, Anna; Joe, Alexius Y; Ezziddin, Samer; Biermann, Kim; Risse, Jörn; Palmedo, Holger; Oldenburg, Johannes; Biersack, Hans-Jürgen

    2008-11-01

    There is little data regarding the impact of subclinical hyperthyroidism on coagulation metabolism in patients undergoing systemic anticoagulation therapy with coumarin derivates. In this retrospective analysis we studied 233 patients with benign thyroid disorders receiving therapeutic iodine-131, as well as concomitant systemic anticoagulation therapy (subclinical hyperthyroidism: n = 178; overt hyperthyroidism: n = 15; euthyroidism: n = 40). Multivariate regression analyses were performed in the total study population as well as in the subgroup of patients with subclinical hyperthyroidism to identify the possible impact of several variables on anticoagulation therapy, large enough to push the International Normalized Ratio (INR) level out of the therapeutic range (INR 3.0). Therapy with antibiotics or nitrates was significantly associated with INR-values >3.0 in the total population, while ACE inhibitors were associated with lower incidence of INR-values subclinical hyperthyroidism, therapy with antibiotics was predictive of INR-values >3.0, whereas therapy with thyroid suppressive drugs or TSH-values subclinical hyperthyroidism and euthyroidism intraindividual comparison with regard to the possible impact on anticoagulation therapy was performed which failed to show any significant differences in INR-values between the two thyroid metabolic conditions. In conclusion, subclinical hyperthyroidism seems to have no significant impact on coagulation metabolism in patients receiving anticoagulation therapy.

  12. Longstanding Hyperthyroidism Is Associated with Normal or Enhanced Intrinsic Cardiomyocyte Function despite Decline in Global Cardiac Function

    Science.gov (United States)

    Redetzke, Rebecca A.; Gerdes, A. Martin

    2012-01-01

    Thyroid hormones (THs) play a pivotal role in cardiac homeostasis. TH imbalances alter cardiac performance and ultimately cause cardiac dysfunction. Although short-term hyperthyroidism typically leads to heightened left ventricular (LV) contractility and improved hemodynamic parameters, chronic hyperthyroidism is associated with deleterious cardiac consequences including increased risk of arrhythmia, impaired cardiac reserve and exercise capacity, myocardial remodeling, and occasionally heart failure. To evaluate the long-term consequences of chronic hyperthyroidism on LV remodeling and function, we examined LV isolated myocyte function, chamber function, and whole tissue remodeling in a hamster model. Three-month-old F1b hamsters were randomized to control or 10 months TH treatment (0.1% grade I desiccated TH). LV chamber remodeling and function was assessed by echocardiography at 1, 2, 4, 6, 8, and 10 months of treatment. After 10 months, terminal cardiac function was assessed by echocardiography and LV hemodynamics. Hyperthyroid hamsters exhibited significant cardiac hypertrophy and deleterious cardiac remodeling characterized by myocyte lengthening, chamber dilatation, decreased relative wall thickness, increased wall stress, and increased LV interstitial fibrotic deposition. Importantly, hyperthyroid hamsters demonstrated significant LV systolic and diastolic dysfunction. Despite the aforementioned remodeling and global cardiac decline, individual isolated cardiac myocytes from chronically hyperthyroid hamsters had enhanced function when compared with myocytes from untreated age-matched controls. Thus, it appears that long-term hyperthyroidism may impair global LV function, at least in part by increasing interstitial ventricular fibrosis, in spite of normal or enhanced intrinsic cardiomyocyte function. PMID:23056390

  13. Subclinical Nonautoimmune Hyperthyroidism in a Family Segregates with a Thyrotropin Receptor Mutation with Weakly Increased Constitutive Activity

    Science.gov (United States)

    Chen, Chun-Rong; Higashiyama, Takuya; Mizutori-Sasai, Yumiko; Ito, Mitsuru; Kubota, Sumihisa; Amino, Nobuyuki; Miyauchi, Akira; Rapoport, Basil

    2010-01-01

    Background Subclinical hyperthyroidism is usually associated with Graves' disease or toxic nodular goiter. Here we report a family with hereditary subclinical hyperthyroidism caused by a constitutively activating germline mutation of the thyrotropin receptor (TSHR) gene. Methods The proband was a 64-year-old Japanese woman who presented with a thyroid nodule and was found to be euthyroid with a suppressed serum TSH. The nodule was not hot. Although antibodies to thyroid peroxidase and thyroglobulin antibodies were present, TSHR antibodies were not detected by TSH-binding inhibition or by bioassay. Two of her middle-aged sons, but not her daughter, also had subclinical hyperthyroidism without TSHR antibodies. Without therapy, the clinical condition of the affected individuals remained unchanged over 3 years without development of overt hyperthyroidism. Results A novel heterozygous TSHR point mutation causing a glutamic acid to lysine substitution at codon 575 (E575K) in the second extracellular loop was detected in the three family members with subclinical hyperthyroidism, but was absent in her one daughter with normal thyroid function. In vitro functional studies of the E575K TSHR mutation demonstrated a weak, but significant, increase in constitutive activation of the cAMP pathway. Conclusion Although hereditary nonautoimmune overt hyperthyroidism is very rare, TSHR activating mutations as a cause of subclinical hyperthyroidism may be more common and should be considered in the differential diagnosis, especially if familial. PMID:20929407

  14. Effectiveness of radioiodine therapy in treatment of hyperthyroidism.

    Science.gov (United States)

    Alam, M N; Chakrabarty, R K; Akhter, M; Nahar, N; Swapan, M K; Alam, M M; Nahar, R; Sultana, N; Hallaz, M M; Alam, M M; Uddin, M M; Hossain, M A; Yasmin, S; Islam, M R

    2013-10-01

    The present non randomized clinical trial was conducted in the Center for Nuclear Medicine and Ultrasound, Mymensingh, Bangladesh for duration of one year. Total 30 patients with hyperthyroidism diagnosed by clinical and biochemical profile were included in the study. All patients received radioiodine treatment and regular follow up at 1st month, 3rd month, 6th month & 9th month were done to evaluate clinical and biochemical status and complications. Data were analyzed by computer with SPSS programme using 't' test and chi-square test. In the present study, out of 30 respondents more than three fourth of the respondents (76.6%) were in the age group of 31-50 years followed by less than 30 years are group (16.7%) and rest of respondents were in the age group of more than 50 years (06.7%). Mean±SD and range of age of the respondents were 39.80±10.02 years and 17-65 years respectively. Among the 30 respondents 11(36.7%) were male and 19(63.3%) were female. Male to female ratio was 1:1.73. Out of 30 patients 26(86.7%) presented with goiter and among them 21(80.8%) has diffused goiter and five (19.2%) had nodular goiter. Baseline mean±SD, median, range of serum T₃ level were 5.24±3.62, 4.34, 1.48-14.65nmol/L respectively. Base line mean±SD, median range of serum T₄ level were 192.25±99.17, 201.77, 1.75-336.25nmol/L respectively. Baseline mean±SD, median range of serum TSH level were 6.33±23.93, 0.15-0.07, 130.46nmol/L respectively. In the present study serum T₃, T₄ level among the respondents sharply decrease from baseline to 2nd follow up then gradually decrease from 2nd to 4th follow up. Serum TSH level gradually increases from baseline to 3rd follow up and then gradually decreases from 3rd to 4th follow up. The result showed radioiodine is an effective option for the treatment of thyrotoxicosis.

  15. Radioiodine therapy increases the risk of cerebrovascular events in hyperthyroid and euthyroid patients

    DEFF Research Database (Denmark)

    la Cour, Jeppe Lerche; Jensen, Lars Thorbjoern; Vej-Hansen, Anders

    2015-01-01

    to radiation and is capable of inducing atherosclerosis. The objective of the study was to elucidate whether ionizing radiation from radioiodine might contribute to cerebrovascular morbidity. METHODS: In a retrospective register cohort study, 4000 hyperthyroid and 1022 euthyroid goitre patients treated...

  16. Epidemiology of subtypes of hyperthyroidism in Denmark: a population-based study

    DEFF Research Database (Denmark)

    Carle, Allan; Pedersen, Inge Bulow; Knudsen, Nils

    2011-01-01

    Z227 632).Methods: A laboratory monitoring system identified subjects with thyroid function tests suggesting overt hyperthyroidism (low s-TSH combined with high s-thyroxine or s-triiodothyronine). For all subjects, we collected information on medical history, thyroid scintigraphy and thyroid hormone...

  17. Detection of combined genomic variants in a Jordanian family with familial non-autoimmune hyperthyroidism

    Indian Academy of Sciences (India)

    Said I. Ismail; Ismail S. Mahmoud; Mahmoud Al-Ardah; Amid Abdelnour; Nidal A. Younes

    2009-08-01

    Five patients, four brothers and their paternal aunt, presented with a history of overt hyperthyroidism and goiter. Hyperthyroidism in this family was remarkable for its poor response to carbimazole (30–50 mg/d). The thyroid ultrasound showed a diffusely enlarged gland in all the affected members, and thyroid stimulating antibodies (TSAB) were negative. Screening for germline mutations in thyroid stimulating hormone (TSH) receptor (TSHR) gene was performed by direct sequencing of genomic DNA extracted from peripheral blood leukocytes of all family members. The sequence analysis of all TSHR gene exons and intron borders revealed two genomic variants. The first was a single nucleotide polymorphism (SNP) within exon seven (Asn187Asn), whereas the other was located in intron seven (IVS7+68T>G). All affected members, two asymptomatic brothers with sub-clinical hyperthyroidism, and their father were heterozygous for those two genomic variants. Anti-thyroid drug treatment for several months successfully relieved symptoms in one subject, whereas the remaining patients required total thyroidectomy to control their disease. This is the first Jordanian family with familial non-autoimmune hyperthyroidism, with mutations affecting the TSHR gene.

  18. Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Heemstra, Karen Anne

    2009-01-01

    Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

  19. Effects of an iodine-restricted food on client-owned cats with hyperthyroidism

    NARCIS (Netherlands)

    van der Kooij, M.; Becvárová, Iveta; Meyer, H.P.; Teske, E.; Kooistra, H.S.

    2014-01-01

    The objective of this prospective, multicentre, non-controlled, open-label study was to evaluate the effects of an iodine-restricted food on circulating total thyroxine (TT4) concentrations and clinical parameters in client-owned cats with hyperthyroidism. Two hundred and twenty-five cats were enrol

  20. Volt-Ampere Characteristics of Acupoint Neiguan (PC 6) on Patients with Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    魏建子; 沈雪勇; 毛慧娟; 王霆

    2008-01-01

    Objective:To observe volt-ampere characteristic of Acupoint Neiguan (PC 6) on patients with hyper-thyroidism for probing into the actions of acupoints and change of qi and blood of human body as well as the relationship between the action of acupoint and the metabolism of energy. Methods:A self-made high-sensitive apparatus was applied to detect volt-ampere curves of Acupoint Neiguan(PC 6)and its control point on 33 patients with hyperthyroidism and 30 healthy people.Results:In patients,the volt-ampere areas (VAA)of both ampere.Increasing scan(AIS)and ampere—decreasing Scan(ADS)as well as the inertia areas (IS) of both side Neiguan(PC 6)were significantly smaller than the control points(P0.05).Conclusion:The volt-ampere characteristics of the right and left Neiguan(PC 61 on patients with hyperthyroidism are in imbalance.Hyperthyroidism exerts certaininfluenceontheheartfunction.

  1. [Apathetic hyperthyroidism with heart failure in an elderly patient with Plummer's disease].

    Science.gov (United States)

    Narisawa, Manabu; Okada, Yosuke; Arao, Tadashi; Kuno, Fumi; Tanaka, Yoshiya

    2014-12-01

    We report a case of apathetic hyperthyroidism associated with unrecognized slowly growing functional thyroid adenoma (Plummer's disease), atrial fibrillation and heart failure. An 81-year-old woman with worsening thyroid dysfunction was admitted to our hospital for the treatment of heart failure. The patient had developed heart failure associated with chronic atrial fibrillation at 76 years of age, and one year later was found to have asymptomatic hyperthyroidism. Anti-thyroid autoantibodies were negative, but thyroid echography showed a 32-mm tumor devoid of internal blood flow in the left lower lobe. Free thyroxine 4 (FT4) decreased from 3.30 to 2.60 ng/dl without treatment. The patient was diagnosed with transient thyroiditis and was followed-up without treatment. However, a repeat thyroid echography showed growth of the tumor to 41 mm in 4 years. Thyroid scintigraphy showed uptake that matched the thyroid mass. Based on these findings, the established diagnosis was Plummer's disease complicated with heart failure. The patient was treated with anti-thyroid drugs, which resulted in improvement of FT4 and reduced the severity of heart failure. In this rare case of an elderly patient, Plummer's disease was associated with a slowly-growing functional thyroid adenoma, apathetic hyperthyroidism, repeated episodes of atrial fibrillation and heart failure. Since symptoms of thyrotoxicosis are likely to be missed in the elderly, it is necessary to include hyperthyroidism in the pathoetiology of heart failure and atrial fibrillation in this population.

  2. Changes of thyroid function, autoantibodies, bone mineral density and bone metabolism indexes in patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Yan Wang; Hua-Ling Ruan; Yi Lia Min Zhang; Chang-Jun Zhao

    2016-01-01

    Objective:To investigate the changes of thyroid function, autoantibodies, bone mineral density and bone metabolism in patients with hyperthyroidism.Methods:A total of 216 cases of hyperthyroidism in our hospital from December 2015 to January 2015 were selected as the case group, 216 cases of healthy people selected the same period in our hospital physical examination center as the control group, detected thyroid function, autoantibodies, bone mineral density and bone metabolism indexes of all the studied subjects and compared with each other.Results:In this study, it was found that diastolic blood pressure, BMI, triglyceride, total cholesterol, HDL-C, VLDL-C, TSH were all significantly lower than the control group (P<0.05), systolic blood pressure, LDL-C, GLU, T3, T4, FT3, FT4, HTG, TG-Ab, TPO-Ab in case group were significantly higher than the control group (P<0.05). Right calcaneal speed of sound (SOS) in case group was significantly lower than the control group (P<0.05), BGP, PTH in case group were significantly higher than the control group (P<0.05).Conclusions:Hyperthyroidism can cause thyroid hormone levels abnormal, abnormal increase autoantibodies, decrease bone density, bone metabolism actively, easy to form osteoporosis, clinical treatment of hyperthyroidism in the same time, should actively prevent the occurrence of osteoporosis.

  3. Prevalence of paraneoplastic hyperthyroidism in patients with metastatic non-seminomatous germ-cell tumors

    NARCIS (Netherlands)

    Oosting, S. F.; de Haas, E. C.; Links, T. P.; de Bruin, D.; Sluiter, W. J.; de Jong, I. J.; Hoekstra, H. J.; Sleijfer, D. T.; Gietema, J. A.

    2010-01-01

    Patients and methods: In all patients with metastatic NSGCT who started chemotherapy at our center from April 2001 to April 2007, thyroid function was analyzed. The association between thyroid function and HCG level was examined and the frequency of hyperthyroidism in patients with low (<5000 IU/l),

  4. Estimation of gastric ghrelin-positive cells activity in hyperthyroid rats.

    Directory of Open Access Journals (Sweden)

    Maria M Winnicka

    2009-01-01

    Full Text Available Ghrelin is a peptide of 28 amino acids that transmits appetite related signals from peripheral organs to the brain. The main source of ghrelin is stomach. The regulation of ghrelin secretion is still unknown. The finding that fasting and food intake, respectively increase and decrease the secretion of ghrelin suggests that this hormone may be a bridge connecting somatic growth with energy metabolism and appears to play an important role in the alteration of energy homeostasis and body weight in pathophisiological conditions. The purpose of this study was the evaluation of gastric ghrelin immunoreactivity and ghrelin plasma concentration in male Wistar rats with hyperthyroidism. Experimental model of hyperthyroidism was induced by intraperitoneal injection of levothyroxine at the dose of 80 microg/kg daily over 21 days. At the end of experiment the animals were anaesthetized, blood was taken from abdominal aorta to determinate plasma ghrelin concentration by RIA and then the animals underwent resection of distal part of stomach. Immunohistochemical study were performed using monoclonal specific antybodies against ghrelin. Hyperthyroidism was a reason of increase of gastric mucosal ghrelin - immunoreactivity, accompanied by a significant decreased of ghrelin plasma concentration. Those observations may indicate, that chronic administration of L-thyroxine cause the change of ghrelin plasma concentration in rats, probably via direct influence on gastric X/A-like cells, but this effect is not responsible for hyperphagia associated with hyperthyroidism.

  5. Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Heemstra, Karen Anne

    2009-01-01

    Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

  6. McCune-Albright syndrome revealed by hyperthyroidism at advanced age.

    Science.gov (United States)

    Elhaï, Muriel; Meunier, Marine; Kahan, André; Cormier, Catherine

    2011-12-01

    We report a case of a 38-year-old woman admitted to our service for diagnosis of osteolytic lesions. She suffered from back, lumbar and costal pain at the time a hyperthyroidism, related to multinodular goiter, was diagnosed. The pain remained despite the cure of hyperthyroidism. Cutaneous examination revealed café au lait skin spots. Analysis of the phosphocalcic metabolism allowed the diagnosis of phosphate diabetes. X-ray showed lytic lesions involving the ribs with thinning of the cortex and vertebral fractures of the dorsal spine. The computed tomography revealed lytic lesions with a typical "ground glass" appearance involving the spine, ribs, sternum, iliac bones and sacrum. The presence of this clinical triad allowed the diagnosis of McCune-Albright syndrome (MAS). The treatment consisted in vitamin D supplementation, and high doses of both oral phosphate and calcitriol to treat the phosphate diabetes as well as cycles of intravenous pamidronate administration to relieve bone pain. We report an uncommon case of the diagnosis of MAS at an advanced age following hyperthyroidism. We believe that the disease was revealed by an increase in bone turnover due to hyperthyroidism.

  7. Pre- and posttreatment ultrasonography of the thyroid gland in hyperthyroid cats.

    Science.gov (United States)

    Barberet, Virginie; Baeumlin, Yseult; Taeymans, Olivier; Duchateau, Luc; Peremans, Kathelijne; van Hoek, Ingrid; Daminet, Sylvie; Saunders, Jimmy H

    2010-01-01

    Ultrasonography is useful for assessing the morphology of the thyroid gland in hyperthyroid cats. Our aim was to describe the ultrasonographic changes of the thyroid gland in hyperthyroid cats after 131I therapy. Ultrasonography was performed in 15 hyperthyroid cats at initial presentation and 6 months after 131I using a multifrequency linear transducer set at 12 MHz. The following criteria were evaluated: length, width, height, volume, shape, homogeneity, and vascularity, using Power Doppler. Pretreatment, 10 cats had bilaterally abnormal thyroid lobes, four cats one abnormal lobe with the contralateral lobe being normal or reduced in size, and one cat with one normal lobe and one lobe not visible. Six months after 131I therapy, there was a reduction in median volume from 819 to 210 mm3, reduced rounding, reduced heterogeneity, and decreased vascularity. In conclusion, ultrasonography may be used to monitor thyroid changes in order to assess 131I treatment response. Further studies are necessary to determine whether ultrasonography could contribute to the detection of a relapsing course of hyperthyroidism.

  8. How could we improve the increased cardiovascular mortality in patients with overt and subclinical hyperthyroidism?

    Science.gov (United States)

    Biondi, Bernadette

    2012-09-01

    Over the past five years several meta-analyses have evaluated the cardiovascular mortality in patients with hyperthyroidism. They assessed various studies in which different inclusion criteria were used for the analysis of the cardiovascular mortality. More selective criteria have been used in recent meta-analyses. Only prospective cohort studies were included and only cohorts using second and third generation TSH assays were chosen. In addition, only the studies where the TSH evaluation was repeated during the follow-up were selected. The results of these recent meta-analyses provide evidence that overt and subclinical hyperthyroidism, particularly in patients with undetectable serum TSH, may increase the cardiovascular mortality. However, still today, the results remain inconclusive and not sufficient enough to recommend treatment for patients with low-detectable serum TSH. The high cardiovascular risk and mortality in presence of thyroid hormone excess suggest that this dysfunction is an important health problem and requires guidelines for the treatment of patients at high cardiovascular risk. Rigorous studies are necessary to evaluate the effects of the various causes of hyperthyroidism on the clinical outcomes. Randomized controlled clinical trials are needed to assess the benefits of treatment to improve the cardiovascular mortality and morbidity of mild and overt hyperthyroidism.

  9. Clinical spectrum and therapeutic approach to hepatocellular injury in patients with hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Mazo DF

    2013-02-01

    Full Text Available Daniel Ferraz de Campos Mazo,1 Graciana Bandeira Salgado de Vasconcelos,1 Maria Adelaide Albergaria Pereira,2 Evandro Sobroza de Mello,3 Telesforo Bacchella,1 Flair Jose Carrilho,1 Eduardo Luiz Rachid Cançado1,41Department of Gastroenterology, 2Department of Internal Medicine, 3Department of Pathology, 4Laboratory of Immunopathology of Schistosomiasis (LIM 06, Institute of Tropical Medicine, University of São Paulo School of Medicine, São Paulo, BrazilAbstract: Liver dysfunction in patients with hyperthyroidism includes abnormalities associated with the effects of thyroid hormone excess, those secondary to drug-induced liver injury, and changes resulting from concomitant liver disease. Our goal was to describe clinical, biochemical, and histopathological patterns in patients suffering from hyperthyroidism and concomitant liver dysfunction and to propose an algorithm of procedures to facilitate diagnosis and management of such cases. This study describes seven patients with liver biochemistry abnormalities detected after diagnosis of hyperthyroidism and one with undiagnosed decompensated hyperthyroidism and acute hepatitis. Two patients showed autoantibody reactivity which, together with liver histology, suggested the diagnosis of classic autoimmune hepatitis. Three patients experienced hepatotoxicity induced by propylthiouracil, the manifestations of which ranged from a benign course after drug withdrawal in one, a longstanding course in another suggesting drug-induced autoimmune hepatitis, and a more severe clinical condition with acute liver failure in a third patient, requiring liver transplantation. The three remaining patients showed no precipitating factors other than thyroid hyperactivity itself. They could be interpreted as having a thyroid storm with different clinical presentations. In conclusion, this series of patients illustrates the most frequent patterns of hepatocellular damage associated with hyperthyroidism and provides an

  10. Cytogenetic damage after 131-iodine treatment for hyperthyroidism and thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, S.; Carbonell, E.; Creus, A.; Marcos, R. [Universitat Autonoma de Barcelona (Spain). Dept. de Genetica i de Microbiologia; Galofre, P. [Servei de Medicina Nuclear, Ciutat Sanitaria i Universitaria Vall d' Hebron, Barcelona (Spain)

    1999-12-01

    To detect the incidence and persistence of potential chromosome damage induced by iodine-131 therapy, we applied the cytokinesis-block micronucleus assay to peripheral blood lymphocytes from hyperthyroidism and thyroid cancer patients treated with {sup 131}I. Two groups of patients were evaluated in a longitudinal study; one group was composed of 47 hyperthyroid patients and the other of 39 thyroid cancer patients. In the hyperthyroidism group, the micronuclei frequency was determined before {sup 131}I therapy and 1 week, 1 month and 3 months after it. Furthermore, an additional sample was taken from a subgroup of 17 hyperthyroidism patients 6 months after treatment. In the thyroid cancer group, the analysis was also conducted over time, and four samples were studied: before treatment and 1 week, 6 months and 1 year later. Simultaneously, a cross-sectional study was performed with 70 control subjects and 54 thyroid cancer patients who had received the last therapeutic dose 1-6 years before the present study. In the hyperthyroidism group a significant increase in the micronuclei average was found over time. In the sample obtained 6 months after therapy, the micronuclei mean frequency was practically the same as in the sample taken 3 months before. In the thyroid cancer group a twofold increase in the frequency of micronuclei was seen 1 week after therapy. Although this value decreased across time, the micronuclei frequency obtained 1 year after {sup 131}I therapy remained higher than the value found before it. Concerning the data from the cross-sectional study, a significant increase in the frequency of micronuclei was detected in the subgroup of thyroid cancer patients treated between 1 and 3 years before the current study. These results indicate that exposure to {sup 131}I therapy induces chromosome damage in peripheral lymphocytes and that the cytokinesis-block micronucleus assay is sensitive enough to detect the genetic damage by exposure to sufficiently high

  11. Quantitative thyroid scintigraphy for the differentiation of Graves' disease and hyperthyroid autoimmune thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    2004-08-01

    The purpose of this study is the evaluation of the TCTUs in the differentiation between AIT and GD in patients with hyperthyroidism. Methods: We determined the TCTUs in 59 patients with untreated hyperthyroid GD and in 51 patients with AIT who had subclinical or manifest hyperthyroidism without medication. Patients with GD were characterized by the presence of hyperthyroidism, decreased echogenicity of the thyroid, elevation of TSH-receptor autoantibodies (TRAb). AIT was defined by a decreased echogenicity of the thyroid, absence of elevated TSH-receptor autoantibodies (TRAb), autoantibodies against the thyroid peroxidase (anti-TPO) and spontaneous remission or development of subclinical hypothyroidism within 3 months. Results: Thyroid volumes of patients with AIT were significantly lower than those of patients with GD (p<0.05). TRAb levels were significantly higher in GD-patients (median: 19.5 U/ml; range: 15.3-35 U/ml) than in AIT-patients (median: 1.3 U/ml; range: 0-4.1 U/ml). 73% (38/59) of patients with GD had elevated anti-TPO levels. In these patients anti-TPO levels (median: 768 U/l; range: 83-6397 U/l) were not significantly different from anti-TPO levels of patients with AIT (median: 834 U/l; range: 107-8675 U/l; p=0.17). TCTUs values of patients with AIT were significantly lower (p<0.05; median: 0.9%; range: 0.1-3.2%) than those of patients with GD (median: 5.7%; range: 1.9-28.3%). Conclusion: In our patients quantitative thyroid scintigraphy with {sup 99m}TcO{sub 4}{sup -} offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

  12. The bidirectional effects of hypothyroidism and hyperthyroidism on anxiety- and depression-like behaviors in rats.

    Science.gov (United States)

    Yu, Dafu; Zhou, Heng; Yang, Yuan; Jiang, Yong; Wang, Tianchao; Lv, Liang; Zhou, Qixin; Yang, Yuexiong; Dong, Xuexian; He, Jianfeng; Huang, Xiaoyan; Chen, Jijun; Wu, Kunhua; Xu, Lin; Mao, Rongrong

    2015-03-01

    Thyroid hormone disorders have long been linked to depression, but the causal relationship between them remains controversial. To address this question, we established rat models of hypothyroidism using (131)iodine ((131)I) and hyperthyroidism using levothyroxine (LT4). Serum free thyroxine (FT4) and triiodothyronine (FT3) significantly decreased in the hypothyroid of rats with single injections of (131)I (5mCi/kg). These rats exhibited decreased depression-like behaviors in forced swimming test and sucrose preference tests, as well as decreased anxiety-like behaviors in an elevated plus maze. Diminished levels of brain serotonin (5-HT) and increased levels of hippocampal brain-derived neurotrophic factor (BDNF) were found in the hypothyroid rats compared to the control saline-vehicle administered rats. LT4 treatment reversed the decrease in thyroid hormones and depression-like behaviors. In contrast, hyperthyroidism induced by weekly injections of LT4 (15μg/kg) caused a greater than 10-fold increase in serum FT4 and FT3 levels. The hyperthyroid rats exhibited higher anxiety- and depression-like behaviors, higher brain 5-HT level, and lower hippocampal BDNF levels than the controls. Treatment with the antidepressant imipramine (15mg/kg) diminished serum FT4 levels as well as anxiety- and depression-like behaviors in the hyperthyroid rats but led to a further increase in brain 5-HT levels, compared with the controls or the hypothyroid rats. Together, our results suggest that hypothyroidism and hyperthyroidism have bidirectional effects on anxiety- and depression-like behaviors in rats, possibly by modulating hippocampal BDNF levels.

  13. Influence of serum levels of TSH receptor antibody in pregnant women with Gravesdisease on neonatal hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhi-ying; Tian Jian; Zhu Li

    2012-01-01

    Objective: To investigate the clinical significance of serum thyroid stimulating hormone (TSH) receptor antibody (TRAb) levels in pregnant women with Graves' disease,on neonatal hyperthyroidism.Methods: The clinical data of 68 pregnant women with Graves’ disease and their newborns were retrospectively analyzed.Testing indicators included thyroid function tests and TRAb levels during pregnancy,at delivery,and within 2 weeks after birth.The serum TRAb and T3,T4,Free T3,Free T4,TSH levels were detected by radio receptor assay (RRA) and electrical chemiluminescence immunoassay (ECLIA),respectively.Results: The results showed that serum TRAb levels of the third trimester of pregnancy was positively correlated with that of the umbilical vein (n=68,r=0.8494,P<0.01),and that of the newborns (n=68,r=0.8286,P<0.01).The incidence of neonatal hyperthyroidism was 11.8% (8/68).The serum TRAb levels in the 8 neonates with hyperthyroidism within 2 weeks after birth were 3 times higher than those in the normal neonates.Of these 8 neonates,2 had 15 times higher serum TRAb levels than those of normal neonates within 2 weeks after birth.The thyroid function and TRAb levels of these 2 neonates were still abnormal 6 months later.Conclusions: The risk of hyperthyroidism in newborn whose mother's TRAb levels were high in the third trimester of pregnancy was increased.This study suggests a significant correlation between TRAb levels in pregnant women with Graves’ disease and the severity of neonatal hyperthyroidism.

  14. Management of Gestational Hyperthyroidism%妊娠期甲亢诊疗决策

    Institute of Scientific and Technical Information of China (English)

    查金顺; 蒋艳

    2011-01-01

    Diagnosing and treatment of hyperthyroidism during pregnancy can be challenging because many of the signs and symptoms are similar to normal physiologic changes that occur in pregnancy and treatment of hyperthyroidism or itself could potentially adversely affect fetal and pregnancy outcome during pregnancy. Patients with Graves's disease require prompt treatment with antithyroid drugs and should undergo frequent monitoring for signs of fetal and maternal hyperthyroidism and hypothyroidism. Rates of maternal and perinatal complications are directly related to control of hyperthyroidism in the mother,so TRAb should be assessed in all Gestational women with hyperthyroidism. Thyroid function tests should be measured in all patients with hyperemesis gravidarum, and few women with hyperemesis gravidarum will require antithyroid drugs treatment.%由于甲亢的一些症状和体征类似于正常妊娠中发生的正常生理变化,且孕期甲亢及其治疗对妊娠结果和胎儿可能的不良影响,所以给孕期甲亢的诊疗带来困难.孕期甲亢息者应尽快接受抗甲状腺药物(antitlayroid drugs,ATD)的治疗并应经常接受胎儿和孕妇甲亢及甲减征象的监测.孕妇和围产期的并发症发生率直接与母亲甲亢的控制有关,应对所有甲亢妇女进行促甲状腺受体抗体(thyrotrophin receptor antibody,TRAb)的评估.所有妊娠剧吐患者均应测定甲状腺功能,少数妊娠剧吐短暂甲亢孕妇需ATD治疗.

  15. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.

    Science.gov (United States)

    Ross, Douglas S; Burch, Henry B; Cooper, David S; Greenlee, M Carol; Laurberg, Peter; Maia, Ana Luiza; Rivkees, Scott A; Samuels, Mary; Sosa, Julie Ann; Stan, Marius N; Walter, Martin A

    2016-10-01

    Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves' hyperthyroidism with antithyroid drugs, the management of pregnant hyperthyroid patients, and the

  16. Effects of electromagnetic fields on bone loss in hyperthyroidism rat model.

    Science.gov (United States)

    Liu, Chaoxu; Zhang, Yingchi; Fu, Tao; Liu, Yang; Wei, Sheng; Yang, Yong; Zhao, Dongming; Zhao, Wenchun; Song, Mingyu; Tang, Xiangyu; Wu, Hua

    2017-02-01

    Optimal therapeutics for hyperthyroidism-induced osteoporosis are still lacking. As a noninvasive treatment, electromagnetic fields (EMF) have been proven to be effective for treating osteoporosis in non-hyperthyroidism conditions. We herein systematically evaluated the reduced effects of EMF on osteoporosis in a hyperthyroidism rat model. With the use of Helmholtz coils and an EMF stimulator, 15 Hz/1 mT EMF was generated. Forty-eight 5-month-old male Sprague-Dawley rats were randomly divided into four different groups: control, levothyroxine treated (L-T4), EMF exposure + levothyroxine (EMF + L-T4), and EMF exposure without levothyroxine administration (EMF). All rats were treated with L-T4 (100 mg/day) except those in control and EMF groups. After 12 weeks, the results obtained from bone mineral density analyses and bone mechanical measurements showed significant differences between L-T4 and EMF + L-T4 groups. Micro CT and bone histomorphometric analyses indicated that trabecular bone mass and architecture in distal femur and proximal tibia were augmented and restored partially in EMF + L-T4 group. In addition, bone thyroid hormone receptors (THR) expression of hyperthyroidism rats was attenuated in EMF + L-T4 group, compared to control group, which was not observed in L-T4 group. According to these results, we concluded that 15 Hz/1 mT EMF significantly inhibited bone loss and micro architecture deterioration in hyperthyroidism rats, which might occur due to reduced THR expression caused by EMF exposure. Bioelectromagnetics. 38:137-150, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  17. Thyroid status influence on adiponectin, acylation stimulating protein (ASP and complement C3 in hyperthyroid and hypothyroid subjects

    Directory of Open Access Journals (Sweden)

    Zhang Jianhua

    2006-02-01

    Full Text Available Abstract Background Thyroid abnormalities (hyperthyroid and hypothyroid are accompanied by changes in intermediary metabolism including alterations in body weight, insulin resistance and lipid profile. The aims of this study were to examine plasma ASP, its precursor C3 and adiponectin in hyperthyroid and hypothyroid subjects as compared to controls. Methods A total of 99 subjects were recruited from endocrinology/out-patient clinics: 46 hyperthyroid subjects, 23 hypothyroid subjects and 30 control subjects. Subjects were evaluated for FT4, FT3, TSH, glucose, insulin, complete lipid profile and the adipokines: adiponectin, acylation stimulating protein (ASP and complement C3. Results Hyperthyroidism was associated with a 95% increase in adiponectin (p = 0.0002, a 47% decrease in C3 (p Conclusion These changes suggest that thyroid disease may be accompanied by changes in adipokines, which may contribute to the phenotype expressed.

  18. The influence of position deviation on RAIU and,the corresponding therapeutic dose calculations in patients with Graves hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    李从心

    2013-01-01

    Objective To evaluate the influence of inappropriate position deviation on radioactive iodine uptake(RAIU),effective half-life(Teff)and the corresponding dose variances in patients suffering from Graves hyperthyroidism.Methods RAIU was examined in 20 patients with

  19. Quality-of-Life Impairments Persist Six Months After Treatment of Graves' Hyperthyroidism and Toxic Nodular Goiter

    DEFF Research Database (Denmark)

    Cramon, Per; Winther, Kristian Hillert; Watt, Torquil

    2016-01-01

    PRO scales in toxic nodular goiter (Anxiety, Overall HRQoL). However, significant disease-specific and generic HRQoL deficits persisted on multiple domains across both patient groups. Conclusions: Graves' hyperthyroidism and toxic nodular goiter cause severe disease-specific and generic HRQoL impairments......Background: The treatment of hyperthyroidism is aimed at improving health-related quality of life (HRQoL) and reducing morbidity and mortality. However, few studies have used validated questionnaires to assess HRQoL prospectively in such patients. The purpose of this study was to assess the impact...... of hyperthyroidism and its treatment on HRQoL using validated disease-specific and generic questionnaires. Methods: This prospective cohort study enrolled 88 patients with Graves' hyperthyroidism and 68 with toxic nodular goiter from endocrine outpatient clinics at two Danish university hospitals. The patients were...

  20. Effects of hyperthyroidism on expression of vascular endothelial growth factor (VEGF and apoptosis in fetal adrenal glands

    Directory of Open Access Journals (Sweden)

    T. Karaca

    2015-11-01

    Full Text Available This study investigated the expression of vascular endothelial growth factor (VEGF, vascular density, and apoptosis in fetal rat adrenal glands with hyperthyroidism in late gestation. Twelve mature female Wistar albino rats with the same biological and physiological features were used for this study. Rats were divided into two groups: control and hyperthyroidism. Hyperthyroidism was induced by daily subcutaneous injections of L-thyroxine (250 μg/kg before pregnancy for 21 days and during pregnancy. Rats in the control and hyperthyroidism groups were caged according to the number of male rats. Zero day of pregnancy (Day 0 was indicated when the animals were observed to have microscopic sperm in vaginal smears. Pregnant rats were sacrificed on the 20th day of pregnancy; blood from each animal was collected to determine the concentrations of maternal adrenocorticotropic hormone and thyroxine. Rat fetuses were then quickly removed from the uterus, and the adrenal glands of the fetuses were dissected. VEGF expression, vascular density, and apoptosis were analyzed in fetal rat adrenal glands. Maternal serum levels of the adrenocorticotropic hormone and free thyroxine were significantly higher in the hyperthyroidism group than in the control group. Immunohistochemistry revealed that the number of VEGF positive cells and vessel density significantly increased in the hyperthyroidism rat fetal adrenal group compared with the control group. Hyperthyroidism did not change the fetal and placental weights and the number of fetuses. This study demonstrates that hyperthyroidism may have an effect on the development of rat adrenal glands mediated by VEGF expression, angiogenesis, and apoptosis. 

  1. Leptin and ghrelin concentration in hyperthyroid cats before and after radioactive iodine therapy compared to euthyroid control cats.

    Science.gov (United States)

    Marsilio, Sina; Glanemann, Barbara; Martin, Lucile; Szladovits, Balazs; Neiger, Reto

    2017-04-19

    Leptin and ghrelin, two peptide hormones with antagonistic effects on satiety and energy balance, could be involved in the pathogenesis of weight loss and polyphagia in cats with hyperthyroidism. Leptin generally decreases appetite and increases energy expenditure, while ghrelin exerts the opposite effects. Leptin and ghrelin were measured in 42 client owned hyperthyroid cats with a body condition score (BCS) ≤ 5/9 before (T0) and 4 weeks after radioactive iodine treatment (RAIT) (T1). Dependent on the serum total thyroxine concentration concentration at T1, cats were sub-classified as still hyperthyroid (ht-ht) (n = 4), euthyroid (ht-eu) (n = 10) or hypothyroid (ht-hypo) (n = 28). Results were compared to those of 22 healthy, euthyroid control cats with a comparable BCS (≤ 5/9) and age (≥ 8 years) to hyperthyroid cats. At T0, there were no significant differences between hyperthyroid and control cats for leptin (p = 0.06) or ghrelin concentrations (p = 0.27). At T1, leptin significantly decreased in ht-hypo cats compared to T0 (p = 0.0008) despite a significantly increased body weight in this group (p = 0.0001). Serum ghrelin concentrations did not differ between hyperthyroid cats with a history of polyphagia compared to non-polyphagic cats (p = 0.42). After RAIT, ghrelin concentration significantly increased in all hyperthyroid cats (p cats with thyroid dysfunction. Leptin fluctuations occurred independently of body weight in different states of thyroid dysfunction; increasing ghrelin concentrations after RAIT suggest a ghrelin-independent mechanism for polyphagia in hyperthyroid cats.

  2. COMPUTED TOMOGRAPHIC CHARACTERISTICS OF THE THYROID GLANDS IN EIGHT HYPERTHYROID CATS PRE- AND POSTMETHIMAZOLE TREATMENT COMPARED WITH SEVEN EUTHYROID CATS.

    Science.gov (United States)

    Bush, Jennifer L; Nemanic, Sarah; Gordon, Jana; Bobe, Gerd

    2017-03-01

    Hyperthyroidism is the most common feline endocrinopathy; thyroid computed tomography (CT) may improve disease detection and methimazole dose selection. Objectives of this experimental pre-post with historical case-control study were to perform thyroid CT imaging in awake or mildly sedated hyperthyroid cats, compare thyroid gland CT appearance in euthyroid and hyperthyroid cats pre- and postmethimazole treatment, and determine whether thyroid size or attenuation correlate with methimazole dose needed for euthyroidism. Premethimazole treatment, eight hyperthyroid cats received CT scans from the head to heart, which were compared to CT of seven euthyroid cats. Total thyroxine levels were monitored every 3-4 weeks. Postmethimazole CT was performed 30 days after achieving euthyroid status. Computed tomography parameters recorded included thyroid length, width, height, attenuation, and heterogeneity. Median time between CT was 70 days (53-213 days). Mild sedation was needed in five hyperthyroid cats premethimazole, and none postmethimazole. Thyroid volume was significantly larger in hyperthyroid cats compared to euthyroid cats (785.0 mm(3) vs. 154.9 mm(3) ; P = 0.002) and remained unchanged by methimazole treatment (-4.5 mm3; P = 0.50). Thyroid attenuation and heterogeneity decreased with methimazole treatment (96.1 HU vs. 85.9 HU; P = 0.02. 12.4 HU vs. 8.1 HU; P = 0.009). Methimazole dose ranged from 2.5 to 10 mg daily with a positive correlation between pretreatment thyroid gland volume and dose needed to achieve euthyroidism (P = 0.03). Euthyroid and hyperthyroid cats are easily imaged awake or mildly sedated with CT. Methimazole in hyperthyroid cats significantly lowers thyroid attenuation and heterogeneity, but not size. © 2016 American College of Veterinary Radiology.

  3. A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism

    OpenAIRE

    Somdul Khoohaphatthanakul; Apiradee Sriwijitkamol

    2016-01-01

    Graves’ hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; ...

  4. Beneficial Effects of Lithium and Radioiodine Therapy in the Treatment of Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Wojciech Barud

    2014-09-01

    Full Text Available Intravenous contrast media used for coronary angiography are iodine-based and could induce thyroid gland dysfunction. We present the case of a 58-year-old woman with coronary artery disease who developed hyperthyroidism after percutaneus coronary intervention. Treatment with thiamazole induced agranulocytosis, complicated with severe tonsillitis. During recurrence of hyperthyroidism, after careful assessment of available methods of treatment, she was recommended to undergo radioiodine therapy (131I. The patient received lithium carbonate as pre-treatment. After 13 days of pre-treatment, patient received the therapeutic dose of 131I. Neither thyrotoxicosis progression nor acute coronary syndrome occurred. After 3 weeks, her thyroid hormones were found to be within normal ranges. Lithium therapy could be used as an effective treatment in patients who developed serious side-effects due to previous treatment with thionamides. Turk Jem 2014; 18: 92-94

  5. Multifocal oral melanoacanthoma associated with Addison's disease and hyperthyroidism: a case report.

    Science.gov (United States)

    Dantas, Thinali Sousa; Nascimento, Isabelly Vidal do; Verde, Maria Elisa Quezado Lima; Alves, Ana Paula Negreiros Nunes; Sousa, Fabrício Bitu; Mota, Mário Rogério Lima

    2017-01-01

    Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.

  6. Down syndrome, insulin-dependent diabetes mellitus and hyperthyroidism: a rare association.

    Science.gov (United States)

    Marques, Inês; Silva, Ana; Castro, Sofia; Lopes, Lurdes

    2015-06-29

    The association between Down syndrome (DS) and autoimmune endocrinopathies is well established. These disorders become increasingly frequent as children grow older and the onset of one often predisposes to the development of others. However, there are few cases in the literature reporting the simultaneous onset of type 1 diabetes mellitus and hyperthyroidism in children with DS. We describe a case of an 8-year-old girl with DS who presented at the emergency department with hyperglycaemia and ketosis as a primary manifestation of type 1 diabetes mellitus. During the initial investigation, hyperthyroidism was detected, with thyroid-stimulating hormone<0.01 µUI/mL, positive antithyroid antibodies and an increase in thyroid gland on ultrasound. The authors present this case to underline the usefulness of monitoring thyroid function at the diagnosis of diabetes, even without apparent clinical manifestations, and to alert for the possibility of autoimmune endocrine dysfunction in children with DS.

  7. Immunogenic and non-immunogenic hyperthyroidism - a comparison. Immunogene und nichtimmunogene Hyperthyreose - ein Vergleich

    Energy Technology Data Exchange (ETDEWEB)

    Pohl, M. (Abt. Nuklearmedizin in Zentrum Radiologie, Georg-August-Univ., Goettingen (Germany)); Emrich, D. (Abt. Nuklearmedizin in Zentrum Radiologie, Georg-August-Univ., Goettingen (Germany))

    1993-08-01

    In a retrospective study 161 hyperthyroid patients without treatment were divided into 74 with immunogenic hyperthyroidism (IMH) and 87 with non-immunogenic hypethyroidism (NIMH). The frequency of complaints and the mean hormone concentrations were significantly higher in IMH and the median thyroid volume was significantly smaller. Diffusely reduced sonographic echos were observed in only 50% of patients with IMH compared to 5% of those with NIMH. Homogenous distribution of [sup 99m]Tc in the thyroid was observed scintigraphically in 95% of patients with IMH and in only 3% of those with NIMH. Although the median of global thyroid uptake of [sup 99m]Tc was significantly higher in IMH there was a broad overlap between the two groups. The mean hormone production is higher in IMH than in NIMH. In order to separate IMH and NIMH, several criteria have to be employed which differ concerning their diagnostic significance. (orig.)

  8. EFFECT OF METHANOLIC EXTRACT OF SWEET CORN SILK ON EXPERIMENTALLY INDUCED HYPERTHYROIDISM IN SWISS ALBINO RATS

    Directory of Open Access Journals (Sweden)

    Thoudam Bhaigyabati

    2012-03-01

    Full Text Available Plant materials have been used as medicine for a wide variety of human ailments due to increase in cost of treatment, side effects of several allopathic drugs and development of resistance to currently used drugs for infectious diseases. In the present study, hyperthyroidism was induced to male Swiss albino rats orally using thyroxine for 14 days. The impact of methanolic extract of sweet corn silk in different concentrations (200, 300 & 400mg/kg for 21 days was assessed in these animals. The serum was analyzed for thyroid hormone level and lipid profile before and during the experiment. Results showed that 400mg/kg concentration of methanolic extract has the highest effectiveness which is equal to that of standard drug to revert the hyperthyroid condition in Swiss albino rats and were confirmed with the histopathological study of the thyroid gland.

  9. Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Chronic Alcoholism: A Case Report.

    Science.gov (United States)

    Tsai, Ming-Hsien; Lin, Shih-Hua; Leu, Jyh-Gang; Fang, Yu-Wei

    2015-09-01

    Thyrotoxic periodic paralysis (TPP) is characterized by the presence of muscle paralysis, hypokalemia, and hyperthyroidism. We report the case of a young man with paralysis of the lower extremities, severe hypokalemia, and concurrent hyperthyroidism. TPP was suspected; therefore, treatment consisting of judicious potassium (K+) repletion and β-blocker administration was initiated. However, urinary K+ excretion rate, as well as refractoriness to treatment, was inconsistent with TPP. Chronic alcoholism was considered as an alternative cause of hypokalemia, and serum K+ was restored through vigorous K repletion and the addition of K+ -sparing diuretics. The presence of thyrotoxicosis and hypokalemia does not always indicate a diagnosis of TPP. Exclusion of TPP can be accomplished by immediate evaluation of urinary K+ excretion, acid-base status, and the amount of potassium chloride required to correct hypokalemia at presentation.

  10. Biological half-time of tritiated water: comparison of hyperthyroid and hypothyroid patients

    Energy Technology Data Exchange (ETDEWEB)

    Eberstadt, P.; Fernandez, M.V.G.; Gonzalez, O.

    1986-01-01

    The half-time values of tritiated water were explored in eleven hyperthyroid patients and in two hypothyroid ones. For reasons of comparability the numbers are expressed in days per square meter (d/m/sup 2/) of body surface. Against the estimated 5.4d/m/sup 2/ in normal subjects, the hyperthyroids reflected 3.9+-0.66 and the two determinations of hypothyroids were 6.42 and 7.13, respectively. During the study neither diagnostic nor therapeutic procedures were ever postponed. The half-time values are not representative of extreme conditions in hyper- or hypothyroids, but are sufficiently clear to indicate well-defined differences from normal people. The total exposure to radiation for the exploratory procedure was minimal, estimated at less than 12 mrem for the normal standard man.

  11. The use of konjac glucomannan to lower serum thyroid hormones in hyperthyroidism.

    Science.gov (United States)

    Azezli, Adil Dogan; Bayraktaroglu, Taner; Orhan, Yusuf

    2007-12-01

    Patients with hyperthyroidism occasionally need rapid restoration to the euthyroid state. In view of the increased enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) in thyrotoxicosis, and metabolic effects of konjac glucomannan in gastrointestinal system, we aimed to determine the activity of glucomannan in treatment of hyperthyroidism. A prospective, randomized, placebo-controlled, one-blind study design was used with newly diagnosed 48 hyperthyroid patients (30 patients with Graves' disease and 12 with multinodulary goitre). They were assigned to one of the following treatment groups: I) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and glucomannan (Propol) 2 x 1.3 gr daily for two months; II) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and placebo powder daily for two months. No differences were detected from the point of view of the baseline thyroid hormone levels between groups (p > 0.05). Further analyses revealed that the patients receiving glucomannan at the end of the second, fourth and sixth weeks of the study had significantly lower serum T3, T4, FT3 and FT4 levels than the patients who received placebo (p 0.05). At week 8, thyroid hormone levels were not shown any differences. The glucomannan-treated group had a more rapid decline in all four serum thyroid hormone levels than the placebo-treated group. We believe our preliminary results indicate that glucomannan may be a safe and easily tolerated adjunctive therapeutic agent in the treatment of thyrotoxicosis. This combination therapy seems most effect during first weeks of treatment of a hyperthyroid patient.

  12. Acute Pancreatitis Induced by Methimazole in a Patient With Subclinical Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Katrina Agito MD

    2015-06-01

    Full Text Available We report here a unique case of methimazole (MMI-induced pancreatitis. To our knowledge, this is the sixth case reported in the literature and the first diagnosed in a patient with toxic multinodular goiter. A 51-year-old Caucasian female with a history of benign multinodular goiter and subclinical hyperthyroidism was started on MMI 10 mg orally daily. Three weeks later, she developed sharp epigastric pain, diarrhea, lack of appetite, and fever. Her lipase was elevated 5 times the upper limit of normal, consistent with acute pancreatitis. There was no history of hypertriglyceridemia, or alcohol abuse. Abdominal computed tomography was consistent with acute uncomplicated pancreatitis, without evidence of gallstones or tumors. MMI was discontinued, and her hyperthyroid symptoms were managed with propranolol. Her acute episode of pancreatitis quickly resolved clinically and biochemically. One year later, she redeveloped mild clinical symptoms of hyperthyroidism with biochemical evidence of subclinical hyperthyroidism. MMI 10 mg orally daily was restarted. Five days later, she experienced progressive abdominal discomfort. Her lipase was elevated 12 times the upper limit of normal, and the abdominal computed tomography was again compatible with acute uncomplicated pancreatitis. MMI was again discontinued, which was followed by rapid resolution of her pancreatitis. The patient is currently considering undergoing definitive therapy with radioactive iodine ablation. Our case as well as previous case reports in the literature should raise awareness about the possibility of pancreatitis in subjects treated with MMI in the presence of suggestive symptoms. If the diagnosis is confirmed by elevated pancreatic enzymes, the drug should be discontinued.

  13. Comparison of Linear and Non-linear Regression Analysis to Determine Pulmonary Pressure in Hyperthyroidism.

    Science.gov (United States)

    Scarneciu, Camelia C; Sangeorzan, Livia; Rus, Horatiu; Scarneciu, Vlad D; Varciu, Mihai S; Andreescu, Oana; Scarneciu, Ioan

    2017-01-01

    This study aimed at assessing the incidence of pulmonary hypertension (PH) at newly diagnosed hyperthyroid patients and at finding a simple model showing the complex functional relation between pulmonary hypertension in hyperthyroidism and the factors causing it. The 53 hyperthyroid patients (H-group) were evaluated mainly by using an echocardiographical method and compared with 35 euthyroid (E-group) and 25 healthy people (C-group). In order to identify the factors causing pulmonary hypertension the statistical method of comparing the values of arithmetical means is used. The functional relation between the two random variables (PAPs and each of the factors determining it within our research study) can be expressed by linear or non-linear function. By applying the linear regression method described by a first-degree equation the line of regression (linear model) has been determined; by applying the non-linear regression method described by a second degree equation, a parabola-type curve of regression (non-linear or polynomial model) has been determined. We made the comparison and the validation of these two models by calculating the determination coefficient (criterion 1), the comparison of residuals (criterion 2), application of AIC criterion (criterion 3) and use of F-test (criterion 4). From the H-group, 47% have pulmonary hypertension completely reversible when obtaining euthyroidism. The factors causing pulmonary hypertension were identified: previously known- level of free thyroxin, pulmonary vascular resistance, cardiac output; new factors identified in this study- pretreatment period, age, systolic blood pressure. According to the four criteria and to the clinical judgment, we consider that the polynomial model (graphically parabola- type) is better than the linear one. The better model showing the functional relation between the pulmonary hypertension in hyperthyroidism and the factors identified in this study is given by a polynomial equation of second

  14. Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Jeong, Hwan Jeong; Kim, Dong Wook; Lim, Seok Tae [Chonbuk National University Medical School, Jeonju (Korea, Republic of)

    2009-04-15

    A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism

  15. Therapeutic Effects of Blue Honeysuckle on Lesions of Hyperthyroidism in Rats.

    Science.gov (United States)

    Park, Sang-In; Lee, Young Joon; Choi, Seong Hun; Park, Soo Jin; Song, Chang-Hyun; Ku, Sae-Kwang

    2016-01-01

    Hyperthyroidism is a hypermetabolic syndrome characterized by an overproduction of thyroid hormones, which enhances the hormone-induced oxidative stress responsible for some complications in the liver, heart and muscle. Blue honeysuckle (BH) is an edible berry, rich in polyphenols, especially flavonoids or anthocyanins, known as strong antioxidants. The chemo-protective activities of the berry have been connected to the improvement of symptoms in cancer, diabetes mellitus, tumor or cardiovascular diseases. Therefore, the therapeutic effects of BH were examined in hyperthyroidism rat model. The hyperthyroidism was induced by injection with levothyroxine (LT4), and the model was treated with distilled water (LT4 control), propylthiouracil (PTU) or BH at 3 dosages of 500, 250 and 125[Formula: see text]mg/kg. The treatment was performed once a day for 15 days. Compared to LT4 control, the oral administration of BH dose-dependently ameliorated the hyperthyroidism, reducing thyroid hormones and increasing thyroid stimulating hormones. These effects were accompanied by improvement of body weight loss and atrophy in the thyroid gland, liver and epididymal fat pads. BH treatments also reduced the levels of hepatic enzymes (AST and ALT), which suggests BH exerts protective effects on hepatocytes. BH might also be involved in the augmentation of the anti-oxidant activities, supported by increased endogenous antioxidant (glutathione). In addition, the histopathological analyses revealed the beneficial effects of BH on the atrophic changes and cellular injuries in the thyroid gland, liver and epididymal fat pads. The therapeutic potentials of BH were either similar or more effective than PTU. These results provide valuable information that will guide more detailed studies to use the BH as a complementary and alternative medicine.

  16. Acute Pancreatitis Induced by Methimazole in a Patient With Subclinical Hyperthyroidism.

    Science.gov (United States)

    Agito, Katrina; Manni, Andrea

    2015-01-01

    We report here a unique case of methimazole (MMI)-induced pancreatitis. To our knowledge, this is the sixth case reported in the literature and the first diagnosed in a patient with toxic multinodular goiter. A 51-year-old Caucasian female with a history of benign multinodular goiter and subclinical hyperthyroidism was started on MMI 10 mg orally daily. Three weeks later, she developed sharp epigastric pain, diarrhea, lack of appetite, and fever. Her lipase was elevated 5 times the upper limit of normal, consistent with acute pancreatitis. There was no history of hypertriglyceridemia, or alcohol abuse. Abdominal computed tomography was consistent with acute uncomplicated pancreatitis, without evidence of gallstones or tumors. MMI was discontinued, and her hyperthyroid symptoms were managed with propranolol. Her acute episode of pancreatitis quickly resolved clinically and biochemically. One year later, she redeveloped mild clinical symptoms of hyperthyroidism with biochemical evidence of subclinical hyperthyroidism. MMI 10 mg orally daily was restarted. Five days later, she experienced progressive abdominal discomfort. Her lipase was elevated 12 times the upper limit of normal, and the abdominal computed tomography was again compatible with acute uncomplicated pancreatitis. MMI was again discontinued, which was followed by rapid resolution of her pancreatitis. The patient is currently considering undergoing definitive therapy with radioactive iodine ablation. Our case as well as previous case reports in the literature should raise awareness about the possibility of pancreatitis in subjects treated with MMI in the presence of suggestive symptoms. If the diagnosis is confirmed by elevated pancreatic enzymes, the drug should be discontinued.

  17. Neurofibromatosis type 1 and autoimmune hyperthyroidism in a 10,5 years-old girl

    Directory of Open Access Journals (Sweden)

    Huseyin Demirbilek

    2013-08-01

    Full Text Available Neurofibromatosis type 1 (NF1 is an autosomal dominant inherited multisystem disease associated with several endocrine disorders. Association of NF1 and hyperthyroidism is extremely rare. All previously reported cases were in adult age group. Herein, we present autoimmune thyrotoxicosis associated to NF1 in a pediatric patient presenting with goiter and symptoms of thyrotoxicosis. [Cukurova Med J 2013; 38(4.000: 805-808

  18. Mediastinal neoplasms in patients with Graves disease: a possible link between sustained hyperthyroidism and thymic neoplasia?

    Directory of Open Access Journals (Sweden)

    Boyd Jonathan D

    2012-07-01

    Full Text Available Abstract Background Anterior mediastinal masses are a rare but well documented finding in Graves disease. The vast majority of these lesions represents benign thymic hypertrophy and regress after treatment of the hyperthyroidism. A small percentage of these cases however represent neoplastic/malignant diseases which require further treatment. Cases 12 year old boy with one year history of refractory Graves disease was found to have an anterior mediastinal mass and underwent curative thyroidectomy for sustained hyperthyroidism. Cervical lymphadenopathy was detected during the procedure and biopsy was obtained. A 23 year old woman who presented with a one month history of hyperthyroid symptoms, was diagnosed with Graves disease and also was found to have an anterior mediastinal mass on imaging. Biopsy of the anterior mediastinal mass was obtained and subsequently the patient underwent robotic thymectomy. Histologic examination and immunophenotyping of the cervical lymph node in a 12 year old boy revealed neoplastic proliferation of T lymphoblasts diagnostic of T lymphoblastic leukemia/lymphoma. Examination of the anterior mediastinal mass biopsy in the 23 year old woman revealed type B1 thymoma which was confirmed after examination of the subsequent robotic thymectomy specimen. Conclusion This is the first reported case of T cell lymphoblastic lymphoma and the third reported case of thymoma associated with sustained hyperthyroidism due to Graves disease. These cases indicate that an anterior mediastinal mass in a patient with active Graves disease may be due to a neoplastic cause, which may require definitive treatment. Caution should be exercised when dismissing a mediastinal mass as benign thymic hyperplasia in patients with active Graves disease.

  19. An FSH and TSH pituitary adenoma, presenting with precocious puberty and central hyperthyroidism

    OpenAIRE

    Guadalupe Vargas; Lourdes-Josefina Balcazar-Hernandez; Virgilio Melgar; Roser-Montserrat Magriña-Mercado; Baldomero Gonzalez; Javier Baquera; Moisés Mercado

    2017-01-01

    A 19-year-old woman with a history of isosexual precocious puberty and bilateral oophorectomy at age 10 years because of giant ovarian cysts, presents with headaches and mild symptoms and signs of hyperthyroidism. Hormonal evaluation revealed elevated FSH and LH levels in the postmenopausal range and free hyperthyroxinemia with an inappropriately normal TSH. Pituitary MRI showed a 2-cm macroadenoma with suprasellar extension. She underwent successful surgical resection of the pituitary tumor,...

  20. Etiology of Overt or Subclinical Hyperthyroidism and Iodine Status in Older Than Sixty Years

    Directory of Open Access Journals (Sweden)

    Oguzhan Aksu

    2016-04-01

    Full Text Available Aim: Thyroid dysfunction is common among older people associated with morbidity and mortality. Overall, the most common cause of hyperthyroidism is Grave%u2019s Disease (GD. In the older population however, Toxic Multinodular Goitre (TMG is more common. Iodine is an essential molecule for thyroid hormone synthesis. This may be due to the presence of autonomic areas with a higher sensitivity to iodine in the thyroid gland. The aim of this study was to detect the etiology of hyperthyroidism among cases older than 60 years.Material and Method: The study included 100 patients %u226560 years or older with hyperthyroidism. Demographic and clinical features of the patients were recorded. All patients were tested for anti-thyroid autoantibodies and underwent thyroid ultrasonographic (USG and scintigraphic examination. Iodine exposure was detected in 24-hour urine specimens. Results: Eighty-one patients (81% had overt and the remaining 19 (19% had subclinical hyperthyroidism and the mean age was 70.48 ± 6.16 (range 60-88. Thirteen patients had recent exposure to iodine and 11 had Jod Basedow Phenomenon (JBP. The most common disease was TMNG (29.2% and 8 patients had no definitive diagnosis; they were designated nondiagnostic (ND. Discussion: This is the first study that investigates the causes of thyrotoxicosis amoung older people in our country. The results indicated that TMNG was the most common cause. JBP cases had a history of exposure to iodine. For this reason, radiocontrast use in older people should be carefully evaluated with this respect.

  1. Intracranial Hypertension in a Patient with a Chiari Malformation Accompanied by Hyperthyroidism.

    Science.gov (United States)

    Pang, Chang Hwan; Lee, Soo Eon; Kim, Chi Heon; Chung, Chun Kee

    2015-09-01

    The Chiari malformation is an infrequently detected congenital anomaly characterized by the downward displacement of the cerebellum with a tonsillar herniation below the foramen magnum that may be accompanied by either syringomyelia or hydrocephalus. Surgery, such as foramen magnum decompression, is indicated for a symptomatic Chiari malformation, although an incidental lesion may be followed-up without further treatment. Infrequently, increased intracranial pressure emerges due to hyperthyroidism. A nineteen-year-old girl visited our outpatient clinic presented with a headache, nausea and vomiting. A brain and spinal magnetic resonance image study (MRI) indicated that the patient had a Chiari I malformation without syringomyelia or hydrocephalus. An enlarged thyroid gland was detected on a physical examination, and serum markers indicated Graves' disease. The patient started anti-hyperthyroid medical treatment. Subsequently, the headache disappeared after the medical treatment of hyperthyroidism without surgical intervention for the Chiari malformation. A symptomatic Chiari malformation is indicated for surgery, but a surgeon should investigate other potential causes of the symptoms of the Chiari malformation to avoid unnecessary surgery.

  2. Insulin action in hyperthyroidism: a focus on muscle and adipose tissue.

    Science.gov (United States)

    Mitrou, Panayota; Raptis, Sotirios A; Dimitriadis, George

    2010-10-01

    Hyperthyroidism leads to an enhanced demand for glucose, which is primarily provided by increased rates of hepatic glucose production due to increased gluconeogenesis (in the fasting state) and increased Cori cycle activity (in the late postprandial and fasting state). Adipose tissue lipolysis is increased in the fasting state, resulting in increased production of glycerol and nonesterified fatty acids. Under these conditions, increased glycerol generated by lipolysis and increased amino acids generated by proteolysis are used as substrates for gluconeogenesis. Increased nonesterified fatty acid levels are necessary to stimulate gluconeogenesis and provide substrate for oxidation in other tissues (such as muscle). In the postprandial period, insulin-stimulated glucose uptake by the skeletal muscle has been found to be normal or increased, mainly due to increased blood flow. Under hyperthyroid conditions, insulin-stimulated rates of glycogen synthesis in skeletal muscle are decreased, whereas there is a preferential increase in the rates of lactate formation vs. glucose oxidation leading to increased Cori cycle activity. In hyperthyroidism, the Cori cycle could be considered as a large substrate cycle; by maintaining a high flux through it, a dynamic buffer of glucose and lactate is provided, which can be used by other tissues as required. Moreover, lipolysis is rapidly suppressed to normal after the meal to facilitate the disposal of glucose by the insulin-resistant muscle. This ensures the preferential use of glucose when available and helps to preserve fat stores.

  3. Oxidized LDL Is Strictly Limited to Hyperthyroidism Irrespective of Fat Feeding in Female Sprague Dawley Rats

    Directory of Open Access Journals (Sweden)

    Sieglinde Zelzer

    2015-05-01

    Full Text Available Metabolic dysfunctions might play a crucial role in the pathophysiology of thyroid dysfunctions. This study aimed to investigate the impact of a controlled diet (normal versus high fat feeding on hypothyroid and hyperthyroid Sprague Dawley rats. Female Sprague Dawley rats (n = 66 were grouped into normal diet (n = 30 and high-fat diet (n = 36 groups and subdivided into controls, hypothyroid and hyperthyroid groups, induced through propylthiouracil or triiodothyronine (T3 treatment, respectively. After 12 weeks of treatment metabolic parameters, such as oxidized LDL (oxLDL, malondialdehyde (MDA, 4-hydroxynonenal (HNE, the lipid profile, body weight and food intake parameters were analyzed. Successfully induced thyroid dysfunctions were shown by T3 levels, both under normal and high fat diet. Thyroid dysfunctions were accompanied by changes in calorie intake and body weight as well as in the lipid profile. In detail, hypothyroid rats showed significantly decreased oxLDL levels, whereas hyperthyroid rats showed significantly increased oxLDL levels. These effects were seen under high fat diet and were less pronounced with normal feeding. Taken together, we showed for the first time in female SD rats that only hyper-, but not hypothyroidism, is associated with high atherogenic oxidized LDL irrespective of normal or high-fat diet in Sprague Dawley rats.

  4. Hypokalemic Paralysis Complicated by Concurrent Hyperthyroidism and Hyperaldosternoism: A Case Report

    Science.gov (United States)

    Hsiao, Yu-Hsin; Fang, Yu-Wei; Leu, Jyh-Gang; Tsai, Ming-Hsien

    2017-01-01

    Patient: Female, 38 Final Diagnosis: Primary hyperaldosteronism Symptoms: Paralysis Medication: — Clinical Procedure: — Specialty: Nephrology Objective: Challenging differential diagnosis Background: Thyrotoxic periodic paralysis (TPP) is commonly observed in patients with acute paralysis and hyperthyroidism. However, there is a possibility of secondary causes of hypokalemia in such a setting. Case Report: Herein, we present the case of a 38-year-old woman with untreated hypertension and hyperthyroidism. She presented with muscle weakness, nausea, vomiting, and diarrhea since one week. The initial diagnosis was TPP. However, biochemistry tests showed hypokalemia with metabolic alkalosis and renal potassium wasting. Moreover, a suppressed plasma renin level and a high plasma aldosterone level were noted, which was suggestive of primary aldosteronism. Abdominal computed tomography confirmed this diagnosis. Conclusions: Therefore, it is imperative to consider other causes of hypokalemia (apart from TPP) in a patient with hyper-thyroidism but with renal potassium wasting and metabolic alkalosis. This can help avoid delay in diagnosis of the underlying disease. PMID:28050008

  5. Pyrroloquinoline quinone ameliorates l-thyroxine-induced hyperthyroidism and associated problems in rats.

    Science.gov (United States)

    Kumar, Narendra; Kar, Anand; Panda, Sunanda

    2014-08-01

    Pyrroloquinoline quinone (PQQ) is believed to be a strong antioxidant. In this study, we have evaluated its hitherto unknown role in l-thyroxin (L-T4 )-induced hyperthyroidism considering laboratory rat as a model. Alterations in the serum concentration of thyroxin (T4 ) and triiodothyronine (T3 ); lipid peroxidation (LPO) of liver, kidney, heart, muscles and brain; in the endogenous antioxidants such as superoxide dismutase, catalase and glutathione and in serum total cholesterol, high-density lipoprotien, triglycerides, serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT) and urea were evaluated. Administration of l-T4 (500-µg kg(-1) body weight) enhanced not only the serum T3 and T4 levels but also the tissue LPO, serum SGOT, SGPT and urea with a parallel decrease in the levels of antioxidants and serum lipids. However, on simultaneous administration of PQQ (5 mg kg(-1) for 6 days), all these adverse effects were ameliorated, indicating the potential of PQQ in the amelioration of hyperthyroidism and associated problems. Possibly, the curative effects were mediated through inhibition of oxidative stress. We suggest that PQQ may be considered for therapeutic use for hyperthyroidism after dose standardization.

  6. Systemic lupus erythematosus and renal tubular acidosis associated with hyperthyroidism. Case Report.

    Science.gov (United States)

    Deng, Datong; Sun, Li; Xia, Tongjia; Xu, Min; Wang, Youmin; Zhang, Qiu

    2016-07-01

    A case of a 42-year-old female with hyperthyroidism was subsequently diagnosed to have systemic lupus erythematosus with distal RTA. The clinical examination on admission showed swelling of the knee joints and the urinalysis showed pH 6.5, pro 3+. Her blood routine results were as follows: white blood cells 1.85×109/L, platelets 100×109/L, erythrocyte 3.06×1012/L. The serum potassium was 3.11 mmol/L, 24 hour urinary electrolyte: K 68.87 mmol/24 H, antinuclear antibodies (ANA) 1:1 000, speckled pattern. The anti-double stranded DNA antibody (anti-dsDNA), anti SS-A(52) antibody and anti SS-A(60) antibody were positive. The light microscopy and immunofluorescence showed diffuse proliferative lupus nephritis. These data were compatible with the diagnosis of systemic lupus erythematosus. The diagnosis of hyperthyroidism and distal RTA is clear. This report showed that other autoimmune disease in the diagnosis of hyperthyroidism should not be ignored.

  7. Efficacy of iopanoic acid for treatment of spontaneous hyperthyroidism in cats.

    Science.gov (United States)

    Gallagher, Alexander E; Panciera, David L

    2011-06-01

    Iopanoic acid is an iodine containing oral cholecystographic agent that has been used to treat hyperthyroidism in humans and has recently been evaluated in an experimental model of feline hyperthyroidism. The aim of this study was to evaluate the efficacy of iopanoic acid in cats with spontaneous hyperthyroidism. Eleven cats were included in the study. Eight were treated initially with 50mg orally q 12h and three were treated with 100mg orally q 12h. Prior to treatment (baseline) and at 2, 4, and 12 weeks of treatment, owner questionnaires, physical exams, complete blood count, biochemistry analyses, and T(3) and T(4) concentrations were evaluated. The mean serum T(3) concentration decreased with treatment at all time periods compared to baseline. Mean T(4) concentrations were increased at weeks 4 and 12 compared to baseline. Five cats had a partial response during the initial 4 weeks of therapy, but the effects were transient and no significant improvements in clinical signs or physical exam findings were noted at any time period. Results suggest that iopanoic acid may be beneficial for acute management of thyrotoxicosis in some cats, but is not suitable for long-term management.

  8. Primary hyperthyroidism--diagnosis and treatment. Indications and contraindications for radioiodine therapy.

    Science.gov (United States)

    Gurgul, Edyta; Sowinski, Jerzy

    2011-01-01

    Isotope therapy is one of the methods used in primary hyperthyroidism. The therapy is based on short-range beta radiation emitted from radioactive iodine. Radioiodine administration must always be preceded by pharmacological normalization of thyroid function. Otherwise, post-radiation thyrocyte destruction and thyroid hormones release may lead to hyperthyroidism exacerbation. Indications for radioiodine therapy in Graves-Basedow disease include recurrent hyperthyroidism after thyrostatic treatment or thyroidectomy and side-effects observed during thyrostatic treatment. In toxic nodule, isotope therapy is the first choice therapy. Radioiodine is absorbed only in autonomous nodule. Therefore, it destroys only this area and does not damage the remaining thyroid tissue. In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years. In patients with thyroid nodules suspected of malignancy, radioiodine treatment may be applied as a preparation for surgery, if thyrostatic drugs are ineffective or contraindicated. In children, radioiodine therapy should be considered in recurrent toxic goitre and when thyrostatic drugs are ineffective. In patients with Graves-Basedow disease and thyroid-associated orbitopathy, radioiodine treatment may increase the inflammatory process and exacerbate the ophthalmological symptoms. However, thyroid-associated orbitopathy cannot be considered as a contraindication for isotope therapy. The potential carcinogenic properties of radioiodine, especially associated with tissues with high iodine uptake (thyroid, salivary glands, stomach, intestine, urinary tract, breast), have not been confirmed.

  9. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism.

    Science.gov (United States)

    Biondi, Bernadette; Bartalena, Luigi; Cooper, David S; Hegedüs, Laszlo; Laurberg, Peter; Kahaly, George J

    2015-09-01

    Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associated with increased risk of coronary heart disease mortality, incident atrial fibrillation, heart failure, fractures and excess mortality in patients with serum TSH levels hyperthyroidism. Treatment could be considered in patients older than 65 years with TSH levels 0.1-0.39 mIU/l (grade 1 SHyper) because of their increased risk of atrial fibrillation, and might also be reasonable in younger (hyperthyroidism and the weaker evidence for adverse health outcomes.

  10. Hyperthyroidism and pregnancy%甲状腺功能亢进症与妊娠

    Institute of Scientific and Technical Information of China (English)

    张闿珍

    2009-01-01

    This paper discusses the safety of pregnancy in patients with hyperthyroidism.PTU or MMI is the first choice of them.And FT_4 is the index to adjust the doses of anti-thyroid drug(ATD).Patients with hyperthyroidism must choose the opportunity of pregnancy.Because the disease may be aggravated and need to increase the dose of ATD in early stage,but it can alleviate and need to decrease or stop the ATD in late stage by immune resisting.Hyperthyroidism is easily relapsed after delivery.%本文研究甲状腺功能亢进症(甲亢)伴妊娠的安全性,无论是妊娠或哺乳,首选丙基硫氧嘧啶,也可用他巴唑;调整抗甲状腺药物(ATD)剂量,以游离T_4为指标.甲亢患者应选择妊娠时机.妊娠早期病情会加重,ATD剂量需增加,晚期由于免疫耐受,甲亢可缓解,需减少剂量或停药,产后甲亢易复发.

  11. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism

    Science.gov (United States)

    Biondi, Bernadette; Bartalena, Luigi; Cooper, David S.; Hegedüs, Laszlo; Laurberg, Peter; Kahaly, George J.

    2015-01-01

    Endogenous subclinical hyperthyroidism (SHyper) is caused by Graves' disease, autonomously functioning thyroid nodules and multinodular goitre. Its diagnosis is based on a persistently subnormal serum thyroid-stimulating hormone (TSH) level with free thyroid hormone levels within their respective reference intervals. In 2014 the European Thyroid Association Executive Committee, given the controversies regarding the treatment of Endo SHyper, formed a task force to develop clinical practice guidelines based on the principles of evidence-based medicine. The task force recognized that recent meta-analyses, including those based on large prospective cohort studies, indicate that SHyper is associated with increased risk of coronary heart disease mortality, incident atrial fibrillation, heart failure, fractures and excess mortality in patients with serum TSH levels hyperthyroidism. Treatment could be considered in patients older than 65 years with TSH levels 0.1-0.39 mIU/l (grade 1 SHyper) because of their increased risk of atrial fibrillation, and might also be reasonable in younger (hyperthyroidism and the weaker evidence for adverse health outcomes. PMID:26558232

  12. Cholestasis and protein-losing enteropathy secondary to hyperthyroidism in a 6-year-old girl.

    Science.gov (United States)

    Gargouri, Lamia; Charfi, Manel; Maalej, Bayen; Majdoub, Imen; Safi, Faiza; Fourati, Hela; Hentati, Yosr; Daoud, Emna; Mnif, Zeineb; Abid, Mohamed; Mahfoudh, Abdelmajid

    2014-09-01

    Hepatic dysfunctions are not infrequent in patients with hyperthyroidism. These disorders may be related to the effects of the excess thyroid hormone secretion, to the uses of antithyroid drugs, or to the presence of concomitant hepatic diseases. Our aim is to describe the clinical and biochemical features of liver dysfunction related to thyrotoxicosis. We report here a case of a 6-year-old girl who was admitted for jaundice and pruritus as a result of the development of hyperthyroidism due to Graves' disease. On physical examination at admission, she was found to have jaundice and hepatomegaly. Laboratory data show cholestasis and protein-losing enteropathy. Investigations exclude other causes of hepatic disorder. One month after the initiation of antithyroid drug, the patient became euthyroid with improvement in jaundice and pruritus and normalization of hepatic tests and alpha antitrypsine clearance. In conclusion, the diagnosis of hyperthyroidism may be delayed in patients in whom the primary manifestations were pruritus and jaundice. The physician should suspect thyrotoxicosis prior to hepatitis or skin manifestations.

  13. Hyperthyroidism secondary to hysterosalpingography: an extremely rare complication: A case report.

    Science.gov (United States)

    Ma, Guotao; Mao, Rui; Zhai, Haixin

    2016-12-01

    Hysterosalpingography (HSG), a standard procedure for the evaluation of women with infertility and repetitive pregnancy loss, is associated with complications such as uterine perforation, infection, allergic reactions, syncope, hemorrhage and shock, and pulmonary or retinal embolus. However, hyperthyroidism has not been reported as one of its complications. We report the case of a 33-year-old euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG. Thyroid function tests revealed a thyroid stimulating hormone (TSH) level of 0.012 μIU/mL (range 0.38-4.34 μIU/mL), free T4 of 2.886 ng/dL (range 0.81-1.89 ng/dL), and free T3 levels of 9.4 pg/mL (range 1.80-4.10 pg/mL), and antithyroglobulin antibody of 31.78 IU/mL (range hyperthyroidism (IIH), but was not treated with antithyroid drugs. She has spontaneously recovered and is pregnant currently. This is the first reported case of overt IIH caused by HSG in a euthyroid patient without risk factors. It suggests that HSG also leads to excessive iodine absorption, which induces secondary hyperthyroidism.

  14. Influence of experimental hypo- and hyperthyroidism on the expression of sialoglycans in rat ovary and endometrium

    Directory of Open Access Journals (Sweden)

    Sogomonian E.A.

    2010-01-01

    Full Text Available 7 lectins with different carbohydrate affinities (SNA, WGA, RCA, UDA, SBA, HPA and PNA were used forhistochemical investigation of sialoglycans and related oligosaccharidic determinants in rat ovary and endometrium underexperimental hypo- and hyperthyroidism. Tissue samples were fixed in 4% neutral formalin and embedded in paraffin. Lectin-peroxidase labels were visualized by diaminobenzidine. Both hypo- and hyperthyroidism significantly influenced ovarianand endometrial glycopolymers: rearrangement of NeuNAc, DGlcNAc, DGalNAc and DGal determinants in each structuralcomponent demonstrated specific and differential manifestations. It was detected that hyperthyroidism in comparison withhypothyroidism influenced carbohydrates of female reproductive system more strongly; endometrium was more susceptibleto thyroxin-modulated impairments in comparison with ovaria. Treatment of hypothyroidism with thyroxin normalized leucocytecount, quantitative and qualitative characteristics of collagen fibers and expression of sialoglycans, but not SBA, HPAand PNA receptor sites. Selective labeling of zona pellucida and corona radiata, luteocytes, atretic follicles and leucocyteswas detected in ovaria; in endometrium lectin label was attributed to leucocytes and collagen fibers, epithelium and secretorycomponents of uterine glands.

  15. PPARalpha activation and increased dietary lipid oppose thyroid hormone signaling and rescue impaired glucose-stimulated insulin secretion in hyperthyroidism.

    Science.gov (United States)

    Holness, Mark J; Greenwood, Gemma K; Smith, Nicholas D; Sugden, Mary C

    2008-12-01

    The aim of the study was to investigate the impact of hyperthyroidism on the characteristics of the islet insulin secretory response to glucose, particularly the consequences of competition between thyroid hormone and peroxisome proliferator-activated receptor (PPAR)alpha in the regulation of islet adaptations to starvation and dietary lipid-induced insulin resistance. Rats maintained on standard (low-fat/high-carbohydrate) diet or high-fat/low-carbohydrate diet were rendered hyperthyroid (HT) by triiodothyronine (T(3)) administration (1 mg.kg body wt(-1).day(-1) sc, 3 days). The PPARalpha agonist WY14643 (50 mg/kg body wt ip) was administered 24 h before sampling. Glucose-stimulated insulin secretion (GSIS) was assessed during hyperglycemic clamps or after acute glucose bolus injection in vivo and with step-up and step-down islet perifusions. Hyperthyroidism decreased the glucose responsiveness of GSIS, precluding sufficient enhancement of insulin secretion for the degree of insulin resistance, in rats fed either standard diet or high-fat diet. Hyperthyroidism partially opposed the starvation-induced increase in the glucose threshold for GSIS and decrease in glucose responsiveness. WY14643 administration restored glucose tolerance by enhancing GSIS in fed HT rats and relieved the impact of hyperthyroidism to partially oppose islet starvation adaptations. Competition between thyroid hormone receptor (TR) and PPARalpha influences the characteristics of GSIS, such that hyperthyroidism impairs GSIS while PPARalpha activation (and increased dietary lipid) opposes TR signaling and restores GSIS in the fed hyperthyroid state. Increased islet PPARalpha signaling and decreased TR signaling during starvation facilitates appropriate modification of islet function.

  16. Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study.

    Science.gov (United States)

    Dekkers, Olaf M; Horváth-Puhó, Erzsébet; Cannegieter, Suzanne C; Vandenbroucke, Jan P; Sørensen, Henrik Toft; Jørgensen, Jens Otto L

    2017-01-01

    Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40-4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33-1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58-8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30-8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism. © 2017 European Society of Endocrinology.

  17. 24 hr Whole-Body Retension of {sup 99m}Tc-Methylene Diphosphonate and Osteocalcin in patients with Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Yeoum, Kwang Seop; Lee, Jin Oh; Kang, Tae Woong; Lim, Sang Moo; Hong, Sung Woon [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    1990-07-15

    The development of histomorphometric and histodynamic investigations has permitted the description of a specific and complex osteopathy in hyperthyroidism. The increased bone turnover rate in hyperthyroid patients may be accompanied by a considerable bone loss. These features are associated with both increased osteoclastic bone resorption and increased osteoclastic bone formation, with an accelerated calcification rate. Conventional biochemical markers of bone metabolism, i.e. serum calcium and alkaline phosphatase and urinary hydroxyproline and calcium are normal in most patients with hyperthyroidism. However, the correlation between serum BGP and serum concentration of thyroid hormon suggests that serum BGP may be a sensitive marker of increased bone formation due to the hypersecretion of thyroid hormones. Any increase in bone turnover, whether focal or diffuse, will result in an increase in {sup 99m}Tc-methylenediphosphonate uptake (MDP). The measurement of this uptake in hyperthyroid patients by bone provides a sensitive and objective means of quantifying skeletal metabolism. Using a standard shadow-shield whole-body monitor and radioimmunoassay kit, we have measured whole-body retention of {sup 99m}Tc-MDP up to 24 hr and concentration of serum Osteocalcin in 20 patients with hyperthyroidism and in 42 normals. The results were as follows; 1) The average of serum Osteocalcin level in 42 patients with normals was 9.90 +- 4.87(ng/ml) and in 20 patients with hyperthyroidism was 19.54 +- 5.7(ng/ml). Both the averages of serum Osteocalcin and 24 hr {sup 99m}Tc-MDP uptakes in hyperthyroid patients were higher than those in normals. 2) {sup 99m}Tc-MDP uptakes in skeletal system increased in proportion to normal ageing after 40 yrs old in 42 patients with normals. The average of {sup 99m}Tc-MDP uptakes in hyperthyroid patients were higher than those in normals without related ageing. 3) A significant relationships between the {sup 99m}Tc-MDP uptakes and serum

  18. Atrial fibrillation associated with exogenous subclinical hyperthyroidism, changing axis deviation, troponin-I positive and without acute coronary syndrome.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2011-08-04

    Changing axis deviation has been rarely reported also during atrial fibrillation or atrial flutter. Changing axis deviation has been also rarely reported during acute myocardial infarction associated with atrial fibrillation or at the end of atrial fibrillation during acute myocardial infarction. Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Serum troponin-I is a sensitive indicator of myocardial damage but abnormal troponin-I levels have been also reported without acute coronary syndrome and without cardiac damage. Abnormal troponin-I levels after supraventricular tachycardia have been also reported. We present a case of changing axis deviation in a 49-year-old Italian man with atrial fibrillation, exogenous subclinical hyperthyroidism and troponin-I positive without acute coronary syndrome. Also this case focuses attention on changing axis deviation, on subclinical hyperthyroidism and on the importance of a correct evaluation of abnormal troponin-I levels.

  19. Sources of circulating 3,5,3'-triiodothyronine in hyperthyroidism estimated after blocking of type 1 and type 2 iodothyronine deiodinases

    DEFF Research Database (Denmark)

    Laurberg, Peter Marvin; Vestergaard, Henrik; Nielsen, Soren

    2007-01-01

    Graves' hyperthyroidism and multinodular toxic goiter lead to high serum T(3) compared with serum T(4). The source of this high T(3) has not been clarified.......Graves' hyperthyroidism and multinodular toxic goiter lead to high serum T(3) compared with serum T(4). The source of this high T(3) has not been clarified....

  20. A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Somdul Khoohaphatthanakul

    2016-01-01

    Full Text Available Graves’ hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; therefore, the diagnosis of Graves’ disease was confirmed. Other investigations to elucidate the etiology of galactorrhea were normal, so the galactorrhea was hypothesized to be caused by Graves’ disease. The gynaecomastia and galactorrhea resolved with the successful treatment of hyperthyroidism. Although the galactorrhea is extremely rare in thyrotoxicosis male patients, to the best of our knowledge, this is the third case which reported gynaecomastia and galactorrhea in male patient who presented with thyrotoxicosis.

  1. A 33-Year-Old Man with Gynaecomastia and Galactorrhea as the First Symptoms of Graves Hyperthyroidism.

    Science.gov (United States)

    Khoohaphatthanakul, Somdul; Sriwijitkamol, Apiradee

    2016-01-01

    Graves' hyperthyroidism has a various number of well-recognized manifestations. Galactorrhea is a rare manifestation in this disease. We describe a 33-year-old man who presented with the symptoms of hyperthyroidism, gynaecomastia, and galactorrhea for 2 months. Physical examination revealed goitre, gynaecomastia, and galactorrhea, bilaterally. Laboratory investigations demonstrated high free thyroxine with suppressed thyroid-stimulating hormone level together with elevated anti-TSH receptor; therefore, the diagnosis of Graves' disease was confirmed. Other investigations to elucidate the etiology of galactorrhea were normal, so the galactorrhea was hypothesized to be caused by Graves' disease. The gynaecomastia and galactorrhea resolved with the successful treatment of hyperthyroidism. Although the galactorrhea is extremely rare in thyrotoxicosis male patients, to the best of our knowledge, this is the third case which reported gynaecomastia and galactorrhea in male patient who presented with thyrotoxicosis.

  2. Revista Espanola de Cirugia Oral y Maxilofacial

    OpenAIRE

    Reinoso Quezada, Santiago; Alemán Iñiguez, Juan Miguel

    2014-01-01

    Maxillary myiasis is a rare tropical disease, it is endemic in several areas around the world, and common of some mammals, although humans are not excluded. The first case of maxillary myiasis in Ecuador is presented, as well as a description of the massive larval invasion. Similar cases reported in the medical literature are also reviewed. Cuenca

  3. Disrupted functional connectivity of the hippocampus in patients with hyperthyroidism: Evidence from resting-state fMRI

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Wei, E-mail: will.zhang.1111@gmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People' s Armed Police Forces, Leshan 614000 (China); Liu, Xianjun, E-mail: xianjun6.liu@gmail.com [Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People' s Armed Police Forces, Leshan 614000 (China); Zhang, Yi, E-mail: yi.zhang.0833@gmail.com [Department of Radiology, Sichuan Provincial Corps Hospital, Chinese People' s Armed Police Forces, Leshan 614000 (China); Song, Lingheng, E-mail: songlh1023@hotmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Hou, Jingming, E-mail: jingminghou@hotmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Chen, Bing, E-mail: chenbing3@medmail.com.cn [Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); He, Mei, E-mail: sunnusunny0105@gmail.com [Department of Clinical Psychology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Cai, Ping, E-mail: pingc_ddd@sina.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China); Lii, Haitao, E-mail: haitaolii023@gmail.com [Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing 400038 (China)

    2014-10-15

    Objective: The hippocampus expresses high levels of thyroid hormone receptors, suggesting that hippocampal functions, including cognition and regulation of mood, can be disrupted by thyroid pathology. Indeed, structural and functional alterations within the hippocampus have been observed in hyperthyroid patients. In addition to internal circuitry, hippocampal processing is dependent on extensive connections with other limbic and neocortical structures, but the effects of hyperthyroidism on functional connectivity (FC) with these areas have not been studied. The purpose of this study was to investigate possible abnormalities in the FC between the hippocampus and other neural structures in hyperthyroid patients using resting-state fMRI. Methods: Seed-based correlation analysis was performed on resting-state fMRI data to reveal possible differences in hippocampal FC between hyperthyroid patients and healthy controls. Correlation analysis was used to investigate the relationships between the strength of FC in regions showing significant group differences and clinical variables. Results: Compared to controls, hyperthyroid patients showed weaker FC between the bilateral hippocampus and both the bilateral anterior cingulate cortex (ACC) and bilateral posterior cingulate cortex (PCC), as well as between the right hippocampus and right medial orbitofrontal cortex (mOFC). Disease duration was negatively correlated with FC strength between the bilateral hippocampus and bilateral ACC and PCC. Levels of depression and anxiety were negatively correlated with FC strength between the bilateral hippocampus and bilateral ACC. Conclusion: Decreased functional connectivity between the hippocampus and bilateral ACC, PCC, and right mOFC may contribute to the emotional and cognitive dysfunction associated with hyperthyroidism.

  4. Mechanisms of Normalisation of Bone Metabolism during Recovery from Hyperthyroidism: Potential Role for Sclerostin and Parathyroid Hormone

    Directory of Open Access Journals (Sweden)

    Elżbieta Skowrońska-Jóźwiak

    2015-01-01

    Full Text Available Sclerostin, a protein expressed by osteocytes, is a negative regulator of bone formation. The aim of the study was to investigate the relationship between parathyroid hormone (PTH and markers of bone metabolism and changes of sclerostin concentrations before and after treatment of hyperthyroidism. Patients and Methods. The study involved 33 patients (26 women, age (mean ± SD 48 ± 15 years, with hyperthyroidism. Serum sclerostin, PTH, calcium, and bone markers [osteocalcin (OC and collagen type I cross-linked C-telopeptide I (CTX] were measured at diagnosis of hyperthyroidism and after treatment with thiamazole. Results. After treatment of hyperthyroidism a significant decrease in free T3 (FT3 and free T4 (FT4 concentrations was accompanied by marked decrease of serum sclerostin (from 43.7 ± 29.3 to 28.1 ± 18.4 pmol/L; p<0.001, OC (from 35.6 ± 22.0 to 27.0 ± 14.3 ng/mL; p<0.001, and CTX (from 0.49 ± 0.35 to 0.35 ± 0.23 ng/dL; p<0.005, accompanied by an increase of PTH (from 29.3 ± 14.9 to 39.8 ± 19.8; p<0.001. During hyperthyroidism there was a positive correlation between sclerostin and CTX (rs=0.41, p<0.05 and between OC and thyroid hormones (with FT3  rs=0.42, with FT4  rs=0.45, p<0.05. Conclusions. Successful treatment of hyperthyroidism results in a significant decrease in serum sclerostin and bone markers concentrations, accompanied by an increase of PTH.

  5. Serum Fructosamine Concentration in Uncontrolled Hyperthyroid Diabetic Cats Is within the Population Reference Interval

    Directory of Open Access Journals (Sweden)

    Arnon Gal

    2017-03-01

    Full Text Available Diabetes mellitus is a common endocrinopathy of cats that is characterized by persistent fasting hyperglycemia. However, stress induces substantial hyperglycemia in cats that poses a challenge to the veterinarian who may wrongly interpret the high serum concentration of blood glucose as evidence of diabetes mellitus. Fructosamine is a glycated serum protein that serves as an index of glycemic control in cats and is useful because it is not affected by stress hyperglycemia. However, factors such as body weight, hypoproteinemia, and increased serum thyroid hormone concentration can alter fructosamine concentration. The goal of this retrospective study was to compare the fructosamine concentrations in diabetic and nondiabetic cats with and without uncontrolled hyperthyroidism. A secondary goal was to determine the effect of sex, age, different populations of cats, and diabetes on the variability of fructosamine. We found that the mean (±SE serum fructosamine of hyperthyroid diabetic cats (332 ± 24 µmol/L, 95% CI 291–379 µmol/L was within the population-based reference interval (200–360 µmol/L and significantly lower in comparison to euthyroid diabetic cats (527 ± 10 µmol/L, 95% CI 515–553 µmol/L. Additionally, in this study, diabetes accounted only for approximately 50% of the variance in serum fructosamine, while age, sex, and population made a minor contribution to this variance. In conclusion, finding serum fructosamine that is within the population-based reference interval in an uncontrolled diabetic cat should alert the veterinarian to the possibility of concurrent hyperthyroidism. Additionally, the veterinary clinician should consider that serum fructosamine might be substantially affected by factors other than diabetes.

  6. 131I therapy for 345 patients with refractory severe hyperthyroidism: Without antithyroid drug pretreatment.

    Science.gov (United States)

    Ding, Yong; Xing, Jialiu; Fang, Yi; Wang, Yong; Zhang, Youren; Long, Yahong

    2016-02-01

    The aim of this study is to evaluate the safety and long-term results of (131)I therapy alone for patients with refractory severe hyperthyroidism without antithyroid drug pretreatment. From January 2002 to December 2012, 408 patients with refractory severe hyperthyroidism were treated with (131)I alone. Among them, 345 were followed up for 1 to 10 years for physical examination, thyroid function, and thyroid ultrasound. Complete Blood Count (CBC) liver function, electrocardiogram, echocardiogram, and Emission Computed Tomography (ECT) thyroid imaging were performed as indicated. The 345 patients had concomitant conditions including thyrotoxic heart disease, severe liver dysfunction, enlarged thyroid weighing 80 to 400 g, severe cytopenia, and vasculitis. One to two weeks prior to (131)I therapy, all patients were given low-iodine diet. The dose of (131)I therapy was 2.59 to 6.66 MBq (70 to180 µCi) per gram of thyroid with an average of 3.83 ± 0.6 MBq (103.6 ± 16.4 µCi); and the total (131)I activity administrated for the individuals was 111 to 3507.6 MBq (3.0 to 94.8 mCi, mean 444 ± 336.7 MBq (12.0 ± 9.1 mCi)). Out of the 408 patients, 283 were cured, 15 with complete remission, and 47 with incomplete remission. No treatment failure or significant clinical worsening was noted in these patients. Our data indicated that (131)I therapy alone for patients with refractory severe hyperthyroidism without antithyroid drug pretreatment is safe and effective.

  7. A survey of owners' perceptions and experiences of radioiodine treatment of feline hyperthyroidism in the UK.

    Science.gov (United States)

    Boland, Lara A; Murray, Jane K; Bovens, Catherine Pv; Hibbert, Angie

    2014-08-01

    The efficacy of radioiodine treatment of feline hyperthyroidism is well established; however, limited information is known about owners' perceptions or experiences of radioiodine. This study aimed to examine factors that influence owner treatment choices and their opinions following radioiodine. Surveys were sent to owners of cats referred for radioiodine treatment between 2002 and 2011 (radioiodine group; 264 cats) and owners of non-radioiodine-treated hyperthyroid cats seen at first-opinion practices (control group; 199 cats). The response rate was 67.0% (310 returned: 175 radioiodine, 135 control). Of 135 controls, 72 (53.3%) were unaware of radioiodine as a treatment option. Owners of cats ⩾15 years old and uninsured cats were less likely to pursue radioiodine. Cost of treatment, travel distance, potential human or animal health risks and waiting periods for radioiodine had a low impact on owners' treatment choice. Owners reported a moderate level of concern about treatment hospitalisation length, which included (158 respondents) the possibility of the cat being unhappy 130 (82.3%), owner missing the cat 102 (64.6%), inappetence 50 (31.6%), other pets missing the cat 32 (20.3%), development of co-morbid disease 28 (17.7%) and side effects 25 (15.8%). Owners assessed their cat's quality of life on a scale of 1 (very poor) to 10 (excellent), as 4 (4) (median [interquartile range]) pre-radioiodine (134 respondents) and 9 (2) post-radioiodine (131 respondents). Of 132 respondents, 121 (91.7%) were happy with their decision to choose radioiodine. The results of this questionnaire may assist veterinarians in addressing common owner concerns when discussing radioiodine as a treatment option for hyperthyroidism.

  8. Sequential defunctionalization followed by thyroxine supple-mentation as preoperative preparation of hyperthyroid patients undergoing thyroidectomy

    Institute of Scientific and Technical Information of China (English)

    ZHU Jing-qiang; WU Xiao-ying; LI Zhi-hui; GONG Ri-xiang; WEI Tao; ZHANG Heng; ZHANG Wen-yan; YANG Xiao-yan; LUO Yan-li; GONG Shu

    2008-01-01

    Background Preparing hyperthyroid patients for thyroid surgery with a combination of antithyroid drugs and thyroxine has long been controversial because this combination usually results in only partial inhibition of thyroid function. We therefore used large doses of antithyroid drugs to completely inhibit the synthesis of thyroxine and render the thyroid gland defunctionalized. We then administered physiologic doses of thyroxine to inhibit thyroid-stimulating hormone secretion. We have named this treatment "sequential thyroid defunctionalization followed by thyroxine supplementation." Methods Four hundred and seventy-one hyperthyroid patients seen at our hospital were divided into experimental and control groups. The control group was treated preoperatively with antithyroid drugs and iodine preparation. The experimental group was further divided into four subgroups and treated with "sequential thyroid defunctionalization followed by thyroxine supplementation". Each of the four subgroups received different doses of antithyroid drugs and thyroxine for differing time periods. Thyroid function was assessed at each stage of treatment, as were operative blood loss volumes and postoperative complications.Results Compared to the control group, the four experimental groups showed less thyroid congestion and surface varices at surgery. Patients in subgroup A also had thyroid glands that were almost histologically normal. The mean operative blood loss volume of the experimental group was less than that of the control group((326±1 63)mlin the control group;(196±57)ml in subgroup A:(230±71)ml in subgroup B;(240±80)ml in subgroup C;and(31 2±97)ml in subgroup D).The postoperative complication rate of the experimental group was 8.64%(21/243)whereas that of the control group was 1 7.54%(40/228).Conclusions Sequential thyroid defunctionalization followed by thyroxine supplementation is effective in reducing the bleeding volume and postoperative complication rate in selected

  9. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism.

    Science.gov (United States)

    Yilmaz, Yeliz; Kamer, Kemal Erdinc; Ureyen, Orhan; Sari, Erdem; Acar, Turan; Karahalli, Onder

    2016-08-01

    To investigate the effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism. This controlled, randomized, prospective cohort was carried out on 40 patients who admitted for surgery due to hyperthyroidism. Cases were randomly assigned to receive either preoperative treatment with Lugol solution (Group 1) or no preoperative treatment with Lugol solution (Group 2). Group 3 (n = 10) consisted of healthy adults with no known history and signs of hyperthyroidism. Blood flow through the thyroid arteries of patients was measured by color flow Doppler ultrasonography. Free T3, free T4, TSH, thyroid volume and the resistance index of the four main thyroid arteries were measured in all patients. There was not a significant difference between gender, preoperative serum thyroid hormone levels, or thyroid gland volumes between groups 1 and 2. The mean blood flow of the patients in Group 1 was significantly lower than values in Group 2. When age, gender, thyroid hormone, TSH, thyroid volume, blood flow, and Lugol solution treatment were included as independent variables, Lugol solution treatment (OR, 7.40; 95% CI, 1.02-58.46; p = 0.001) was found to be the only significant independent determinant of intraoperative blood loss. Lugol solution treatment resulted in a 7.40-fold decrease in the rate of intraoperative blood loss. Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.

  10. [Hyperthyroid and acute tonsillitis in a 23-year-old woman].

    Science.gov (United States)

    Beyer, G; Küster, I; Budde, C; Wilhelm, E; Hoene, A; Evert, K; Stracke, S; Friesecke, S; Mayerle, J; Steveling, A

    2016-07-01

    A 23-year-old woman with preexisting Graves' disease who received thiamazole treatment presented with fever, dysphagia, hyperthyroidism and leukopenia. With suspicion of thyreotoxicosis accompanied by drug-induced agranulocytosis she was successfully managed by plasmapheresis, G‑CSF administration and inhibition of periphereal conversion of thyroid hormones. In due course she underwent thyroidectomy. Thiamazole is frequently associated with drug-induced agranulocytosis. Long-term therapy with thiamazole requires critical evaluation and alternatives should be considered early. Plasmapheresis is an adequate treatment option to achieve normal thyroid hormonal status.

  11. Future Prospects for the Treatment of Graves' Hyperthyroidism and Eye Disease.

    Science.gov (United States)

    Neumann, S; Place, R F; Krieger, C C; Gershengorn, M C

    2015-09-01

    Although there are adequate therapies for Graves' hyperthyroidism, mild to moderate Graves' orbitopathy (GO) is usually treated symptomatically whereas definitive therapy is reserved for severe, vision-threatening GO. Importantly, none of the treatment regimens for Graves' disease used today are directed at the pathogenesis of the disease. Herein, we review some aspects of what is known about the pathogenesis of these 2 major components of Graves' disease, specifically the apparent important roles of the TSH and IGF-1 receptors, and thereafter describe future therapeutic approaches directed at these receptors. We propose that targeting these receptors will yield effective and better tolerated treatments for Graves' disease, especially for GO.

  12. Immunothyropathy with hyperthyroidism following /sup 131/iodine treatment for toxic thyroid nodule

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, H.W.; Schneider, C.; Schroeder, S.

    1985-06-01

    The rare case of a diffuse immunothyropathy with hyperthyroidism 3 weeks after /sup 131/Iodine treatment for a toxic thyroid nodule is presented. Diagnosis of 'toxic thyroid nodule' has been established by /sup 131/Iodine scintiscan and suppression test. The diagnosis 'immunothyropathy' is based on thyroid-antibody-determinations (TAK, MAK), ultrasound, histology, and clinical course. Corresponding to the knowledge of pathogenesis in immunothyropathies (Graves' disease, Hashimoto's disease) /sup 131/Iodine therapy is considered as inducing factor of the recorded immunothyropathy.

  13. Giant primary synchronously bilateral mesenteric dedifferentiated liposarcoma with hyperparathyroidism, hyperthyroidism, type-2 diabetes mellitus and hypertension.

    Science.gov (United States)

    Korukluoglu, Birol; Ergul, Emre; Sisman, Ibrahim Cagatay; Yalcin, Samet; Kusdemir, Ahmet

    2009-08-01

    Liposarcomas represent the single most common type of soft tissue sarcoma, occurring most commonly in the extremities and retroperitoneum. There is no relation between liposarcomas and multiple endocrine syndromes. We presented a 61-year old woman with giant primary synchronously bilateral mesenteric dedifferentiated liposarcoma with hyperparathyroidism, hyperthyroidism, Type-2 diabetes mellitus (T2DM) and hypertension. The mesenteric liposarcoma was reported neither synchronously bilateral nor with endocrine disorders. We must note if the patients' presentation was a co-incidence or an undescribed syndrome, waiting to be discovered.

  14. Treatment of hyperthyroidism: use of 131I and 125I

    Energy Technology Data Exchange (ETDEWEB)

    Atkins, Harold L.

    1977-01-01

    Factors related to late hypothyroidism following the use of /sup 131/I for treatment of hyperthyroidism are discussed with regard to age of patient, size of dose, previous surgery, immune status, and others. Possible reasons for the post-therapeutic hypothyroidism are discussed with regard to effects of radiation on the reproductive capacity of thyroid cells, effects of radiation on blood vessels, and dose distribution of radioiodine. The following therapeutic strategies are discussed: reduction of initial dose; multiple small doses; high dose radioiodine followed by replacement therapy; the use of external beam irradiation; and the use of /sup 125/I. (HLW)

  15. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine.

    Science.gov (United States)

    Boelaert, Kristien; Maisonneuve, Patrick; Torlinska, Barbara; Franklyn, Jayne A

    2013-05-01

    Hyperthyroidism is common, but opinions regarding optimal therapy with antithyroid drugs or radioiodine (131-I) differ. There are no randomized trials comparing these options in terms of mortality. The aim of the study was to determine whether mortality associated with hyperthyroidism varies with treatment administered or other factors. We conducted a prospective observational population-based study of 1036 subjects aged ≥ 40 years presenting to a single specialist clinic from 1989-2003 with a first episode of hyperthyroidism who were followed until June 2012. Antithyroid drugs or radioiodine (131-I) were administered. We compared causes of death with age-, sex-, and period-specific mortality in England and Wales and used within-cohort analysis of influence of treatment modality, outcome, disease etiology, severity and control, and comorbidities. In 12 868 person-years of follow-up, 334 died vs 290.6 expected (standardized mortality ratio [SMR], 1.15 [95% confidence interval (CI),1.03-1.28]; P = .01). Increased all-cause mortality largely reflected increased circulatory deaths (SMR, 1.20 [95% CI, 1.01-1.43]; P = .04). All-cause mortality was increased for the person-years accumulated during thionamide treatment (SMR, 1.30 [95% CI, 1.05-1.61]; P = .02) and after 131-I not associated with hypothyroidism (SMR, 1.24 [95% CI, 1.04-1.46]; P = .01) but not during T₄ replacement for 131-I-induced hypothyroidism (SMR, 0.98 [95% CI, 0.82-1.18]; P = .85). Within-cohort analysis comparing mortality during thionamide treatment showed a similar hazard ratio (HR) for all-cause mortality when 131-I did not result in hypothyroidism (HR, 0.95 [95% CI, 0.70-1.29]), but reduced mortality with 131-I-induced hypothyroidism (HR, 0.70 [95% CI, 0.51-0.96]). Reduced mortality associated with hypothyroidism was seen only in those without significant comorbidities and not in those with other serious diseases. Atrial fibrillation at presentation (P = .02) and an increment of 10 pmol/L in

  16. [Evaluation of the diagnostic power of 3 methods for assaying free T4. Results in the diagnostic strategy of hyperthyroidism].

    Science.gov (United States)

    Fragu, P; Noel, M; Patois, E; Delarue, J C; Paugam-Capelle, J; Parmentier, C

    1985-01-01

    The free thyroxin (FT4) tests of Amersham, Clinical Assay and Corning Medical were evaluated in 240 patients who were suspected of hyperthyroidism. The diagnostic performances of the Corning method were of less value while those of the other methods were equivalent to that obtained with the free thyroxin index for an average cost reduced. Furthermore our results show that T3 determination is better than T4 determination in patients who remained doubtful after FT4. However the development of ultra-short methods of measurement of total thyroid hormone blood levels using fluorescence polarization could lead to reconsider the diagnostic strategy of hyperthyroidism.

  17. Newly diagnosed hyperthyroidism in the 25th gestational week of pregnancy presenting with systolic arterial hypertension only.

    Science.gov (United States)

    Zaveljcina, Janez; Legan, Mateja; Gaberšček, Simona

    2016-05-01

    We present a case of a 30-year-old woman diagnosed with arterial hypertension in the 25th week of pregnancy. Our search for secondary causes of arterial hypertension revealed hyperthyroid Hashimoto's thyroiditis (HT), which was treated with propilthiouracil. Three weeks after delivery, she was normotensive without medication. In the next four months, she developed hypothyroidism and treatment with L-thyroxine was started. In conclusion, in the second half of pregnancy, a hyperthyroid HT can occur - in spite of the well-known amelioration of autoimmune thyroid disorders in that period, and can be the only cause of arterial hypertension.

  18. Reciprocal changes in parathyroid hormone and thyroid function after radioiodine treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ross, D.S.; Nussbaum, S.R.

    1989-06-01

    Hyperthyroidism is associated with negative calcium balance, normal to increased serum calcium concentrations, and decreased cortical bone mass. There is no agreement concerning serum PTH levels in such patients. In this study, we measured serum PTH concentrations using a newly developed sensitive 2-site immunoradiometric assay in 17 hyperthyroid patients before and after radioiodine therapy. The mean serum PTH and calcium concentrations were 28 +/- 15 (+/- SD) ng/L (normal range, 12-65 ng/L) and 2.4 +/- 0.5 mmol/L (normal range, 2.1-2.6 mmol/L) before therapy. After therapy serum PTH concentrations increased in 16 of the 17 patients. The increase in serum PTH was greater in the 9 patients who became hypothyroid rapidly (29 +/- 15 to 75 +/- 29 ng/L) compared with that in the 8 patients who became euthyroid gradually (26 +/- 16 to 45 +/- 24 ng/L). Serum PTH rose along with TSH as the patients became hypothyroid after radioiodine, and both serum PTH and TSH fell when L-T4 therapy was given. The reciprocal changes in serum PTH concentrations and thyroid function over time suggest a strong association of bone mineral metabolism and thyroid status.

  19. I-131 therapy for hyperthyroidism in carbimazole induced acute aplastic anaemia

    Energy Technology Data Exchange (ETDEWEB)

    Jenkin, B.A.; Van Every, B.; Kelly, M.J. [Alfred Hospital, Prahran, VIC (Australia). Nuclear Medicine Department

    1998-06-01

    Full text: We present a case of a 39 year old previously well woman who developed carbimazole-induced acute aplastic anaemia. Following 6 weeks of carbimazole for Grave`s disease she presented with fever, sore throat and lethargy and was found to be pancytopaenic. Haemoglobin fell to 79g/l (normal>120g/l), neutrophils to an undetectable level and platelets to 4,000/ml (normal>150,000/ml). From the MIRD schema it was estimated that a therapeutic dose of 444 MBq (12mCi) to treat her hyperthyroidism would deliver a red marrow radiation dose of about 30 mSv, at least an order of magnitude below any expected demonstrable deleterious effect on the marrow. Subsequently a dose of 444 MBq of I-131 was given and within 2 weeks the marrow had begun to recover, eventually to normal. This case would support the use of 1-131 for hyperthyroidism in carbimazole-induced marrow aplasia, even in profoundly depressed marrow

  20. Iodine-induced hyperthyroidism as combination of different etiologies: an overlooked entity in the elderly.

    Science.gov (United States)

    Foppiani, Luca; Cascio, Christian; Lo Pinto, Giuliano

    2016-10-01

    Iodine-induced thyrotoxicosis, which raises several diagnostic and therapeutical challenges, is often overlooked. Hyperthyroidism can induce atrial fibrillation, a harmful arrhythmia which can precipitate heart failure and cause stroke. We report the case of an elderly man who was diagnosed with tachyfibrillation secondary to hyperthyroidism. Thyroid hyperfunction was subsequently related both to previous amiodarone therapy (probably mixed form) and the recent use of iodinated contrast medium for computed tomography scan. Thyroid ultrasonography showed a plongeant multinodular goitre. After initial worsening, thyroid function improved slowly but progressively on high-dose thyreostatic therapy combined with steroid therapy; tachyfibrillation caused heart failure and a thrombus in the left atrium, and proved initially resistant to combined antiarrhythmic treatments. Progressive reduction in thyroid hormone levels, together with combined cardiologic therapies, controlled the heart rate, though atrial fibrillation persisted; anticoagulant therapy resolved the atrial thrombus. Alterations in thyroid function are common in amiodarone-treated patients, who therefore require regular hormonal checks. The different forms of amiodarone-induced thyrotoxicosis must be investigated, since they require different therapies, though mixed forms often occur. The superimposition of further iodine excess due to other causes may be catastrophic and cause severe cardiac problems in these patients.

  1. Association between TSH-Receptor Autoimmunity, Hyperthyroidism, Goitre, and Orbitopathy in 208 Patients Included in the Remission Induction and Sustenance in Graves’ Disease Study

    Directory of Open Access Journals (Sweden)

    Peter Laurberg

    2014-01-01

    Full Text Available Background. Graves’ disease may have a number of clinical manifestations with varying degrees of activity that may not always run in parallel. Objectives. To study associations between serum levels of TSH-receptor autoantibodies and the three main manifestations of Graves’ disease (hyperthyroidism, goiter, and presence of orbitopathy at the time of diagnosis of hyperthyroidism. Methods. We describe a cohort of 208 patients with newly diagnosed Graves’ hyperthyroidism. Patients were enrolled in a multiphase study of antithyroid drug therapy of Graves’ hyperthyroidism, entitled “Remission Induction and Sustenance in Graves’ Disease (RISG.” Patients were systematically tested for degree of biochemical hyperthyroidism, enlarged thyroid volume by ultrasonography, and the presence of orbitopathy. Results. Positive correlations were found between the levels of TSH-receptor autoantibodies in serum and the three manifestations of Graves’ disease: severeness of hyperthyroidism, presence of enlarged thyroid, and presence of orbitopathy, as well as between the different types of manifestations. Only around half of patients had enlarged thyroid gland at the time of diagnosis of hyperthyroidism, whereas 25–30% had orbitopathy. Conclusions. A positive but rather weak correlation was found between TSH-receptor antibodies in serum and the major clinical manifestation of Graves’ disease. Only half of the patients had an enlarged thyroid gland at the time of diagnosis.

  2. Cardiovascular morbidity and mortality in surgically treated hyperthyroidism - a nation-wide cohort study with a long-term follow-up.

    Science.gov (United States)

    Ryödi, Essi; Salmi, Jorma; Jaatinen, Pia; Huhtala, Heini; Saaristo, Rauni; Välimäki, Matti; Auvinen, Anssi; Metso, Saara

    2014-05-01

    Previous studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long-term follow-up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroid patients treated surgically with an age- and gender-matched reference population. A population-based cohort study was conducted among 4334 hyperthyroid patients (median age 46 years) treated with thyroidectomy in 1986-2007 in Finland and among 12,991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy. The risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroid patients compared to the controls (P hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality. The present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle-aged patient cohort studied. © 2013 John Wiley & Sons Ltd.

  3. Increase in incidence of hyperthyroidism predominantly occurs in young people after iodine fortification of salt in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Inge Bülow; Laurberg, Peter; Knudsen, Nils

    2006-01-01

    a computer-based register of all new cases of hyperthyroidism in two population subcohorts with moderate iodine deficiency ( Aalborg, n = 310,124) and mild iodine deficiency ( Copenhagen, n = 225,707), respectively. Data were obtained 1) before IF ( 1997 - 1998); 2) during voluntary IF ( 1999 - 2000); 3...

  4. The effect of metformin on the hypothalamic-pituitary-thyroid axis in patients with type 2 diabetes and subclinical hyperthyroidism.

    Science.gov (United States)

    Krysiak, R; Szkrobka, W; Okopien, B

    2015-04-01

    In hypothyroid patients, metformin was found to reduce serum levels of TSH. No previous study investigated metformin action on hypothalamic-pituitary-thyroid axis in patients with hyperthyroidism. The aim of our study was to assess the effect of metformin treatment on thyroid function tests in patients with untreated subclinical hyperthyroidism. We studied 15 patients with low but detectable TSH levels (0.1-0.4 mIU/L) (group 1), 12 patients with suppressed TSH levels (less than 0.1 mIU/L) (group 2) and 15 euthyroid patients with a history of hyperthyroidism, who because of coexisting 2 diabetes were treated with metformin (2.55-3 g daily). Glucose homeostasis markers, as well as serum levels of TSH and total and free thyroxine and triiodothyronine levels were assessed at baseline and after 3 and 6 months of therapy. As expected, metformin reduced plasma glucose, insulin resistance and glycated hemoglobin. However, with the exception of an insignificant decrease in TSH levels after 3-month therapy in group 2, metformin therapy did not affect thyroid function tests. Our results indicate that metformin has a negligible effect on hypothalamic-pituitary-thyroid axis activity in type 2 diabetic patients with subclinical hyperthyroidism.

  5. Outcome of Very Long-Term Treatment with Antithyroid Drugs in Graves' Hyperthyroidism Associated with Graves' Orbitopathy

    NARCIS (Netherlands)

    L. Elbers; M. Mourits; W. Wiersinga

    2011-01-01

    Background: It is still debated which treatment modality for Graves' hyperthyroidism (GH) is most appropriate when Graves' orbitopathy (GO) is present. The preference in our center has been always to continue antithyroid drugs for GH (as the block-and-replace [B-R] regimen) until all medical and/or

  6. Hyperthyroidism and ischemic stroke%甲状腺功能亢进症和缺血性脑卒中

    Institute of Scientific and Technical Information of China (English)

    王燕燕

    2010-01-01

    The occurrence of atrial fibrillation in hyperthyroidism and subclinical hyperthyroidism increases over the time. Hypercoagulability state,usually accompanying with these two diseases above,can also result in the formation of cardioembolic stroke. Additionally, hyperthyroidism is related with ischemic cerebro-vascular disease,for instance acute cerebral venous thrombosis,giant cell temporal arteritis. Moyamoya disease, but sound evidence is lacking. Here reviews the relationship between hyperthyroidism and cerebrovas-cular disease, in order to investigate the pathogenesis and clinical characteristics and provide the evidence for corrent therapy.%甲状腺功能亢进症(甲亢)和亚临床甲亢时房颤的发生率增加,其伴有的高凝状态也可引起心源性脑卒中的发生.此外,甲亢时可伴有急性脑静脉血栓形成、巨细胞性颞动脉炎和烟雾病等缺血性脑血管病,但缺乏相关证据.现对甲亢与脑血管疾病之间的关系作一综述,旨在探讨其共同的发病机制及临床特点,并为两者合并存在时的正确治疗提供参考.

  7. Adaptive changes in transmembrane transport and metabolism of triiodothyronine in perfused livers of fed and fasted hypothyroid and hyperthyroid rats

    NARCIS (Netherlands)

    M. de Jong (Marcel); R. Docter (Roel); H.J. van der Hoek (H.); E.P. Krenning (Eric); G. Hennemann

    1994-01-01

    textabstractThe transport and subsequent metabolism of triiodothyronine (T3) were studied in isolated perfused livers of euthyroid, hypothyroid, and hyperthyroid rats, both fed and 48-hour-fasted. T3 kinetics (transport and metabolism) during perfusion were evaluated by a two-pool model, whereas the

  8. Novel germline mutation (Leu512Met) in the thyrotropin receptor gene (TSHR) leading to sporadic non-autoimmune hyperthyroidism.

    Science.gov (United States)

    Roberts, Stephanie A; Moon, Jennifer E; Dauber, Andrew; Smith, Jessica R

    2017-03-01

    Primary nonautoimmune hyperthyroidism is a rare cause of neonatal hyperthyroidism. This results from an activating mutation in the thyrotropin-receptor (TSHR). It can be inherited in an autosomal dominant manner or occur sporadically as a de novo mutation. Affected individuals display a wide phenotype from severe neonatal to mild subclinical hyperthyroidism. We describe a 6-month-old boy with a de novo mutation in the TSHR gene who presented with accelerated growth, enlarging head circumference, tremor and thyrotoxicosis. Genomic DNA from the patient's and parents' peripheral blood leukocytes was extracted. Exons 9 and 10 of the TSHR gene were amplified by PCR and sequenced. Sequencing exon 10 of the TSHR gene revealed a novel heterozygous missense mutation substituting cytosine to adenine at nucleotide position 1534 in the patient's peripheral blood leukocytes. This leads to a substitution of leucine to methionine at amino acid position 512. The mutation was absent in the parents. In silico modeling by PolyPhen-2 and SIFT predicted the mutation to be deleterious. The p.Leu512Met mutation (c.1534C>A) of the TSHR gene has not been previously described in germline or somatic mutations. This case presentation highlights the possibility of mild thyrotoxicosis in affected individuals and contributes to the understanding of sporadic non-autoimmune primary hyperthyroidism.

  9. Clinical research of juvenile hyperthyroidism treatment with radioiodine%131I治療青少年及兒童甲亢臨床應用研究

    Institute of Scientific and Technical Information of China (English)

    邱陵; 張春銀; 陳躍

    2001-01-01

    Objective To evaluate the effects and side effects in the radioiodine management of juvenile hyperthyroidism. Methods 80 patients with poor effects using anti-thyroid drug were assigned to receive 131Itherapy. The follows of therapy outcome were assessed 1, 3, 6 and 12 months after the start of treatment. One follows up per 1-3 years. Results Among 80 patients followed by 6 months, clinical response was excellent in 65patients (81%), good in 15 (19 % ). There were 12 patients with hypothyroidism followed 4 years, and with no other side effects, Conclusion The good therapeutic effect was obtained in radioiodine treatment for juvenile hyperthyroidism. Radioiodine was effective to juvenile hyperthyroidism.

  10. Reliability of the thyroid stimulating hormone receptor antibodies level determination in diagnosing and prognosing of immunogenic hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Aleksić Aleksandar Z.

    2009-01-01

    Full Text Available Background/Aim. Graves disease (GD is defined as hyperthyroidism with diffuse goiter caused by immunogenic disturbances. Antibodies to the thyroid stimulating hormone (TSH receptors of thyroid gland (TRAb have crucial pathogenetic importance in the development and maintenance of autoimmune hyperthyroidism. The aim of this study was to identify sensitivity, specificity, positive an negative predictive value of TRAb level in sera of patients with GD as well as to estimate significance of TRAb level for remission and GD relapses occurrence. Methods. We studied prospectively and partly retrospectively 149 patients, 109 female and 40 male patients, 5-78 years old, in the period 1982-2007. There were 96 patients with GD. The control group consisted of 53 patients, 21 with hyperthyroidism of second etiology and 32 patients on amiodarone therapy, with or without thyroid dysfunction TRAb was measured by radioreceptor assay (TRAK Assay and DYNO Test TRAK Human Brahms Diagnostica GMBH. Results. According to the results the sensitivity (Sn of TRAb test was 80%, specificity (Sp 100%, positive predictive value (PP 100% and negative predictive value (NP 83%. Also, the Sn of hTRAb test was 94%, Sp 100%, PP 100% and NP 94%. Our results show that an increased level of TRAb/hTRAb at the beginning of the disease and the level at the end of medical therapy is associated with an increased number of GD relapses and a shorter remission duration. Conclusion. Detection and measurement of TRAb in serum is a very sensitive method for diagnosing GD and very highly specific in vitro method for differential diagnosis of various forms of hyperthyroidism. Clinical significance of differentiating various forms of hyperthyroidism, using this in vitro assay, lays in adequate therapeutic choice for these entities.

  11. Risk factors of hepatic dysfunction in patients with Graves’ hyperthyroidism and the efficacy of 131iodine treatment

    Science.gov (United States)

    Wang, Renfei; Tan, Jian; Zhang, Guizhi; Zheng, Wei; Li, Chengxia

    2017-01-01

    Abstract Hepatic dysfunction is often observed in patients with Graves’ hyperthyroidism. The aims of this study were to investigate the risk factors for hepatic dysfunction and to analyze the efficacy of 131I (radioactive iodine-131) treatment. In total, 2385 patients with Graves’ hyperthyroidism (478 males, 1907 females; age 42.8 ± 13.5 years) were involved in our study. Of these, 1552 cases with hepatic dysfunction received 131I treatment. All clinical data were retrospectively reviewed to explore the risk factors associated with hepatic dysfunction using logistic regression analysis. Furthermore, we observed thyroid and liver function indices for the 1552 subjects at 3, 6 and 12 months after 131I treatment, in order to evaluate efficacy. Overall, 65% patients were affected by hepatic dysfunction. The most common abnormality was elevated alkaline phosphatase (ALP), of which the prevalence was 52.3%. The percentages of hepatocellular injury type, bile stasis, and mixed type were 45.8%, 32.4%, and 21.8%, respectively. Both univariate and multivariate analyses demonstrated that age, duration of Graves hyperthyroidism, free triiodothyronine (FT3)level, and thyrotrophin receptor antibody (TRAb) concentration were the most significant risk factors predicting hepatic dysfunction. Additionally, the patients with mild hepatic dysfunction, or hepatocellular injury type were more likely to attain normal liver function after 131I treatment. Furthermore, after 131I treatment, liver function was more likely to return to normal in the cured group of patients compared with the uncured group. Older patients and cases with a longer history of Graves’ hyperthyroidism, higher FT3 or TRAb concentration were more likely to be associated with hepatic dysfunction, and the prognosis of hepatic dysfunction was closely associated with the outcomes of Graves’ hyperthyroidism after 131I treatment. PMID:28151911

  12. Vitamin E levels in soleus muscles of experimentally induced hyperthyroid rats differ consequent to feeding of edible oils.

    Science.gov (United States)

    Merican, Z; Suboh, B; Marzuki, A; Khalid, B A

    1999-12-01

    It has been shown that lipid peroxidation product levels in the soleus muscles of rats fed palm olein were lower than in the soleus muscles of rats fed soya bean oil. A study was carried out to test our hypothesis that the lower level of lipid peroxidation products in the soleus muscle of palm olein-fed rats is due, at least partly, to the higher amount of vitamin E in their soleus muscles. Experimentally induced hyperthyroid rats were fed either ground rat chow or ground rat chow mixed with palm olein oil or soya bean oil for a period of 8 weeks. Euthyroid rats fed ground rat chow for a similar period served as controls. At the end of the 8-week period, the rats were sacrificed and the α-tocopherol and tocotrienol levels in their soleus muscles were measured using high pressure liquid chromatography. It was found that the levels of α-tocopherol (23.682 ± 0.363), α-tocotrienol (1.974 ± 0.040) and γ-tocotrienol (1.418 ± 0.054) in μg/g tissue wet weight in the soleus muscles of hyperthyroid rats fed palm olein oil were statistically significantly higher than those found in the soleus muscles of hyperthyroid rats fed soya bean oil, which were 14.299 ± 0.378, 0.053 ± 0.053 and 0.184 ± 0.120μg/g tissue wet weight, respectively. The result shows that the increased level of a-tocopherol and tocotrienols found in the soleus muscles of hyperthyroid rats fed palm olein oil is responsible, at least partly, for the lower amount of lipid peroxidation products in these muscles compared with the soleus muscles of hyperthyroid rats fed soya bean oil in our earlier study.

  13. Hipertireoidismo na gravidez: repercussões materno-fetais Hyperthyroidism during pregnancy: maternal-fetal outcomes

    Directory of Open Access Journals (Sweden)

    Amanda Tavares Pinheiro

    2008-09-01

    Full Text Available OBJETIVO: avaliar a experiência do Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", no acompanhamento de gestantes com hipertireoidismo. MÉTODOS: foram estudadas, retrospectivamente, 60 pacientes, divididas em grupos com hipertireoidismo compensado (GHC=24 e com hipertireoidismo descompensado (GHD=36 e comparadas quanto a características clínico-laboratoriais e intercorrências. Para análise dos resultados, foram utilizados o teste t de Student, as tabelas de contingência, regressão linear múltipla e regressão logística múltipla, com nível de significância de 5,0%. RESULTADOS: propiltiouracil (PTU foi usado por 94,0% do GHD e 42,0% do GHC (pPURPOSE: to evaluate the experience of Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", in the follow-up of pregnant women with hyperthyroidism. METHODS: Sixty patients, divided in groups with compensated hyperthyroidism (CHG=24 and with uncompensated hyperthyroidism (UHG=36 were retrospectively studied and compared concerning clinical-laboratorial characteristics and intercurrences. The t-Student test, contingency tables, multiple linear regression and multiple logistic regression with significance level at 5.0% were used. RESULTS: propylthiouracil (PTU was used by 94.0% of UHG and by 42.0% of CHG (p<0.0001; maternal complications close to delivery have occurred in 20.6% of UHG and in 11.8% of CHG, and UHG presented three fetal deaths, influenced by the mother age, higher level of T4L (lT4L and of PTU dose (PTUd in the third trimester (p=0.007; restriction of intra-uterine growth, influenced by lT4L and PTUd in the third trimester has occurred in nine UHG and in three CHG cases, and oligoamnios has occurred in 12 patients (83.3% of UGH and 16.7% of CGH, influenced by age and lT4L in the third trimester (p=0.04; the gestational age at delivery was 34.4

  14. [Two Cases of Germ Cell Tumors with Hyperthyroidism Due to High Serum hCGLevels].

    Science.gov (United States)

    Chihara, Ichiro; Nitta, Satoshi; Kimura, Tomokazu; Kandori, Shuya; Kawahara, Takashi; Waku, Natsui; Kojima, Takahiro; Joraku, Akira; Miyazaki, Jun; Iwasaki, Hitoshi; Suzuki, Hiroaki; Kawai, Koji; Nishiyama, Hiroyuki

    2016-09-01

    We reported two cases of hyperthyroidism that developed during induction chemotherapy for advanced germ cell tumors with high serum human chorionic gonadotropin (hCG) levels. Case 1 : An 18-year-old man with mediastinal choriocarcinoma complained of tachycardia and tremor. His pretreatment serum hCG level was 1.37 million mIU/ml. The free thyroxine (fT4) level measured on day 2 of the first course of bleomycin, etoposide and cisplatin (BEP) was elevated to 7.8 ng/dl (<1.7 ng/dl), whereasthe thyroidstimulating hormone (TSH) level was undetectable. We diagnosed the patient with hyperthyroidism and started oral propranolol and thiamazole. Subsequently, his tachycardia and tremor disappeared. On day 12 of the first course of BEP, his hCG level decreased to less than 50,000 mIU/ml. Also, his fT4 level returned to the normal range. Case 2 : A 29-year-old man presented with a left scrotal mass. He was diagnosed with non-seminoma testicular cancer (embryonal carcinoma and choriocarcinoma) with multiple lung, liver and lymph node metastases. On the admission day, his serum hCG and fT4 levels were high ; 3.23 million mIU/ml and 2.2 ng/dl, respectively. The TSH level was low at 0.011 mIU/ml. On day 3 of the first course of BEP, his hCG and fT4 levels increased to 4.5 million mIU/ml and 3.0 ng/dl, respectively. He complained of tachycardia, tremor and hyperhydrosis. He was started on propranolol and potassium iodide. After the treatment, histachycardia, tremor and hyperhidrosisdis appeared. HisfT4 level normalized on day 17 of the first course of BEP. The TSH-like activity of hCG is considered to be responsible for paraneoplastic hyperthyroidism among germ cell cancer patients with high hCG levels. To our knowledge, thisisthe first report of such a case in Japan. However, thisphenomenon isnot rare among patients with extremely high hCG levels. Therefore, we should be careful of these patients.

  15. Micronuclei induction by {sup 131}I exposure. Study in hyperthyroidism patients

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, S.; Carbonell, E.; Creus, A.; Marcos, R. [Grup de Mutagenesi, Departament de Genetica i de Microbiologia, Edifici Cn, Universitat Autonoma de Barcelona, Bellaterra (Spain); Galofre, P. [Servei de Medicina Nuclear, Ciutat Sanitaria i Universitaria Vall d`Hebron, Barcelona (Spain)

    1997-01-03

    To evaluate the eventual genetic damage induced by therapeutic exposure to {sup 131}I, we have studied the presence of micronuclei (MN) in binucleated peripheral blood lymphocytes from a group of 28 hyperthyroidism patients who received {sup 131}I sodium iodide, via oral administration. The study was conducted over time and blood samples were obtained before the treatment, and 1 week, 1 month and 3 months after it. The results obtained indicate a positive relationship between dose and BNMN frequency as calculated by the linear regression coefficient, showing significant increases in the frequency of MN and BNMN (binucleated cells with MN) in the subgroup of patients that received more than 500 MBq. Taking into account that the patients studied were treated with relatively low doses of {sup 131}I, our positive results support the view that the MN assay is sensitive enough to monitor the chromosome damage resulting from the exposure.

  16. Explore the Possibility of Early Clinical Diagnosis of Endocrine Ophthalmopathy Based on Eye Symptoms of Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    V. G. Likhvantseva

    2016-01-01

    Full Text Available Purpose: to study the possibility of early clinical diagnosis of endocrine ophthalmopathy based on ocular symptoms of hyperthyroidism. Patients and methods: we analyzed the prevalence of ocular symptoms of hyperthyroidism in 139 patients (278 orbits with newly diagnosed endocrine ophthalmopathy (group 1, developed on the background of diffuse toxic goiter. The comparison group consisted of 80 patients (160 orbits with newly diagnosed diffuse toxic goiter with no radiographic evidence of endocrine ophthalmopathy (group 2. All patients were examined by an ophthalmologist and endocrinologist. We analyzed the prevalence of ocular symptoms of hyperthyroidism (symptom Dalrymple’, Mobius’, Zenger’, and combinations thereof, often encountered in diffuse toxic goiter, flowing with endocrine ophthalmopathy, and/or lack thereof - in the group of “thyrotoxic exophthalmos”. We took into account the frequency distribution of these clinical signs, and their combinations. We analyzed the clinical sensitivity and specificity of diagnosis based on the three most common symptoms, and their combinations, associated both with thyrotoxicosis and with endocrine ophthalmopathy. Results: Dalrymple’ symptom, is more common in thyrotoxic exophthalmos than with endocrine ophthalmopathy (compared to 100.0% versus 61.9 %, p<0,001. This suggests that Dalrymple’ symptom leads to over diagnosis aspect endocrine ophthalmopathy. It is obvious that it can be used to recognize and thyrotoxic exophthalmos hyperthyroidism, but you cann’t credibly claim based on orbit about the presence of the disease. In this aspect, the greatest practical interest to provide a comparative assessment of the frequency of detection of symptoms of Mobius’ and Zenger’ and their combinations in a population of endocrine ophthalmopathy and in the group of thyrotoxic exophthalmos. Significantly more symptoms Zenger’ and Mobius’ developed with endocrine ophthalmopathy (66,2% and 81

  17. ANAESTHETIC MANAGEMENT OF PREGNANT PATIENT WITH UNCONTROLLED HYPERTHYROIDISM FOR EMERGENCY CAESARIAN SECTION

    Directory of Open Access Journals (Sweden)

    Bala Subramanya

    2014-09-01

    Full Text Available The anaesthetic management of patient with uncontrolled hyperthyroidism requiring emergency cesarean section is presented here. Elevated free T3 and T4 and severely suppressed TSH levels confirmed the diagnosis. Propyl thio uracil was started preoperatively. IV Metoprolol was used to control the pre-operative heart rate. After adequate preloading with crystalloids, spinal anaesthesia was administered. There were three episodes of hypotension and tachycardia which were successfully managed with small dose of IV Phenylephrine. Post-operative anaelgesia was administered through epidural catheter. Patient was observed in intensive care unit for congestive cardiac failure and thyroid storm. Anti-thyroid drugs, Propranolol and Dexamethasone were given in the post-operative period.

  18. A critical review of food-associated factors proposed in the etiology of feline hyperthyroidism.

    Science.gov (United States)

    van Hoek, Ingrid; Hesta, Myriam; Biourge, Vincent

    2015-10-01

    Since the first description of feline hyperthyroidism (HT) in 1979, several studies have been undertaken to define the etiology of the disease. Epidemiologic studies, after investigating non-food- and food-associated factors, suggest a multifactorial etiology. However, in the absence of prospective cohort studies that can confirm a cause-and-effect relationship between HT and associated risk factors, no causative factor for HT has been identified to date. Feline HT resembles toxic nodular goiter in humans, with autonomously functioning upregulated iodide uptake systems. Contribution of the diet to HT development remains controversial. The purpose of this paper is to review critically the reported food-associated risk factors for HT. © ISFM and AAFP 2014.

  19. Myopathy in hyperthyroidism as a consequence of rapid reduction of thyroid hormone: A case report.

    Science.gov (United States)

    Li, Qianrui; Liu, Yuping; Zhang, Qianying; Tian, Haoming; Li, Jianwei; Li, Sheyu

    2017-07-01

    Myalgia and elevated creatine kinase (CK) are occasionally observed during the treatment of hyperthyroid patients. Relative hypothyroidism resulted from rapid thyroid hormone reduction had been promoted as a plausible cause of these myopathic changes, however rarely reported. We hereby presented a 20-year-old female with Grave's disease, who developed myopathy and elevated CK during rapid correction of thyroid hormone. Relative hypothyroidism-induced myopathy. Antithyroid drug (ATD) dosage was reduced without levothyroxine replacement. The muscular symptoms were recovered with CK level returned to normal after adoption of the euthyroid status. Differentiation of relative hypothyroidism from other causes of myopathy, especially with the effect of ATD, is important for clinical practice, although difficult in many cases.

  20. 甲亢患者的内科治疗配合舆护理%Medical Therapy's Cooperation and Nursing of Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    李柳芳; 陈彦茹; 戈兰; 陈琳玲

    2002-01-01

    To retrospect 46 cases of treating and nursing hyperthyroidism to sum up key point of therapy' s cooperation and nursing.The results suggests that strengthen the attention to antithyrotropic drugs. Psychological nursing and health education contribute to convalesce.

  1. Paroxysmal atrial fibrillation during acute myocardial infarction associated with subclinical hyperthyroidism, severe three vessels coronary artery disease and elevation of prostate-specific antigen after TURP.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-01-21

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Paroxysmal atrial fibrillation is a frequent complication of acute myocardial infarction. It has been reported that subclinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but it is sufficient to induce an increase in atrial fibrillation rate and increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has also been reported that serum prostate-specific antigen (PSA) decreases drastically in patients who undergo transurethral resection of the prostate(TURP). We present a case of paroxysmal atrial fibrillation during acute myocardial infarction associated with subclinical hyperthyroidism, severe three vessels coronary artery disease and elevation of PSA after TURP in a 78-year-old Italian man.

  2. Thyrotropin receptor antibody activities significantly correlate with the outcome of radioiodine ( sup 131 I) therapy for hyperthyroid Graves' disease

    Energy Technology Data Exchange (ETDEWEB)

    Kaise, Kazuro; Kaise, Nobuko; Yoshida, Katsumi; Fukazawa, Hiroshi; Mori, Koki; Yamamoto, Makiko; Sakurada, Toshiro; Saito, Shintaro; Yoshinaga, Kaoru (Tohoku Univ., Sendai (Japan). School of Medicine)

    1991-08-01

    The outcome of {sup 131}I therapy for 109 patients with Graves' disease was analysed according to pretreatment laboratory data including thyrotropin receptor antibody (TRAb) activities. Forty-five percent of patients became euthyroid, and 13% of patients became hypothyroid within one year after {sup 131}I therapy. Forty-two percent of patients remained hyperthyroid one year after {sup 131}I therapy. Pretreatment values for serum T{sub 4}, T{sub 3}, and the estimated weight of the thyroid were significantly higher in the hyperthyroid group. The mean for the TRAb index of the hyperthyroid group was significantly higher than that of the euthyroid group. Life table analysis revealed a significant effect of the TRAb index on the rate of hyperthyroidism after 3 months or later. These results appear to suggest that the TRAb index is one of the factors which influence the outcome of {sup 131}I therapy for Graves' disease. (author).

  3. Delusional parasitosis with hyperthyroidism in an elderly woman: a case report.

    Science.gov (United States)

    Ozten, Eylem; Tufan, Ali Evren; Cerit, Cem; Sayar, Gökben Hızlı; Ulubil, Irem Yalug

    2013-01-10

    Delusional parasitosis is a rare, monosymptomatic psychosis involving a delusion of being infested with parasites. It is commonly observed among female patients over the age of 50. It is classified as a 'delusional disorder' according to the 10th revision of the International Classification of Diseases and as a 'delusional disorder - somatic type' according to the Diagnostic and Statistical Manual, Fourth Edition. Delusional parasitosis was reported to be associated with physical disorders such as hypoparathyroidism, Huntington's chorea and Alzheimer's disease, among others. Other than vitamin deficiencies however, a causal relationship has not to date been identified. We present this case due to the rarity of Turkish patients with this condition, its duration of follow-up, and its temporal pattern of symptoms paralleling thyroid function tests. Our patient was a 70-year-old white Anatolian Turkish woman with primary school education who had been living alone for the past five years. She presented to our psychiatry department complaining of 'feeling large worms moving in her body'. The complaints started after she was diagnosed with hyperthyroidism, increased when she did not use her thyroid medications and remitted when she was compliant with treatment. She was treated with pimozide 2mg/day for 20 months and followed-up without any antipsychotic treatment for an additional nine months. At her last examination, she was euthyroid, not receiving antipsychotics and was not having any delusions. Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the etiology and that atypical antipsychotics may help in the management of primary delusional

  4. Treatment of hyperthyroidism with radioiodine targeted activity: A comparison between two dosimetric methods.

    Science.gov (United States)

    Amato, Ernesto; Campennì, Alfredo; Leotta, Salvatore; Ruggeri, Rosaria M; Baldari, Sergio

    2016-06-01

    Radioiodine therapy is an effective and safe treatment of hyperthyroidism due to Graves' disease, toxic adenoma, toxic multinodular goiter. We compared the outcomes of a traditional calculation method based on an analytical fit of the uptake curve and subsequent dose calculation with the MIRD approach, and an alternative computation approach based on a formulation implemented in a public-access website, searching for the best timing of radioiodine uptake measurements in pre-therapeutic dosimetry. We report about sixty-nine hyperthyroid patients that were treated after performing a pre-therapeutic dosimetry calculated by fitting a six-point uptake curve (3-168h). In order to evaluate the results of the radioiodine treatment, patients were followed up to sixty-four months after treatment (mean 47.4±16.9). Patient dosimetry was then retrospectively recalculated with the two above-mentioned methods. Several time schedules for uptake measurements were considered, with different timings and total number of points. Early time schedules, sampling uptake up to 48h, do not allow to set-up an accurate treatment plan, while schedules including the measurement at one week give significantly better results. The analytical fit procedure applied to the three-point time schedule 3(6)-24-168h gave results significantly more accurate than the website approach exploiting either the same schedule, or the single measurement at 168h. Consequently, the best strategy among the ones considered is to sample the uptake at 3(6)-24-168h, and carry out an analytical fit of the curve, while extra measurements at 48 and 72h lead only marginal improvements in the accuracy of therapeutic activity determination.

  5. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Bartalena, L.; Marcocci, C.; Bogazzi, F.; Panicucci, M.; Lepri, A.; Pinchera, A. (Univ. of Pisa (Italy))

    1989-11-16

    We studied the effects of radioiodine treatment of hyperthyroidism due to Graves' disease on Graves' ophthalmopathy and the possible protective role of corticosteroids. Between June 1985 and June 1988, 26 patients were randomly assigned to treatment with radioiodine alone (group 1) and 26 to treatment with this agent and concomitant administration of systemic prednisone for four months (group 2). The initial dose of prednisone was 0.4 to 0.5 mg per kilogram of body weight for one month; the drug was gradually withdrawn over the next three months. All patients were evaluated at 3-month intervals for 18 months after they underwent radioiodine therapy. Ocular changes were assessed with the ophthalmopathy index; patients with moderate-to-severe changes (scores greater than or equal to 4) were excluded from the study. Before treatment, 10 patients in group 1 and 5 in group 2 had no evidence of ophthalmopathy: in none of them did ocular symptoms appear after radioiodine therapy. Among the patients in group 1 with an initial ophthalmopathy index greater than or equal to 1, ocular disease worsened in 56 percent (mostly involving soft-tissue changes and extraocular-muscle function) and did not change in 44 percent. In contrast, ophthalmopathy improved in 52 percent and did not change in 48 percent of group 2. The mean ophthalmopathy index increased from 1.5 to 3.0 in group 1 (P less than 0.005) and decreased from 2.2 to 1.3 in group 2 (P less than 0.05). We conclude that systemic corticosteroid treatment prevents the exacerbations of Graves' ophthalmopathy that occur after radioiodine therapy in a substantial proportion of patients with hyperthyroidism who have some degree of ocular involvement before treatment.

  6. Hipertiroidismo neonatal: presentación de 2 pacientes Neonatal hyperthyroidism: Report of 2 cases

    Directory of Open Access Journals (Sweden)

    Pedro González Fernández

    2002-08-01

    Full Text Available Se presentaron 2 pacientes con diagnóstico de hipertiroidismo neonatal: uno del sexo masculino y otro del femenino; con antecedentes de ser hijos de madres con enfermedad de Graves; una de ellas se encontraba sin tratamiento, y con síntomas de hipertiroidismo y la otra con tratamiento y tenía controlada esa afección. Se realizó el diagnóstico por los antecedentes de ser hijos de madres con enfermedad de Graves Basedow; así como por las manifestaciones clínicas: bocio, exoftalmos, pérdida de peso, irritabilidad, taquicardia e insuficiencia cardíaca en uno de los pacientes. Según los exámenes de laboratorio realizados, se obtuvieron los resultados siguientes: T4 ³ 180 nmol/L y TSH 2 patients with diagnosis of neonatal hyperthyroidism, a male and a female, are presented. Their mothers suffer from Graves’ disease, one of them has no treatment and presents symptoms of hyperthyroidism, and the other is under treatment and her disease is under control. The diagnosis was made taking into account that they are children from mothers with Graves Basedow’ disease and the following clinical manifestations: goiter, exophthalmos, weight loss, irritability, tachycardia and cardiac insufficiency in one of the patients. The results of the laboratory tests for both patients were: T4 ³ l80 nmol/L and TSH < 1 U/L. Treatment with propylthiouracilo, propanolol and phenobarbital as well as general measures and digitalis therapy in the patient requiring it were indicated. A favorable evolution was observed in these 2 patients.

  7. An FSH and TSH pituitary adenoma, presenting with precocious puberty and central hyperthyroidism.

    Science.gov (United States)

    Vargas, Guadalupe; Balcazar-Hernandez, Lourdes-Josefina; Melgar, Virgilio; Magriña-Mercado, Roser-Montserrat; Gonzalez, Baldomero; Baquera, Javier; Mercado, Moisés

    2017-01-01

    A 19-year-old woman with a history of isosexual precocious puberty and bilateral oophorectomy at age 10 years because of giant ovarian cysts, presents with headaches and mild symptoms and signs of hyperthyroidism. Hormonal evaluation revealed elevated FSH and LH levels in the postmenopausal range and free hyperthyroxinemia with an inappropriately normal TSH. Pituitary MRI showed a 2-cm macroadenoma with suprasellar extension. She underwent successful surgical resection of the pituitary tumor, which proved to be composed of two distinct populations of cells, each of them strongly immunoreactive for FSH and TSH, respectively. This mixed adenoma resulted in two different hormonal hypersecretion syndromes: the first one during childhood and consisting of central precocious puberty and ovarian hyperstimulation due to the excessive secretion of biologically active FSH and which was not investigated in detail and 10 years later, central hyperthyroidism due to inappropriate secretion of biologically active TSH. Although infrequent, two cases of isosexual central precocious puberty in girls due to biologically active FSH secreted by a pituitary adenoma have been previously reported in the literature. However, this is the first reported case of a mixed adenoma capable of secreting both, biologically active FSH and TSH. Although functioning gonadotrophinomas are infrequent, they should be included in the differential diagnosis of isosexual central precocious puberty.Some functioning gonadotrophinomas are mixed adenomas, secreting other biologically active hormones besides FSH, such as TSH.Early recognition and appropriate treatment of these tumors by transsphenoidal surgery is crucial in order to avoid unnecessary therapeutic interventions that may irreversibly compromise gonadal function.

  8. A Study to Assess the Validity of Estimation of Serum Ostase Level in Hyperthyroid and Hypothyroid Cases

    Science.gov (United States)

    Boruah, Polina; Hajong, Ranendra; Nath, Chandan Kumar; Barman, Bhupen; Chutia, Happy; Sarma, Kalyan

    2016-01-01

    Introduction One of the more specific assessments of the metabolic status of bone in normal and in disease conditions is the measurement of bone specific alkaline phosphatase or ostase. The measurement of serum ostase has several advantages over the measurements of other bone parameter. Because of its relatively long half-life, in-vivo (1 to 3days), it is relatively unaffected by diurnal variation. Aim To find the correlation of serum ostase level in hyper and hypothyroid cases and also to study the validity of routine estimation of serum ostase in hyper and hypothyroid cases so as to monitor the base level bone health on presentation. Materials and Methods Serum ostase level was studied in 74 patients with disorder of thyroid function. Serum ostase level, Thyroid Stimulating Hormone (TSH), FT3, FT4 levels were estimated by chemiluminescent technique. The instrument used was Beckman- coulter Access 2. A total of 39 patients were hypothyroid, 31 were hyperthyroid and 4 patients had subclinical hyperthyroidism. Results The serum ostase level was found to be elevated above 40 μg/L in 26 of the cases and above 16 μg/L but below 40μg/L in 5 cases of hyperthyroidism along with decrease in Bone Mineral Density (BMD). Serum ostase level was found to be directly proportional to the serum FT3 level (Normal range of serum ostase is 8-16 μg/L). Conclusion From this study, an inference can be drawn that a routine estimation of serum ostase level in hyperthyroid cases will help in proper monitoring of decrease bone turnover as indicated by increase serum ostase level. Besides, the estimation of serum ostase level in hyperthyroid cases it is found to be valid in this study, which can turn to be an important guiding parameter to the treating physician to formulate necessary protocols and guidelines for prophylaxis, treatment and to monitor the response to therapy in cases of reduced bone turnover related to hyperthyroid state. PMID:27790421

  9. Comparison of high-sensitivity C-reactive protein and fetuin-A levels before and after treatment for subjects with subclinical hyperthyroidism.

    Science.gov (United States)

    Bilgir, Oktay; Bilgir, Ferda; Topcuoglu, Tuba; Calan, Mehmet; Calan, Ozlem

    2014-03-01

    This study was designed to show the effect of propylthiouracil treatment on sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels on subjects with subclinical hyperthyroidism. After checking sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels of 35 patients with subclinical hyperthyroidism, each was given 50 mg tablets of propylthiouracil three times daily. After 3 months, sCD40L, high-sensitivity C-reactive protein, and fetuin-A levels were then compared to the levels before treatment. Although high-sensitivity C-reactive protein and sCD40L levels were normal in the subclinical hyperthyroidism patients compared to the healthy controls, fetuin-A levels were statistically significantly higher (*p = 0.022). After treatment, fetuin-A levels of subclinical hyperthyroidism patients decreased statistically significantly compared to the levels before treatment (**p = 0.026). sCD40L and high-sensitivity C-reactive protein levels did not have a statistically significant difference compared to the control group and post-propylthiouracil treatment. In subclinical hyperthyroidism patients, high fetuin-A levels before propylthiouracil treatment and decreases in these levels after treatment in cases with subclinical hyperthyroidism indicated the possibility of preventing long-term cardiac complications with propylthiouracil treatment.

  10. Treatment Experience of One Case of Pregnancy with Hyperthyroidism Crisis%妊娠合并甲亢危象1例救治体会

    Institute of Scientific and Technical Information of China (English)

    张林; 姬淑英

    2015-01-01

    妊娠合并甲亢危象是一种致死率高、治疗困难的重症疾病,未治疗的甲亢孕妇其早产、流产、致畸及新生儿低体质量和新生儿病死率均显著增加。妊娠合并甲亢危象的发生率不高,但分娩、手术、感染等诱因可致甲亢危象,使孕妇死亡率急剧上升。因此,妊娠合并甲亢时应尽可能将甲亢控制良好以改善母体及胎儿的预后。%Pregnancy with hyperthyroidism crisis is normally lethal and difficult to treat.Premature birth,abortion,birth defects,neonatal low body mass and fetus mortality are increased significantly in pregnancy women with untreated hyperthyroidism.The incidence of pregnancy with hyperthyroidism crisis is not high,but the hyperthyroidism crisis can be caused by childbirth,surgery and infection,it makes the pregnant women mortality rate rising sharply.It is vital for pregnant women with hyperthyroidism to well control the hyperthyroidism,so as to improve the outcomes of mothers and fetus.

  11. Clinical Glargine Joint Compound Hyperthyroidism Tablet to Treat Diabetes With Hyperthyroidism%甘精胰岛素联合复方甲亢片治疗糖尿病伴甲亢的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨永杰

    2015-01-01

    Objective Joint analysis glargine Fufangjiakang tablets to treat diabetes with hyperthyroidism clinical results. MethodsRetrospective analysis of December 2012 December -2014 hospital 89 cases of diabetic patients with hyperthyroidism data, divided into two groups according to the different treatment options, the control group of 43 regular routine treatment, research group of 46 routine glargine and Fufangjiakang tablets treatment, blood sugar and complications were observed.ResultsResearch on blood glucose levels were significantly lower than the control group, and the complication rate 6.5% 27.9% lower than the control group, the difference was statistically signiifcant (P<0.05).Conclusion Glargine and compound hyperthyroidism tablet to treat diabetes with hyperthyroidism effect is signiifcant.%目的:分析甘精胰岛素联合复方甲亢片治疗糖尿病伴甲亢的临床效果。方法回顾分析2012年12月~2014年12月本院89例糖尿病伴甲亢患者资料,按不同治疗方案分为两组,对照组43例行常规治疗,研究组46例行甘精胰岛素与复方甲亢片治疗,观察两组血糖及并发症。结果研究组血糖水平均低于对照组,且并发症发生率(6.5%)低于对照组(27.9%),差异具统计学意义(P<0.05)。结论甘精胰岛素与复方甲亢片治疗糖尿病伴甲亢的效果显著。

  12. The role of nuclear medicine in diagnosis and treatment of feline hyperthyroidism; Nuklearmedizinische Diagnostik und Therapie der felinen Hyperthyreose

    Energy Technology Data Exchange (ETDEWEB)

    Puille, Max; Puille, N. [MVZ fuer Diagnostik und Therapie, Regensburg (Germany)

    2010-03-15

    Feline hyperthyroidism is the most common endocrinological disorder of older cats. Diagnosis is established by assessment of thyroid stimulating hormone (TSH) and free thyroxine (FT4). In hyperthyroidism FT4 is found up to ten times above the normal range. Thyroid scintigraphy using {sup 99m}Tc-pertechnetate shows goiter size, which can reach more than 20 ml, and differentiates between unifocal and multifocal thyroid adenoma. In rare cases, ectopic tracer accumulation may be found, suggesting thyroid carcinoma. Radioiodine is the safest, simplest and most effective treatment for benign thyroid disease in the cat. Normal thyroid function is usually established within two weeks. Practical and legal radiation protection rules are strictly to be observed. Even so, the rapid elimination of {sup 131}I usually allows patient discharge within one week. Internal and external radiation risks are very low for clinic staff and cat owners. (orig.)

  13. Traditional Chinese and Western Medicine Treatment of Hyperthyroidism Crisis%甲亢危象的中西医治疗

    Institute of Scientific and Technical Information of China (English)

    卢虹

    2013-01-01

    This paper summarizes the etiology,pathogenesis,diagnosis,treatment of traditional Chinese and Western medicine methods of hyperthyroidism crisis and hyperthyroidism crisis with neutropenia or agranulocytosis.A case of the portent with agranulocytosis was reported and analysed,so as to provide reference for the clinical treatment.%文章总结了甲亢危象及甲亢危象合并粒细胞减少或缺乏的病因、发病机制、诊断、中西医治疗方法.并报道分析了甲亢危象先兆合并粒细胞缺乏临床病案一例,为临床治疗提供借鉴.

  14. Pharmacotherapy in Hyperthyroidism%甲状腺功能亢进症的药物治疗

    Institute of Scientific and Technical Information of China (English)

    王淑琴

    2013-01-01

      甲状腺功能亢进症是临床上常见的以代谢亢进为主要特点的内分泌疾病,本文通过对该病的病因和发病机制、临床症状、本病及其眼病的治疗方案进行阐述,旨在对甲状腺功能亢进症有更深的了解,为临床治疗和研究提供新的思路。%Hyperthyroidism is a common endocrine disease with hypermetabolism as the main characteristics in clinic. This paper expounds the cause, pathogenesis, clinical symptom, treatment for this disease and exophthalmos, and is aimed at hyperthyroidism to have a deeper understanding, provides new ideas to clinic treatment and research.

  15. The Effect of Maternal Thyroid Disorders (Hypothyroidism and Hyperthyroidism During Pregnancy and Lactation on Skin Development in Wistar Rat Newborns

    Directory of Open Access Journals (Sweden)

    Maryam Amerion

    2013-05-01

    Full Text Available   Objective(s: Previous studies have shown that thyroid hormones are necessary for normal development of many organs and because of the importance of skin as the largest and the most important organ in human body protection in spite of external environment, the study of thyroid hormones effects on skin development is considerable. In this survey we have tried to study the effects of maternal hypothyroidism on skin development in fetus during pregnancy and lactation by immunohistochemistry technique.   Materials and Methods: Rats were divided into 4 groups, hypothyroids, hyperthyroids, hypothyroids are treated with levothyroxin and a control group. The rat mothers were exposed to PTU with 50 mg/lit dosage and levothyroxin with 1 mg/lit dosage and PTU and levothyroxin simultaneously and with the same dosage respectively in hypothyroid, hyperthyroid and treated hypothyroids with levothyroxin groups. After 14 days, blood sample was taken from mothers, and if thyroid hormones level had change well, mating was allowed. After pregnancy and delivery, 1th day dorsal skin (as the sample for pregnancy assay and 10th day skin (as for lactation assay was used for immunohystochemical and morphometric studies. Results: In this study it was observed that maternal hypothyroidism during pregnancy and lactation causes significant increase in laminin expression, in most areas of skin, and maternal hyperthyroidism during pregnancy and lactation causes significant decrease in laminin expression. Also significant decrease was observed in hair follicles number and epidermis thickness in hypothyroidism groups. Conclusion: This study showed maternal hypothyroidism causes significant decrease in epidermis thickness and hair follicles number and it causes less hair in fetus. Also maternal hypothyroidism causes large changes in laminin expression in different parts of skin. At the same time,maternal hyperthyroidism causes opposite results. In fact, thyroid hormones

  16. Endogenous subclinical hyperthyroidism affects quality of life and cardiac morphology and function in young and middle-aged patients.

    Science.gov (United States)

    Biondi, B; Palmieri, E A; Fazio, S; Cosco, C; Nocera, M; Saccà, L; Filetti, S; Lombardi, G; Perticone, F

    2000-12-01

    To determine the clinical impact of endogenous subclinical hyperthyroidism, specific symptoms and signs of thyroid hormone excess and quality of life were assessed in 23 patients (3 males and 20 females; mean age, 43 +/- 9 yr) and 23 age-, sex-, and lifestyle-matched normal subjects by using the Symptoms Rating Scale and the Short Form 36 Health Survey questionnaires. Because the heart is one of the main target organs of the thyroid hormone, cardiac morphology and function were also investigated by means of standard 12-lead electrocardiogram (ECG), 24-h Holter ECG, and complete Doppler echocardiography. Stable endogenous subclinical hyperthyroidism had been diagnosed in all patients at least 6 months before the study (TSH, 0.15 +/- 0.1 mU/L; free T(3), 6.9 +/- 1.1, pmol/L; free T(4), 17.2 +/- 2.3, pmol/L). Fifteen patients were affected by multinodular goiter, and eight patients by autonomously functioning thyroid nodule. The mean Symptoms Rating Scale score (9. 8 +/- 5.5 vs. 4.3 +/- 2.2, P: affects cardiac morphology and function. Moreover, they suggest that treatment of persistent endogenous subclinical hyperthyroidism should be considered also in young and middle-aged patients to attenuate specific symptoms and signs of thyroid hormone excess, ameliorate the quality of life, and avoid the consequences to the heart of long exposure to a mild excess of thyroid hormone.

  17. ANCA Associated Vasculitis and Renal Failure Related to Propylthiouracil and Hyperthyroidism Induced Cholestasis in the Same Case

    Directory of Open Access Journals (Sweden)

    Mehmet Tuncay

    2014-01-01

    Full Text Available Introduction. Liver involvement due to hyperthyroidism and also ANCA positive vasculitis related renal failure cases were reported separately several times before. However, to our knowledge, these two complications together in the same case had never been observed before. Case Presentation. The case of an ANCA positive 71-year-old Caucasian male with renal failure and lung involvement, subclinical hyperthyroidism, and intrahepatic cholestatic jaundice was presented in this paper. After exclusion of all of the other possibilities, cholestatic hepatitis was explained by subclinical hyperthyroidism; renal failure and lung involvement were interpreted as ANCA related vasculitis which might be a side effect of propylthiouracil use. Conclusion. The coexistence of these rare conditions in the same patient deserves emphasis and it is worth reporting. This case demonstrates that following the clinical course of the patient is essential after prescribing any medications to see whether any complication occurs or not. If the complications of this case were noticed earlier, it would be possible to treat and to prevent the permanent damages.

  18. Radioiodine treatment of feline hyperthyroidism in Germany; Radioiodtherapie bei Katzen mit Hyperthyreose in Deutschland

    Energy Technology Data Exchange (ETDEWEB)

    Puille, M.; Bauer, R. [Klinik fuer Nuklearmedizin der Justus-Liebig-Univ. Giessen (Germany); Knietsch, M.; Spillmann, T.; Gruenbaum, E.G. [Medizinische und Gerichtliche Veterinaerklinik I, Innere Krankheiten der Kleintiere der Justus-Liebig-Univ. Giessen (Germany)

    2002-12-01

    Aim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with {sup 131}I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German ''Strahlenschutzverordnung''. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT{sub 3} and FT{sub 4} were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 {+-} 10%, effective halflife 2.5 {+-} 0.7 days. Whole body activity <1 MBq was reached 13 {+-} 4 days after application of {sup 131}I. Radiation exposure of cat owners was estimated as 1.97 {mu}Sv/MBq for adults. Conclusion: Radioiodine therapy of feline hyperthyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are highly desirable. (orig.) [German] Ziel: Etablierung der Radioiodtherapie als veterinaermedizinische Routinetherapie der felinen Hyperthyreose in Uebereinstimmung mit der deutschen Strahlenschutzverordnung. Patienten und Methoden: 35 Katzen mit gesicherter Hyperthyreose wurden in einen Kontrollbereich stationaer mit Iod-131 behandelt. Uptake und effektive Halbwertszeit wurden mittels Kameradosimetrie ermittelt. Der Behandlungserfolg wurde labor-chemisch geprueft. Die Entlassung

  19. Delusional parasitosis with hyperthyroidism in an elderly woman: a case report

    Directory of Open Access Journals (Sweden)

    Ozten Eylem

    2013-01-01

    Full Text Available Abstract Introduction Delusional parasitosis is a rare, monosymptomatic psychosis involving a delusion of being infested with parasites. It is commonly observed among female patients over the age of 50. It is classified as a ‘delusional disorder’ according to the 10th revision of the International Classification of Diseases and as a ‘delusional disorder - somatic type’ according to the Diagnostic and Statistical Manual, Fourth Edition. Delusional parasitosis was reported to be associated with physical disorders such as hypoparathyroidism, Huntington’s chorea and Alzheimer’s disease, among others. Other than vitamin deficiencies however, a causal relationship has not to date been identified. We present this case due to the rarity of Turkish patients with this condition, its duration of follow-up, and its temporal pattern of symptoms paralleling thyroid function tests. Case presentation Our patient was a 70-year-old white Anatolian Turkish woman with primary school education who had been living alone for the past five years. She presented to our psychiatry department complaining of ‘feeling large worms moving in her body’. The complaints started after she was diagnosed with hyperthyroidism, increased when she did not use her thyroid medications and remitted when she was compliant with treatment. She was treated with pimozide 2mg/day for 20 months and followed-up without any antipsychotic treatment for an additional nine months. At her last examination, she was euthyroid, not receiving antipsychotics and was not having any delusions. Conclusion Although endocrine disorders, including hyperthyroidism, are listed among the etiological factors contributing to secondary delusional parasitosis, as far as we are aware this is the first case demonstrating a temporal pattern of thyroid hyperfunction and delusions through a protracted period of follow-up. It may be that the treatment of delusional parasitosis depends on clarifying the

  20. Radiation exposure of the families of outpatients treated with radioiodine (iodine-131) for hyperthyroidism.

    Science.gov (United States)

    Barrington, S F; O'Doherty, M J; Kettle, A G; Thomson, W H; Mountford, P J; Burrell, D N; Farrell, R J; Batchelor, S; Seed, P; Harding, L K

    1999-07-01

    Patients who receive radioiodine (iodine-131) treatment for hyperthyroidism (195-800 MBq) emit radiation and represent a potential hazard to other individuals. Critical groups amongst the public are fellow travellers on the patient's journey home from hospital and members of the patient's family, particularly young children. The dose which members of the public are allowed to receive as a result of a patient's treatment has been reduced in Europe following recently revised recommendations from ICRP. The annual public dose limit is 1 mSv, though adult members of the patient's family are allowed to receive higher doses, with the proviso that a limit of 5 mSv should not be exceeded over 5 years. Unless the doses received during out-patient administration of radioiodine can be demonstrated to comply with these new limits, hospitalisation of patients will be necessary. The radiation doses received by family members (35 adults and 87 children) of patients treated with radioiodine at five UK hospitals were measured using thermoluminescent dosimeters mounted in wrist bands. Families were given advice (according to current practice) from their treatment centre about limiting close contact with the patient for a period of time after treatment. Doses measured over 3-6 weeks were adjusted to give an estimate of values which might have been expected if the dosimeters had been worn indefinitely. Thirty-five passengers accompanying patients home after treatment also recorded the dose received during the journey using electronic (digital) personal dosimeters. For the "adjusted" doses to infinity, 97% of adults complied with a 5-mSv dose limit (range:0.2-5.8 mSv) and 89% of children with a 1-mSv limit (range: 0.2-7.2 mSv). However 6 of 17 children aged 3 years or less had an adjusted dose which exceeded this 1 mSv limit. The dose received by adults during travel was small in comparison with the total dose received. The median travel dose was 0.03 mSv for 1 h travel (range: 2 micro

  1. Hyperthyroid heart disease%甲状腺功能亢进性心脏病

    Institute of Scientific and Technical Information of China (English)

    张遵城

    2009-01-01

    Hyperthyroid heart disease is a series of signs and symptoms of cardiovascular system resuiting from metabolic disorder,which caused by the direct or indirect toxic actions of excessive thyroid hormones.Its pathogenesis is associated with age of patient,coulee of disease,regular therapy or not,hypopotas-saemia,infection,pregnancy and SO on.There is no unified diagnostic standard at present.Heart dilatation,ar-rhythmia and/or heart failure are thought necessary signs and symptoms.But in order to decrease misdiagnosis and missed diagnosis,we should exclude heart diseases caused by other reasons.The majority of hyperthymid heart disease are often curative or improved companied by the controll of hyperthyroidism,although some patients will hold it all the time,even become permanent sequelae.%甲状腺功能亢进(甲亢)性心脏病是由于甲亢时过量的甲状腺激素对心脏的直接毒性作用或间接影响而引起的一系列心血管系统症状和体征的一种内分泌代谢紊乱性心脏病.它的发生与患者的年龄、病程、治疗是否规范、低钾、感染和妊娠等因素有关.甲亢性心脏病目前尚无统一的诊断标准,一般认为,甲亢伴心律失常、心脏扩大、心力衰竭常为其必备症状和体征,但需除外其他原因引起的心脏疾患,以减少误诊和漏诊.而且多数甲亢性心脏病可随甲亢的治愈或有效控制而治愈或好转,但也町继续存在,甚全成为永久性后遗症.

  2. Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, M.B.; Maloof, F.; Monson, R.R.; Aschengrau, A.; Cooper, D.S.; Ridgway, E.C.

    1988-05-01

    A follow-up study of 1762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6).

  3. The atrial natriuretic peptide- and catecholamine-induced lipolysis and expression of related genes in adipose tissue in hypothyroid and hyperthyroid patients.

    Science.gov (United States)

    Polak, J; Moro, C; Klimcakova, E; Kovacikova, M; Bajzova, M; Vitkova, M; Kovacova, Z; Sotornik, R; Berlan, M; Viguerie, N; Langin, D; Stich, V

    2007-07-01

    Thyroid dysfunction is associated with several abnormalities in intermediary metabolism, including impairment of lipolytic response to catecholamines in subcutaneous abdominal adipose tissue (SCAAT). Atrial natriuretic peptide (ANP) is a powerful lipolytic peptide; however, the role of ANP-mediated lipolysis in thyroid disease has not been elucidated. The aim of this study was to investigate the role of thyroid hormones in the regulation of ANP-induced lipolysis as well as in the gene expression of hormone-sensitive lipase, phosphodiesterase 3B (PDE3B), uncoupling protein-2 (UCP2), natriuretic peptide receptor type A, and beta(2)-adrenergic receptor in SCAAT of hyperthyroid and hypothyroid patients. Gene expression in SCAAT was studied in 13 hypothyroid and 11 hyperthyroid age-matched women before and 2-4 mo after the normalization of their thyroid status. A microdialysis study was performed on a subset of nine hyperthyroid and 10 hypothyroid subjects. ANP- and isoprenaline-induced lipolyses were higher in hyperthyroid subjects, with no differences between the groups following treatment. Hormone-sensitive lipase gene expression was higher in hyperthyroid compared with hypothyroid subjects before treatment, whereas no difference was observed following treatment. No differences in gene expression of other genes were observed between the two groups. Following treatment, the gene expression of UCP2 decreased in hyperthyroid, whereas the expression of PDE3B decreased in hypothyroid subjects. We conclude that thyroid hormones regulate ANP- and isoprenaline-mediated lipolysis in human SCAAT in vivo. Increased lipolytic subcutaneous adipose tissue response in hyperthyroid patients may involve postreceptor signaling mechanisms.

  4. 甲亢合并糖尿病临床治疗体会%Clinical treatment experience of hyperthyroidism combined with diabetes

    Institute of Scientific and Technical Information of China (English)

    孙宝华

    2015-01-01

    目的:分析甲亢合并糖尿病的临床治疗方法和效果.方法:收治甲亢合并糖尿病患者118例,首先治疗患者的甲亢症状,待甲亢有效缓解后进行降糖治疗,对治疗效果进行观察.结果:经过治疗后,所有患者甲亢症状都得到了有效的控制,同时糖代谢功能都得到了有效的改善,治疗总有效率94.9%.结论:对甲亢合并糖尿病患者治疗时首先要控制甲亢症状,同时降低降糖药物的使用剂量,避免因为药量过大而出现低血糖的症状.%Objective:To analyze the clinical treatment method and effect of hyperthyroidism combined with diabetes.Methods:118 patients with hyperthyroidism combined with diabetes were selected.We first treated the hyperthyroidism symptoms of patients.After the effective remission of the hyperthyroidism,they were given hypoglycemic treatment.The treatment effect was observed.Results:After treatment,the hyperthyroidism symptoms of all patients had been effective control,and the sugar metabolism function had been effectively improved.The treatment total effective rate was 94.9%.Conclusion:In the treatment of patients with hyperthyroidism combined with diabetes,it should firstly control the hyperthyroidism symptoms,and reduce the dosage of hypoglycemic drugs to avoid the hypoglycemia symptoms caused by the excessive amount of drug.

  5. 133例甲亢患者心电图分析%Electrocardiogram analysis of 133 hyperthyroidism patients

    Institute of Scientific and Technical Information of China (English)

    乔洁; 李敬涛; 曲桂一

    2015-01-01

    Objective To investigate the electrocardiogram expression of hyperthyroidism patient. Methods A total of 133 hyperthyroidism patients were taken as hyperthyroidism group (group A), and another 133 healthy people with matched gender and age were taken as normal control group (group B). Analysis and comparison were made on the electrocardiogram data of the two groups. Results There were 111 cases (83.46%)with abnormal change of electrocardiogram in the group A, and 39 cases (29.32%) with abnormal change of electrocardiogram in the group B. The difference had statistical significance (P<0.05). The changes of electrocardiogram in hyperthyroidism patients mainly included nodal tachycardia, atrial premature beats, ST-T change, and auricular fibrillation. Conclusion Incidence of abnormal electrocardiogram is high in hyperthyroidism patient, and it is mainly showed as nodal tachycardia, atrial premature beats, ST-T change, and auricular fibrillation.%目的:探讨甲状腺功能亢进(甲亢)患者的心电图表现。方法133例甲亢患者作为甲亢组(A组),133例性别、年龄匹配的健康体检者作为正常对照组(B组),对两组心电图资料进行分析对比。结果 A组心电图异常改变111例(83.46%), B组心电图异常改变为39例(29.32%),差异有统计学意义(P<0.05)。甲亢患者心电图改变以窦性心动过速(窦速),房性早搏(房早), ST-T改变,心房颤动(房颤)为主。结论甲亢患者心电图异常发生率较高,多表现为窦速、房早、ST-T改变、房颤。

  6. Lipid profile and levels of homocysteine, leptin, fibrinogen and C-reactive protein in hyperthyroid patients before and after treatment

    Directory of Open Access Journals (Sweden)

    Emine Sütken

    2010-03-01

    Full Text Available Objectives: The present study was carried out to determine whether thyroid hormones affect lipid profile and levels of erithrocyte sedimentation rate (ESR, serum total homocysteine (t-hcy, leptin, fibrinogen, C-reactive protein (CRP in patients with hyperthyroidism.Materials and methods: This study was carried out on 23 hyperthroid subjects (3 men / 20 women, mean age 41.8 ± 2.4 years. Serum levels of homocysteine, leptin, fibrinogen, CRP, total cholesterol (TC, high-density lipoprotein cholesterol (HDL-C, low-density lipoprotein cholesterol (LDL-C and ESR were measured and body mass index (BMI were calculated before and after treatment of hyperthyroidism.Results: Pretreatment t-hcy, TC, LDL-C, HDL-C levels and BMI of patients were significantly lower than those of the post-treatment (p<0.001, for each variable. However, fibrinogen and ESR decreased after the treatment (p<0.001 and p<0.05, respectively. There were no differences in leptin and CRP levels between pre- and post-treatment periods. Pre and post treatment TC and LDL-C levels were negatively correlated with free triiodothyronine (fT3 levels (r=-0.588, p<0.01; r=-0.534, p<0.01; r=-0.543, p<0.01 and r =-0.653, p<0.01, respectively. Pre-treatment HDL-C was inversely correlated with TSH (r=-0.423, p<0.05. Pre-post- treatment LDL-C was negatively correlated with free thyroxine (fT4 levels (r=-0.536, p<0.001 and r=- 0.422, p<0.05 respectively. Pre-treatment TC was inversely correlated with fT4 (r=-0.590, p<0.01.Conclusion: Hyperthyroidism is associated with high plasma fibrinogen and ESR levels. Elevated plasma fibrinogen and ESR levels may be a possible explanation for the high cardiovascular morbidity among hyperthyroidic subjects. These changes may reflect low-grade inflammation or disturbances in coagulation in hyperthyroidism.

  7. Experimental Hyperthyroidism Decreases Gene Expression and Serum Levels of Adipokines in Obesity

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    Renata de Azevedo Melo Luvizotto

    2012-01-01

    Full Text Available Aims. To analyze the influence of hyperthyroidism on the gene expression and serum concentration of leptin, resistin, and adiponectin in obese animals. Main Methods. Male Wistar rats were randomly divided into two groups: control (C—fed with commercial chow ad libitum—and obese (OB—fed with a hypercaloric diet. After group characterization, the OB rats continued receiving a hypercaloric diet and were randomized into two groups: obese animals (OB and obese with 25 μg triiodothyronine (T3/100 BW (OT. The T3 dose was administered every day for the last 2 weeks of the study. After 30 weeks the animals were euthanized. Samples of blood and adipose tissue were collected for biochemical and hormonal analyses as well as gene expression of leptin, resistin, and adiponectin. Results. T3 treatment was effective, increasing fT3 levels and decreasing fT4 and TSH serum concentration. Administration of T3 promotes weight loss, decreases all fat deposits, and diminishes serum levels of leptin, resistin, and adiponectin by reducing their gene expression. Conclusions. Our results suggest that T3 modulate serum and gene expression levels of leptin, resistin, and adiponectin in experimental model of obesity, providing new insights regarding the relationship between T3 and adipokines in obesity.

  8. Periplogenin, isolated from Lagenaria siceraria, ameliorates L-T₄-induced hyperthyroidism and associated cardiovascular problems.

    Science.gov (United States)

    Panda, S; Kar, A

    2011-03-01

    The importance of glycoside in the regulation of thyroid dysfunction is not well understood. In the present investigation, effects of periplogenin-3- O-D-glucopyranosyl (1→6)(1→4)-D-cymaropyranoside, isolated from the vegetable, LAGENARIA SICERARIA, in L-thyroxine (L-T₄)-induced hyperthyroidism and in related cardiovascular abnormalities have been revealed in Wistar albino rats. L-T₄ (500 μg/kg, s. c./d) administration for 12 days significantly increased serum concentrations of thyroxine (T₄), triidothyronine (T₃), and hepatic 5'-deiodinase I (5'-DI) activity with a parallel increase in lipid peroxidation (LPO) in different organs such as heart, liver and kidney; serum glucose and insulin concentrations and a decrease in cardiac Na (+)-K (+)-ATPase activity as well as serum total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and triglycerides. Most of these adverse effects were reversed following the administration of isolated periplogenin. However, out of its 3 different concentrations (5.0, 10, and 25 mg/kg), 5 mg/kg appeared to be the most effective one as it could nearly normalize the level of T₃, glucose, insulin, Na (+)-K (+)-ATPase activity, tissue LPO and different serum lipids suggesting the protective role of periplogenin against thyrotoxicosis and associated cardiovascular problems. It appears that the periplogenin actions are mediated through its direct antithyroidal and/or LPO inhibiting properties.

  9. 妊娠合并甲状腺功能亢进症的临床治疗体会%Clinical Treatment Experience of Pregnant Combine With Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    李博

    2015-01-01

    目的:探讨妊娠合并甲状腺功能亢进症的临床治疗体会。方法选取我院2012年1月~2013年7月收治的35例妊娠合并甲状腺功能亢进症患者资料进行分析。结果20例孕妇在孕期时无甲亢症状,15例孕妇在孕期出现不同程度的甲亢症状,因治疗及时病情均得以控制。结论发现甲亢时及早的治疗,对并发症的预防及改善意义重大。%Objective To explore the clinical treatment of pregnant women with hyperthyroidism. Methods Selected 35 pregnant with hyperthyroidism from January 2012 to July 2013 in our hospital. Results 20 cases on pregnancy without hyperthyroidism, 15 cases pregnant with varying degrees of symptoms of hyperthyroidism during pregnancy, treatment timely were able to control the disease. Conclusion The early discovery of hyperthyroidism treatment, prevention and improvement of signiifcant complications.

  10. Paroxysmal ventricular tachycardia and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism, chronic renal failure and elevation of prostate-specific antigen during acute myocardial infarction.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-02-04

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Paroxysmal atrial fibrillation is a frequent complication of acute myocardial infarction. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including an increase in atrial fibrillation rate. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover chronic renal failure presents an increased arrhythmic risk. Apparently spurious result has been reported in a work about mean serum prostate-specific antigen (PSA) concentration during acute myocardial infarction with mean serum PSA concentration significantly lower on day 2 than either day 1 or day 3 and it has been reported that these preliminary results could reflect several factors, such as antiinfarctual treatment, reduced physical activity or an acute-phase response. We present a case of paroxysmal ventricular tachycardia and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism, chronic renal failure and elevation of serum PSA concentration in a 90-year-old Italian man during acute myocardial infarction. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism and of chronic renal failure. Moreover, our report also confirms previous findings and extends the evaluation of PSA during acute myocardial infarction.

  11. The Basedow disease on ectopic thyroid: a cause of hyperthyroidism with 'white' thyroid scintigraphy; Maladie de Basedow sur thyroide ectopique: une cause d'hyperthyroidie avec scintigraphie thyroidienne 'blanche'

    Energy Technology Data Exchange (ETDEWEB)

    Tessonnier, L.; Taieb, D.; Mundler, O. [Service central de medecine nucleaire, CHU La Timone, Marseille, (France); Imbert-Joscht, I. [servicede medecine nucleaire, hopital Nord, Marseille, (France)

    2009-05-15

    We report the case of a 55 years old patient sent for a scintigraphy exploration of a biological hyperthyroidism, for which has been enlightened an ectopic thyroid in lingual position. The hyperthyroidism is a rare circumstance of finding a thyroid ectopy. (N.C.)

  12. Clinical retrospective analysis of the relationship between serum calcium levels and apathetic hyperthyroidism%淡漠型甲状腺功能亢进症与血钙水平关系的临床回顾分析

    Institute of Scientific and Technical Information of China (English)

    吴伟华; 孙振杰; 孙丽芳; 匡洪宇

    2009-01-01

    分析典型甲状腺功能亢进症(甲亢)与淡漠型甲亢患者血钙水平的差异,发现淡漠型甲亢血钙较典型甲亢显著增高,血清骨源性碱性磷酸酶(BAP)则显著降低(均P<0.01).淡漠型甲亢临床表现不典型的原因可能与血钙过度增高有关.%The difference in serum calcium levels between patients with typical hyperthyroidism and apathetic hyperthyroidism was analyzed. Serum calcium levels in patients with apathetic hyperthyroidism were higher than those in patients with typical hyperthyroidism, while bone-specific alkaline phosphatase levels were lower. The atypical manifestation of apathetic hyperthyroidism may be due to the significant elevation of serum calcium level.

  13. [Effect of melaxen and valdoxan on free radical processes intensity, aconitate hydratase activity and citrate content in rats tissues under hyperthyroidism].

    Science.gov (United States)

    Gorbenko, M V; Popova, T N; Shul'gin, K K; Popov, S S; Agarkov, A A

    2014-01-01

    The influence of melaxen and valdoxan on the biochemiluminescence parameters, aconitate hydratase activity and citrate level in rats heart and liver during development of experimental hyperthyroidism has been investigated. Administration of these substances promoted a decrease of biochemiluminescence parameters, which had been increased in tissues of rats in response to the development of oxidative stress under hyperthyroidism. Aconitate hydratase activity and citrate concentration in rats liver and heart, growing at pathological conditions, changed towards control value after administration of the drugs correcting melatonin level. The results indicate the positive effect of valdoxan and melaxen on oxidative status of the organism under the development of experimental hyperthyroidism that is associated with antioxidant action of melatonin.

  14. Pharmaceutical treatment for hyperthyroidism%甲状腺功能亢进症的药物治疗

    Institute of Scientific and Technical Information of China (English)

    卢艳慧

    2013-01-01

    The pathogenesis of hyperthyroidism is relatively complicated. In clinical practice, diffuse toxic goiter accompanied with hyperthyroidism (as known as Graves' disease) is more common. The pharmaceutical treatment of Graves' disease includes antithyroid drugs (ATD), iodine, P-blocker, glucocorticoids and lithium carbonate. ATD are the main treatment for hyperthyroidism, and Methimazole (MMI) and propylthiouracil (PTU) are the two drugs which are most commonly used currently. Generally, ATD are safe and effective, though their clinical adverse reactions are also relatively common. These reactions are usually reversible and disappeared spontaneously when the drug is discontinued. However, the serious rare side effects also occur sometimes. MMI is usually preferred over PTU because it has significantly fewer adverse reactions in a dose-dependent fashion. MMI is the first choice for treating mild and moderate hyperthyroidism. Iodine is mainly used in hyperthyroidism crisis and before operation. Glucocorticoids are mainly used for Graves' ophthalmopathy and hyperthyroidism crisis, p-blocker is used to control the symptoms at initial treatment. Lithium carbonate is not commonly used, and only suitable for short-term treatment. The clinicians should evaluate comprehensively and individually to choose appropriate agents for better outcome, and closely monitor their efficiency and side effects.%甲状腺功能亢进症(甲亢)病因较复杂,在临床上以弥漫性毒性甲状腺肿伴甲亢(Graves病)最常见.甲亢的药物治疗包括抗甲状腺药(ATD)、碘剂、β受体阻滞剂、糖皮质激素、碳酸锂等.ATD是治疗甲亢的主要手段,常用药物为丙基硫氧嘧啶(PTU)和甲巯咪唑(MMI).总的来说,ATD治疗安全且有效,但其临床不良反应亦较常见,一般程度较轻,及时停药能自行恢复,但亦可出现少见、严重的副作用.MMI与PTU比较,其不良反应显著低于PTU,且前者大多具有剂量依赖性.因此轻中度

  15. Effectiveness of Fixed Dose Radioactive Iodine (RAI for the Treatment of Hyperthyroidism: Experience of a Teaching Hospital in South West Nigeria

    Directory of Open Access Journals (Sweden)

    Karounwi Omotayo Ogunjobi

    2013-08-01

    Full Text Available Objective: Using radioactive iodine (RAI as the first line therapy for Graves’ hyperthyroidism and as the treatment of choice for relapsed Graves’ disease is increasing in recent times. However, there has been little consensus on the most appropriate dose to use. So this study is to determine the response of hyperthyroidism to fixed doses of 370 MBq and 555 MBq RAI therapies and determine the incidence of hypothyroidism at 6 months post therapy. Methods: Hyperthyroid patients’ case records treated with radioiodine was retrospectively reviewed to determine the response rate of hyperthyroidism to the two fixed dose regimens. Statistical analysis was done with SPSS version 15.0 and the level of statistical significance was taken as p<0.05. Forty subjects, 6 males (15% and 34 females (85% received RAI therapy for Graves’ hyperthyroidism, mean age was 49.4 years (range, 25-75years. The thyroid function status at 6 months post therapy was available for all subjects. 24 patients (60% received 370 MBq while 16 patients (40% received 555 MBq. Results: The response for fixed doses of 370 MBq and 555 MBq were similar (100%. Also, the incidence of hypothyroidism in these subjects which was 66.6% with fixed dose of 370 MBq and 62.5% with fixed dose of 555 MBq within 6 months post RAI therapy were similar. Conclusion: SRAI is highly effective for the treatment of hyperthyroidism, with a cure rate of 100%. However, it has proved impossible to determine a fixed dose regimen for individual patients accurately to guarantee an euthyroid state. This is because hypothyroidism is a natural predictable sequel of RAI therapy.

  16. Feline hyperthyroidism reported in primary-care veterinary practices in England: prevalence, associated factors and spatial distribution.

    Science.gov (United States)

    Stephens, M J; O'Neill, D G; Church, D B; McGreevy, P D; Thomson, P C; Brodbelt, D C

    2014-11-08

    Feline hyperthyroidism is a commonly diagnosed endocrinopathy that can have a substantial deleterious impact on the welfare of affected cats. This study aimed to estimate the prevalence, associated factors and geographical distribution for feline hyperthyroidism in England, using primary-care veterinary practice clinical data from the VetCompass Animal Surveillance Project. Prevalence was estimated from the overall cat cohort. Associated factor analysis used an age-matched, nested, case-control design with multivariable logistic regression. There were 2,276 cases of feline hyperthyroidism identified from 95,629 cats attending 84 practices from September 2009 to December 2011. Cases were aged 6-25 years. 3.7 per cent of cases and 9.9 per cent of controls were purebred, 56.4 per cent of cases and 56.5 per cent of controls were female, and 88.1 per cent of cases and 86.0 per cent of controls were neutered. The apparent prevalence was 2.4 per cent (95% CI 2.3 to 2.5 per cent) overall, and 8.7 per cent (95% CI 8.3 to 9.0 per cent) in cats aged 10 years or above. Burmese (OR 0.15, 95% CI 0.07 to 0.32, Phyperthyroidism than non-purebred cats. Insured cats had increased odds (OR 1.78, 95% CI 1.56 to 2.03, Phyperthyroidism as a high-prevalence disease in England, and reports reduced odds of diagnosis in certain breeds and purebred cats overall.

  17. 甲状腺功能亢进症患者的护理%Nursing Care of Patients with Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    闫晗

    2014-01-01

    Objective The measures as well as the value of clinical treatment intervention of patients with hyperthyroidism to be investigated.MethodsMaking a selection of 26 cases of patients with hyperthyroidism who get treated in hospital at random, the patients are given comprehensive treatment attendance apart from elementary and conventional attendance, and then make an analysis of the clinical treatment effects.ResultsGiven the effective treatment intervention, 24 cases of patients have their illness controlled and their health state improved, and they get cured, and two cases of patients are transferred to other hospital, the probabilities of effectiveness reach to 92.30 percent.Conclusion Hyperthyroidism is a common endocrine disease which is easily relapsed. Offering them with considerate and comprehensive intervention treatment based on elementary attendance in order to assist them with getting recovery soon.%目的:探讨甲状腺功能亢进症患者的临床护理措施干预及应用价值。方法选取本院收治的甲状腺功能亢进症患者26例,患者在常规治疗的同时给予全面细致的护理干预,并针对护理效果进行临床分析。结果经过积极有效的护理干预,24例患者病情得到有效的控制,好转、病愈,2例转院,有效率92.30%。结论甲状腺功能亢进是一种常见,多发的内分泌疾病。在治疗的同时给予细致全面的护理干预措施,促使其早日康复。

  18. Hyperthyroidism and Pregnancy%甲状腺功能亢进与妊娠的关系

    Institute of Scientific and Technical Information of China (English)

    周佳雁

    2011-01-01

    甲状腺功能亢进是常见的内分泌疾病,也是年轻妇女的常见病.母体与胎儿甲状腺功能关系密切,药物可同时影响两者的甲状腺功能.妊娠期间发生甲状腺功能亢进,既有其共性,又有其特征性表现.患有甲状腺功能亢进的患者妊娠后是终止还是继续?继续妊娠者应采取何种治疗方法?能否哺乳?选择何种药物对胎儿比较安全?均是临床经常遇到且非常棘手而急需解决的问题,现就上述方面的问题予以综述.%Hyperthyroidism is a common disease of endocrine. The maternal function of thyroid gland has a strong association with that of fetus'. Some Signs and symptoms of hyperthyroidism in pregnancy are similar to those which happen on nonpregnant persons,but some are not. If persons who are in pregnancy have got hyperthyroidism,what can they do ? How to choose the treaments? Are the antithyoriod drugs safe enough for the mothers and fetus? Can they choose to continue the pregnancy or to stop? Our article will give related delineation.

  19. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.

    Science.gov (United States)

    Bahn, Rebecca S; Burch, Henry B; Cooper, David S; Garber, Jeffrey R; Greenlee, M Carol; Klein, Irwin; Laurberg, Peter; McDougall, I Ross; Montori, Victor M; Rivkees, Scott A; Ross, Douglas S; Sosa, Julie Ann; Stan, Marius N

    2011-01-01

    Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. The development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis. One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.

  20. Radioiodine Therapy of Hyperthyroidism. Simplified patient-specific absorbed dose planning

    Energy Technology Data Exchange (ETDEWEB)

    Joensson, Helene

    2003-10-01

    Radioiodine therapy of hyperthyroidism is the most frequently performed radiopharmaceutical therapy. To calculate the activity of {sup 131}I to be administered for giving a certain absorbed dose to the thyroid, the mass of the thyroid and the individual biokinetic data, normally in the form of uptake and biologic half-time, have to be determined. The biologic half-time is estimated from several uptake measurements and the first one is usually made 24 hours after the intake of the test activity. However, many hospitals consider it time-consuming since at least three visits of the patient to the hospital are required (administration of test activity, first uptake measurement, second uptake measurement plus treatment). Instead, many hospitals use a fixed effective half-time or even a fixed administered activity, only requiring two visits. However, none of these methods considers the absorbed dose to the thyroid of the individual patient. In this work a simplified patient-specific method for treating hyperthyroidism is proposed, based on one single uptake measurement, thus requiring only two visits to the hospital. The calculation is as accurate as using the individual biokinetic data. The simplified method is as patient-convenient and time effective as using a fixed effective half-time or a fixed administered activity. The simplified method is based upon a linear relation between the late uptake measurement 4-7 days after intake of the test activity and the product of the extrapolated initial uptake and the effective half-time. Treatments not considering individual biokinetics in the thyroid result in a distribution of administered absorbed dose to the thyroid, with a range of -50 % to +160 % compared to a protocol calculating the absorbed dose to the thyroid of the individual patient. Treatments with a fixed administered activity of 370 MBq will in general administer 250 % higher activity to the patient, with a range of -30 % to +770 %. The absorbed dose to other

  1. The influence of subclinical hyperthyroidism on blood pressure, heart rate variability, and prevalence of arrhythmias.

    Science.gov (United States)

    Kaminski, Grzegorz; Makowski, Karol; Michałkiewicz, Dariusz; Kowal, Jarosław; Ruchala, Marek; Szczepanek, Ewelina; Gielerak, Grzegorz

    2012-05-01

    The impact of subclinical hyperthyroidism (sHT) on the cardiovascular system still needs to be elucidated. The aim of the study was to prospectively assess blood pressure (BP), variability in heart rate, and the prevalence of arrhythmias in patients with sHT, both before and after they are restored to the euthyroid state. The study group consisted of 44 normotensive patients (37 women, 7 men), aged 22-65 years (mean±SD: 45.9±11.0) with sHT. Enrolled patients were drawn from 1080 patients referred to our department for treatment of hyperthyroidism. Study patients were treated with radioiodine treatment to restore the euthyroid state. Ambulatory BP monitoring and Holter electrocardiography were performed (i) when sHT was diagnosed and (ii) at least 6 months after they became euthyroid. sHT in comparison to the euthyroid state was associated with higher (109.3±7.1 vs. 107.1±7.7 mmHg) nocturnal systolic mean BP (p=0.035) and BP load (14.8 vs. 10.2%, p=0.033), mean diastolic BP (66.4±6.6 vs. 64.8±6.6 mmHg, p=0.047), and mean arterial pressure (80.8±43.1 vs. 79.3±43.6 mmHg, p=0.049). Moreover, significant changes in both the time and frequency domain measures of heart rate variability (HRV) were observed: decrease of the square root of the mean squared differences of successive NN intervals (rMSSD) (45.68±34.1 vs. 65.09±50.6 ms, p=0.03) and the low frequency power (LF) (5.71±0.99 vs. 6.0±1.01 ms(2), p=0.049) as well as increase of QT interval dispersion (58.25±28.5 vs. 46.90±12.1 ms, p=0.020). This was accompanied by a clinically insignificant increase in the frequency of ventricular extrasystoles (VES) (3.1±7.4 vs. 0.6±1.2 per hour, p=0.048) and increased mean heart rate (78.4±6.8 vs. 76.0±8.0 beats/min, p=0.004). Some of the parameters correlated positively with thyroid hormones: nocturnal diastolic BP with free triiodothyronine (FT(3)) (r=0.397, p=0.008), rMSSD with free thyroxine (FT(4)) (r=0.389, p=0.013), and QT interval dispersion with FT(4

  2. Hiperparatireoidismo em gatos com hipertireoidismo experimental Hyperparathyroidism in cats with experimental hyperthyroidism

    Directory of Open Access Journals (Sweden)

    M.J.L. Cardoso

    2008-06-01

    Full Text Available Os efeitos do hipertireoidismo experimental, 150µg/kg/dia/42 dias de levotiroxina sódica, na homeostase do cálcio foram estudados em 14 gatos sem raça definida, com idades entre um e três anos. A cada 14 dias foram colhidas amostras de soro para a determinação da concentração da tiroxina total (T4, tiroxina livre (FT4, paratormônio intacto (PTH, cálcio total e ionizado, fósforo e, além disso, realizaram-se radiografias para a determinação da densidade mineral óssea (DMO. Observou-se aumento das concentrações séricas do PTH a partir do momento inicial (M0, com diferença significativa deste em relação às concentrações obtidas aos 14 (M1, 28 (M2 e 42 (M3 dias. Não houve diferença significativa nas concentrações séricas de cálcio total e fósforo entre todos os momentos. O cálcio ionizado diminui de M0 para M1 e de M1 para M3, com diferença significativa. Os hormônios tireoidianos apresentaram correlação positiva com o PTH e negativa com o cálcio ionizado. A correlação entre DMO e PTH a partir de M2 foi negativa e entre DMO e fósforo foi negativa somente em M2. Não se observou correlação entre DMO e as demais variáveis. Em M1, M2 e M3 foi observada correlação negativa entre o PTH e o cálcio ionizado. Conclui-se que o hipertireoidismo em gatos adultos jovens está associado ao hiperparatireoidismo secundário devido ao aumento do PTH e diminuição do cálcio ionizado. Os efeitos combinados dos hormônios tireoidianos e do PTH contribuíram para a diminuição da DMO.The effect of experimental hyperthyroidism, 150µg/kg/day/42 days, on calcium homeostasis was studied in 14 mongrel cats aging from one to three-year-old. Total thyroxine (T4, free thyroxine (FT4, parathyroid hormone (PTH, total and ionized calcium, phosphorus, bone mineral density were measured. Serum concentrations of PTH of increased from the initial moment (MO, with significant differences to when measured after 14(M1, 28(M2, and 42(M3

  3. Cerebral cortex hyperthyroidism of newborn mct8-deficient mice transiently suppressed by lat2 inactivation.

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    Bárbara Núñez

    Full Text Available Thyroid hormone entry into cells is facilitated by transmembrane transporters. Mutations of the specific thyroid hormone transporter, MCT8 (Monocarboxylate Transporter 8, SLC16A2 cause an X-linked syndrome of profound neurological impairment and altered thyroid function known as the Allan-Herndon-Dudley syndrome. MCT8 deficiency presumably results in failure of thyroid hormone to reach the neural target cells in adequate amounts to sustain normal brain development. However during the perinatal period the absence of Mct8 in mice induces a state of cerebral cortex hyperthyroidism, indicating increased brain access and/or retention of thyroid hormone. The contribution of other transporters to thyroid hormone metabolism and action, especially in the context of MCT8 deficiency is not clear. We have analyzed the role of the heterodimeric aminoacid transporter Lat2 (Slc7a8, in the presence or absence of Mct8, on thyroid hormone concentrations and on expression of thyroid hormone-dependent cerebral cortex genes. To this end we generated Lat2-/-, and Mct8-/yLat2-/- mice, to compare with wild type and Mct8-/y mice during postnatal development. As described previously the single Mct8 KO neonates had a transient increase of 3,5,3'-triiodothyronine concentration and expression of thyroid hormone target genes in the cerebral cortex. Strikingly the absence of Lat2 in the double Mct8Lat2 KO prevented the effect of Mct8 inactivation in newborns. The Lat2 effect was not observed from postnatal day 5 onwards. On postnatal day 21 the Mct8 KO displayed the typical pattern of thyroid hormone concentrations in plasma, decreased cortex 3,5,3'-triiodothyronine concentration and Hr expression, and concomitant Lat2 inactivation produced little to no modifications. As Lat2 is expressed in neurons and in the choroid plexus, the results support a role for Lat2 in the supply of thyroid hormone to the cerebral cortex during early postnatal development.

  4. 1311治療甲亢71例回顧%Analysis of 131I therapy in 71 patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    王平; 陳澤泉; 王遠智; 葉世琴

    2001-01-01

    Objective To evaluate the clinical significance of iodine-131 treatment in patients with hyperthyroidism. Methods The dose of 131I was determined according to thyroid absorption of 131I at 24 hrs post administration and thyroid weight estimated in ECT examination. Results One dose cure rate of 131I treatment was 96% (68/71). Hypothyroidism occurred in 3 of 71 patients (4%) in one year after administration. No other serious complication was observed. Conclusion The therapeutic effect of 131I in treating hyperthyroidism was quite encouraging. The administration regime was also simple

  5. Radioactive Iodine-131 as a Definitive Treatment in Rare Association of Down Syndrome With Hyperthyroidism: A Case Report and Review of Literature

    Science.gov (United States)

    Khan, Shoukat H.; Mahajan, Aditya; Rather, Tanveer A.

    2017-01-01

    Down syndrome characterized by trisomy of chromosome 21 is frequently associated with thyroid dysfunctions due to underlying autoimmune disorders. Hypothyroidism is the commonest thyroid dysfunction and hyperthyroidism, usually Graves’ disease, is far less common. On literature review, we came across approximately 112 cases reported so far with the first such case report in 1946. The published data from India on hyperthyroidism in Down syndrome is of three case reports. We report one such patient, an adult male of 28 years who was administered Iodine-131 as a definitive treatment after 9-10 years of initial diagnosis. PMID:28242979

  6. Analysis of influence of dosimetric factors on the outcome of I-131 therapy in patients with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Knapska-Kucharska, M.; Oszukowska, L.; Makarewicz, J. [Department of Nuclear Medecine and Oncological Endocrinology, Province Hospital, Zgierz (Poland); Lewinski, A. [Chair and Department of Endocrinology and Metabolic Diseases, Medical University, Lodz (Poland)

    2012-07-01

    The influence of dosimetric factors on the outcome of {sup 131}I therapy has been examined in hyperthyroid patients submitted to {sup 131}I treatment. The following factors - which could have influence on the effects of therapy with radioiodine - were analysed: the goitre volume, the thyroid radioiodine uptake after 24 h, and the effective half-life time of {sup 131}I (EHL). Five hundred (500) randomly selected patients with hyperthyroidism, treated with {sup 131}I, were studied. They were divided into three groups (based on clinical examination, hormonal and immunological tests, thyroid scintigraphy and ultrasound imaging). The study shows that the effectiveness of {sup 131}I therapy depends on the thyroid volume and absorbed dose in all the groups of patients and on the thyroid radioiodine uptake and EHL in patients with a single autonomously functioning thyroid nodule. We have failed to determine the borderline D, distinguishing between effective and ineffective therapy. The treatment outcome can be predicted with approximately 70% accuracy, based on minimal absorbed dose

  7. Proposal of a methodology for individualized iodine-131 therapy for Graves' disease in patients with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Francisco de [Instituto de Radioprotecao e Dosimetria (IRD), Rio de Janeiro, RJ (Brazil)]. E-mail: faraujo@ird.gov.br; Melo, Rossana Corbo de [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); Rebelo, Ana Maria de Oliveira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE); Dantas, Bernardo Maranhao; Dantas, Ana Leticia A.; Lucena, Eder Augusto de [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil)

    2007-11-15

    Objective: Several methods are utilized for determining the radioiodine activity in the treatment of Graves' disease (hyperthyroidism). Some of this methods do not take into consideration the thyroid absorbed dose or the necessary parameters for this estimation. The association between absorbed dose and administered activity depends on effective half-life, iodine uptake and thyroid mass of each patient. The present study was aimed at developing a methodology for individualized {sup 131}I therapy for Graves' disease in patients with hyperthyroidism of the Graves' disease. Materials and methods: A neck-thyroid phantom developed at Instituto de Radioprotecao e Dosimetria, containing a standard solution of {sup 131}I, was utilized for calibrating the scintillation gamma camera and uptake probe installed in the Department of Nuclear Medicine of the Hospital Universitario Clementino Fraga Filho da Universidade Federal do Rio de Janeiro. Results: The view angle of the collimator/detector assembly presented values compatible with the thyroid gland size for distances of 25 cm (uptake probe) and 45.8 cm (scintillation gamma camera). Calibration factors were 39.3 {+-} 0.78 and 4.3 {+-} 0.17 cpm/kBq, respectively. The 14-30-hour interval in the retention curve allows the estimation of activity between two points for determining the effective iodine half-life in the thyroid. Conclusion: The utilization of equipment usually available in nuclear medicine clinics is feasible, so this is a simple, effective and low cost methodology. (author)

  8. Myelodysplastic syndrome and pancytopenia responding to treatment of hyperthyroidism: Peripheral blood and bone marrow analysis before and after antihormonal treatment

    Directory of Open Access Journals (Sweden)

    Akoum Riad

    2007-01-01

    Full Text Available Hematological disorders, especially single lineage abnormalities, have been described in hyperthyroidism. Pancytopenia has been reported, without myelodysplastic syndrome or megaloblastic anemia. We studied the peripheral blood smear and the bone marrow aspiration and biopsy of a 65-year-old lady, who presented with pancytopenia and thyrotoxicosis due to multinodular goiter. She denied ingesting any toxic medication. At diagnosis: WBC: 2500 /ul, platelets count: 58.000/ul, hemoglobin level: 6.5 g/dl. The bone marrow was moderately hyper cellular with moderate myelofibrosis and arrested hematopoiesis. The TSH level was: 0.02 mIU/l (N: 0.25-4, the fT3: 18 pmol/l (N: 4-10, the routine serum immunologic tests were negative. After treatment with single agent neomercazole (carbimazole, complete recovery of the blood cell counts was obtained within one month. The bone marrow aspiration, performed three months after starting therapy, showed normal hematopoiesis. The thyroid function tests returned to normal and no autoimmune reaction was detected on routine serum testing. Persistent response was observed six months later under medical treatment. The patient has refused surgical treatment. Reversible myelodysplastic syndrome may also be part of the changes in blood picture of patients with hyperthyroidism, probably due to direct toxic mechanism.

  9. McCune Albright syndrome - association of fibrous dysplasia, café-au-lait skin spots and hyperthyroidism - case report.

    Science.gov (United States)

    Raus, Iulian; Coroiu, Roxana Elena

    2016-01-01

    McCune-Albright syndrome is a rare sporadic disease characterized by bone fibrous dysplasia, café-au-lait skin spots and a variable association of hyperfunctional endocrine disorders. Fibrous dysplasia (FD), which can involve the craniofacial, axial, and appendicular skeleton, may range from an isolated, asymptomatic monostotic lesion to a severe disabling polyostotic disease involving the entire skeleton. A twenty-five-year old male patient presented to our clinic with recently developed heart palpitations. He had also been feeling pain in the right femur since he was younger, without any trauma history, leading to difficulties of ambulation and limping occasionally. His physical examination revealed café-au-lait spots with irregular borders and right testicular agenesis. Laboratory findings identified hyperthyroidism with hyperparathyroidism. Radiographs of the pelvis revealed multiple lytic lesions of the right femur and magnetic resonance imaging (MRI) characterized these lesions as specific to fibrous dysplasia of the bone, without any insufficiency fracture at this level. The association of café-au-lait skin spots with bone fibrous dysplasia, and hyperthyroidism in this patient suggested the diagnosis of McCune - Albright syndrome.

  10. Graves病甲状腺功能亢进症与血糖代谢%Graves disease hyperthyroidism and glycometabolism

    Institute of Scientific and Technical Information of China (English)

    孙琦婷; 赵德善

    2010-01-01

    Graves病甲状腺功能亢进症(甲亢)患者常伴有糖代谢紊乱,其机制主要与胰岛β细胞功能受损及胰岛素抵抗有关,而免疫遗传因素也起一定的作用.在131I和抗甲状腺药物治疗后,伴随着甲状腺激素水平的恢复,血糖逐渐开始下调并恢复正常.因此,对Graves病甲亢伴糖代谢紊乱患者进行积极的早期治疗有助于血糖的控制及并发症的预防.%The patients with Graves disease hyperthyroidism are often accompanied by disorder of glycometabolism. β-cell dysfunction and insulin resistance play a main role in this disease,while the immune and genetic factors are also relevant with the disease. The blood glycose level can become normal gradually with the recovery of thyroid hormone after 131I and antithyroid drug treatment. Therefore, the blood glycose level could be improved and complications could be prevented by early treatment in the patients with Graves disease hyperthyroidism accompanied with glycometabolism disorder is helpful for improving the blood glycose level.

  11. Concurrent hyperthyroidism and papillary thyroid cancer: a fortuitous and ambiguous case report from a resource-poor setting.

    Science.gov (United States)

    Kadia, Benjamin Momo; Dimala, Christian Akem; Bechem, Ndemazie Nkafu; Aroke, Desmond

    2016-07-26

    Concurrent thyroid cancer (TC) and hyperthyroidism (HT) is rare though increasingly being reported. HT due to TC is much rarer and more challenging especially in Africa where TC and HT have significant case fatality rates. We present a 37-year-old Cameroonian female who had been on irregular regimens of propranolol and digoxin as treatment for worsening palpitations for 12 months. She came to our district hospital for her propranolol medication refill. We fortuitously identified features of HT and found a left uninodular goiter with no cervical lymphadenopathy. She was referred for thyroid assessment which suggested primary HT and an enlarged heterogeneous left lobe with a well-defined homogenous solid mass. We restarted her on propranolol and referred her for a course of methimazole. At the referral hospital, she also underwent a left thyroid lobectomy. The resected lobe was sent for histopathology which revealed a neoplastic nodule with features suggestive of a papillary thyroid cancer (PTC) causing HT. The patient's clinical progress postoperatively was good and there was regression of hyperthyroid symptoms. The historical, clinical, and laboratory findings were suggestive of HT due to PTC. A high index of suspicion, prompt referral and counter-referral lead to a positive outcome of such a rare case in a resource poor setting. We advocate for systematic and careful evaluation of all thyroid nodules.

  12. Antenatal management of recurrent fetal goitrous hyperthyroidism associated with fetal cardiac failure in a pregnant woman with persistent high levels of thyroid-stimulating hormone receptor antibody after ablative therapy.

    Science.gov (United States)

    Matsumoto, Tadashi; Miyakoshi, Kei; Saisho, Yoshifumi; Ishii, Tomohiro; Ikenoue, Satoru; Kasuga, Yoshifumi; Kadohira, Ikuko; Sato, Seiji; Momotani, Naoko; Minegishi, Kazuhiro; Yoshimura, Yasunori

    2013-01-01

    High titer of maternal thyroid-stimulating hormone receptor antibody (TRAb) in patients with Graves' disease could cause fetal hyperthyroidism during pregnancy. Clinical features of fetal hyperthyroidism include tachycardia, goiter, growth restriction, advanced bone maturation, cardiomegaly, and fetal death. The recognition and treatment of fetal hyperthyroidism are believed to be important to optimize growth and intellectual development in affected fetuses. We herein report a case of fetal treatment in two successive siblings showing in utero hyperthyroid status in a woman with a history of ablative treatment for Graves' disease. The fetuses were considered in hyperthyroid status based on high levels of maternal TRAb, a goiter, and persistent tachycardia. In particular, cardiac failure was observed in the second fetus. With intrauterine treatment using potassium iodine and propylthiouracil, fetal cardiac function improved. A high level of TRAb was detected in the both neonates. To the best of our knowledge, this is the first report on the changes of fetal cardiac function in response to fetal treatment in two siblings showing in utero hyperthyroid status. This case report illustrates the impact of prenatal medication via the maternal circulation for fetal hyperthyroidism and cardiac failure.

  13. 131I治疗甲状腺功能亢进症的进展%Advances of 131I in the treatment of hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    邢家骝

    2013-01-01

    The guidelines of management of hyperthyroidism has been published by American Thyroid Association (ATA) and American Association of Clinical Endocrinologists (AACE) in 2011. This article introduced its key points related to 131I therapy for hyperthyroidism, and the advances of 131I in the treatment of hyperthyroidism at home and abroad in recent years. Our clinical experiences on 131I in the treatment of refractory severe hyperthyroidism without antithyroid drug pretreatment in China were highlighted particularly.%本文介绍美国甲状腺学会和美国临床内分泌医师学会近年发表的《甲状腺功能亢进症和其他原因引起的甲状腺毒症处理指南》中有关131I治疗甲状腺功能亢进症(甲亢)的要点,同时介绍近年来国内外用131I治疗甲亢的进展,重点介绍我国不用抗甲状腺药物预治疗而直接用131I治疗难治性重度甲亢的经验.

  14. 131I治疗甲状腺功能亢进疗效分析%Observation of Curative Effect of 131I in Treatment of Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    黄克斌; 徐樊; 张亚萍; 王景昌; 赵明利; 叶明

    2012-01-01

    目的 探讨131I治疗甲状腺功能亢进(甲亢)的临床疗效.方法 对126例甲亢患者给予131I治疗,并对其疗效进行分析.结果 治疗的126例甲亢中,117例痊愈,治愈率92.9%,1年后发生甲减9例,甲减发生率7.1%.结论 131I治疗甲亢是一种安全、有效的方法.%Objective To explore the curative effect of 131I in the treatment of hyperthyroidism. Method 126 patients with hyperthyroidism were treated with 131I and the curative effect was analyzed. Result The results showed that among 126 cases of hyperthyroidism treated with 131I, 117 cases had recovered and the cure rate was 92.9%. 9 cases were found hypothyroidism in one-year follow-up and the occurrence rate was 7. 1%. Conclusion The treatment of hyperthyroidism with 131I is safe and effective method.

  15. 131I治疗甲亢的现状和研究进展%The development and current status of 131I treatment for hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    王春梅; 王雪梅

    2010-01-01

    甲状腺功能亢进症(甲亢)是由多种病因导致甲状腺激素分泌过多的自身免疫性疾病.治疗的方法目前主要包括:抗甲状腺药物治疗、131I治疗以及于术治疗.131I已被公认为治疗成人及儿童甲亢的有效、安全、简便的方法.目前,131I治疗甲亢的研究趋势主要集中在两个方面,即131I治疗甲亢存在的问题和远期安全性.%Hyperthyroidism is an autoimmune diseasein which excessive amounts of thyroid hormones circulate in the blood. The treatments for hyperthyroidism mainly include antithyroid drugs, 131I treatment,and surgery. 131I had been verified as an effective, safe, simple method to treat adult and children hyperthyroidism. Current research trends of 131I treatment mainly are problems of 131I treatment of hyperthyroidism and its long-term security.

  16. Up-regulation of avian uncoupling protein in cold-acclimated and hyperthyroid ducklings prevents reactive oxygen species production by skeletal muscle mitochondria

    Directory of Open Access Journals (Sweden)

    Servais Stéphane

    2010-04-01

    Full Text Available Abstract Background Although identified in several bird species, the biological role of the avian homolog of mammalian uncoupling proteins (avUCP remains extensively debated. In the present study, the functional properties of isolated mitochondria were examined in physiological or pharmacological situations that induce large changes in avUCP expression in duckling skeletal muscle. Results The abundance of avUCP mRNA, as detected by RT-PCR in gastrocnemius muscle but not in the liver, was markedly increased by cold acclimation (CA or pharmacological hyperthyroidism but was down-regulated by hypothyroidism. Activators of UCPs, such as superoxide with low doses of fatty acids, stimulated a GDP-sensitive proton conductance across the inner membrane of muscle mitochondria from CA or hyperthyroid ducklings. The stimulation was much weaker in controls and not observed in hypothyroid ducklings or in any liver mitochondrial preparations. The production of endogenous mitochondrial reactive oxygen species (ROS was much lower in muscle mitochondria from CA and hyperthyroid ducklings than in the control or hypothyroid groups. The addition of GDP markedly increased the mitochondrial ROS production of CA or hyperthyroid birds up to, or above, the level of control or hypothyroid ducklings. Differences in ROS production among groups could not be attributed to changes in antioxidant enzyme activities (superoxide dismutase or glutathione peroxidase. Conclusion This work provides the first functional in vitro evidence that avian UCP regulates mitochondrial ROS production in situations of enhanced metabolic activity.

  17. 青壮年甲状腺功能亢进患者的骨代谢特征%Bone metabolism characteristics of young patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    梁赟; 虞艳芳; 叶吉云

    2013-01-01

    目的:通过对初发的青壮年甲状腺功能亢进症(甲亢)患者的骨密度(BMD)的测定,研究甲亢患者骨代谢的特征。方法采用双能X线吸收法对我院369例初发未经治疗的青壮年甲亢患者组和148名健康对照组进行腰椎L2-4,股骨近端的BMD检测,同时测定甲状腺功能、AKP、PTH、CT、24 h尿钙、血钙等。结果比较甲亢组与健康对照组的FT3、FT4和TSH差异有统计学意义(P0.05);甲亢骨量正常组24 h尿钙与对照组比较差异无统计学意义(P>0.05),而甲亢骨量异常组24 h尿钙与对照组比较有显著性差异(P0.05). There were no significant difference of 24 h urine calcium in hyperthyroidism bone mass normal group and control group (P>0.05). And 24 h urine calcium in hyperthyroidism abnormal bone mass group and the control group were significant difference (P<0.05). The BMD were negatively correlated with serum FT3, FT4 in hyperthyroidism patients, and positively correlated with TSH. Conclusion It was found that hyperthyroidism could cause bone loss and osteoporosis in young adults through the analysis of thyroid function, BMD and bone metabolism. So the prevention of osteoporosis should not be ignored in the treatment of hyperthyroidism..

  18. Clinical analysis of 40 cases of hyperthyroid heart disease%甲状腺功能亢进性心脏病40例临床分析

    Institute of Scientific and Technical Information of China (English)

    张权孝; 闫敏

    2014-01-01

    目的:分析甲状腺功能亢进性心脏病(甲亢性心脏病)患者临床表现及相关因素。方法:40例合并甲亢性心脏病病人为观察组,260例甲亢患者为对照组,进行性别、病因、年龄、病程以及合并症分析,采用卡方检验。结果:统计分析发现观察组与对照组在年龄、病程发生率上存在显著差异。结论:年龄越大、病程越长甲亢患者易合并甲亢性心脏病。原因不明的房性及房室交界性心律失常建议行甲状腺相关检查,即时排除甲亢性心脏病。%Objective:To analyze hyperthyroid heart disease ( HHD) clinical manifestations and related factors in patients with .Meth-ods:40 patients with hyperthyroid heart disease patients as the observation group , 260 patients as control group , sex, age, cause analysis , course and complications , by chi square test .Results:Statistical analysis found in the observation group and the control group in age , course of disease occurrence difference rate .Conclusion:The older, the longer the duration of hyperthyroidism patients with hyperthyroid heart disease .The real reason might be unknown and AV junction arrhythmia suggestions for thyroid associated examination , the immedi-ate elimination of hyperthyroid heart disease .

  19. 抗甲状腺药物治疗甲状腺功能亢进症临床分析%Antithyroid Drug Therapy of Hyperthyroidism Clinical Analysis

    Institute of Scientific and Technical Information of China (English)

    刘国萍

    2013-01-01

      目的:对甲状腺功能亢进患者行抗甲状腺药物治疗临床治疗方法分析。方法:临床采取抗甲状腺药物治疗甲状腺功能亢进症。结果:早期诊断、早期治疗,防止并发症,尤其是防止浸润性突眼、甲亢性肌病、甲亢性心脏病及甲亢危象等,患者症状逐渐缓解,病情得到控制。结论:抗甲状腺药物可作为单独治疗、手术治疗前准备、辅助131碘治疗、中西医结合治疗及甲亢危象治疗,提高疗效。%Objective:On hyperthyroidism patients with antithyroid drug therapy clinical treatment analysis. Methods: clinical taken antithyroid drug therapy of hyperthyroidism.Results:early diagnosis, early treatment, prevention of complications, especially to prevent infiltration exophthalmos, thyrotoxic myopathy, hyperthyroid heart disease and hyperthyroidism crisis, symptoms were in remission, the disease under control. Conclusions: anti thyroid drugs as single treatment, preoperative preparation, operation, adjuvant iodine 131 in the treatment of integrated traditional Chinese and western medicine therapy and hyperthyroidism crisis treatment, improve the curative effect.

  20. Late manifestation of subclinical hyperthyroidism after goitrogenesis in an index patient with a N670S TSH receptor germline mutation masquerading as TSH receptor antibody negative Graves' disease.

    Science.gov (United States)

    Schaarschmidt, J; Paschke, S; Özerden, M; Jäschke, H; Huth, S; Eszlinger, M; Meller, J; Paschke, R

    2012-12-01

    In 27 families with familial non-autoimmune hyperthyroidism (FNAH) reported up to date, the onset of hyperthyroidism varies from 18 months to 60 years. Also the manifestation of goitres is variable in these families. A 74-year-old woman first presented at the age of 69 years with tachyarrhythmia and hypertension. After initial treatment of her hypertension and oral anticoagulation for her intermittent atrial fibrillation, a thyroid workup revealed a suppressed TSH and normal fT3 and fT4. TPO, TSH receptor (TSHR), and thyroglobulin antibodies were negative. Thyroid ultrasound revealed a thyroid volume of 102 ml with several nodules with diameters of up to 2.6 cm right and up to 1.8 cm left. Scintigraphy showed a homogeneous Technetium-99 m ((99 m)Tc) uptake of 1.27%. She was subsequently treated with 1 GBq radioiodine ((131)I). At the age of 74, her thyroid function was normal and her thyroid volume decreased to 90 ml. Because of the diffuse (99 m)Tc uptake and the negative TPO, TSHR, and thyroglobulin antibodies, genetic analysis of her TSHR gene was performed, in spite of her negative family history for hyperthyroidism. Sequencing revealed a N670S TSHR germline mutation. Previous in vitro characterisation of this TSHR mutation suggests a weak constitutive activity, yet the experimental data are ambiguous. This case illustrates the necessity to analyse patients with hyperthyroidism accompanied by diffuse (99 m)Tc uptake and negative TPO, TSHR, and thyroglobulin antibodies for TSHR germline mutations. Moreover, it demonstrates that TSHR germline mutations may first lead to longstanding nodular goitrogenesis before the late manifestation of subclinical hyperthyroidism.

  1. Investigation on the Treatment of Interferon-induced Hyperthyroidism%IFNα引起甲状腺功能亢进治疗的初探

    Institute of Scientific and Technical Information of China (English)

    张旭祥; 念馨; 蒋世钊

    2011-01-01

    目的 探讨干扰素(IFNα)所致甲状腺功能亢进的治疗方案.方法 入组病例共23例,随机分两组,抗甲亢药物组给予甲巯咪唑或丙硫氧嘧啶,病例13例,对症处理组给予普奈洛尔,病例10例.结果 抗甲亢药物组与普奈洛尔对症处理组,在治疗3个月两组甲亢治疗缓解率无差异,6个月及12个月两组甲减发生率无差异.结论 在IFNα所致甲亢的治疗方案中,抗甲亢药物治疗与普奈洛尔对症治疗效果无明显差异,停用IFNα是甲亢缓解的关键.%Objective To investigate the treatment of interferon (IFN alpha) induced hyperthyroidism.Methods 23 patients with interferon-induced hyperthyroidism were randomly divided into two groups. 13patients in the treatment group were administered with anti-thyroid drugs of thiamazole or propyl thiouracil, 10patients in the control grnup were administered with propranolol. Results There was no significant difference in the remission rate of hyperthyroidism between the treatment group and control group 3 months after treatmen.There was no significance difference in the prevalence of hypothyroidism between the two groups 6 and 12 months after treatmen. Conclusion No significant difference can be found in the therapeutic effects on INF-alpha induced hyperthyroidism between anti-thyroid and propranolol therapy, cessation of INF- alpha plays a key role in the remission of hyperthyroidism.

  2. The Brazilian consensus for the diagnosis and treatment of hyperthyroidism: recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism.

    Science.gov (United States)

    Maia, Ana Luiza; Scheffel, Rafael S; Meyer, Erika Laurini Souza; Mazeto, Glaucia M F S; Carvalho, Gisah Amaral de; Graf, Hans; Vaisman, Mario; Maciel, Lea M Z; Ramos, Helton E; Tincani, Alfio José; Andrada, Nathalia Carvalho de; Ward, Laura S

    2013-04-01

    Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis. This consensus, developed by Brazilian experts and sponsored by the Department of Thyroid Brazilian Society of Endocrinology and Metabolism, aims to address the management, diagnosis and treatment of patients with thyrotoxicosis, according to the most recent evidence from the literature and appropriate for the clinical reality of Brazil. After structuring clinical questions, search for evidence was made available in the literature, initially in the database MedLine, PubMed and Embase databases and subsequently in SciELO - Lilacs. The strength of evidence was evaluated by Oxford classification system was established from the study design used, considering the best available evidence for each question. We have defined 13 questions about the initial clinical approach for the diagnosis and treatment that resulted in 53 recommendations, including the etiology, treatment with antithyroid drugs, radioactive iodine and surgery. We also addressed hyperthyroidism in children, teenagers or pregnant patients, and management of hyperthyroidism in patients with Graves' ophthalmopathy and various other causes of thyrotoxicosis. The clinical diagnosis of hyperthyroidism usually offers no difficulty and should be made with measurements of serum TSH and thyroid hormones. The treatment can be performed with antithyroid drugs, surgery or administration of radioactive iodine according to the etiology of thyrotoxicosis, local availability of methods and preferences of the attending physician and patient.

  3. Drug therapy of hyperthyroidism%甲状腺功能亢进症的药物治疗

    Institute of Scientific and Technical Information of China (English)

    何婷婷; 肖海鹏

    2011-01-01

    抗甲状腺药物(ATD)治疗的最佳方案要从药物的选择、具体剂量、给药方式、服药疗程、是否合用左旋甲状腺素(L-T4)、免疫抑制剂及其他影响患者缓解率的因素等多方面综合考虑.除妊娠期妇女外,目前大多数学者将甲硫咪唑(MMI)列为治疗甲状腺功能亢进症(甲亢)的首选药物.药物具体起始剂量可根据患者甲状腺的大小、甲亢病情的严重程度决定,治疗持续时间为12~18个月.但也有将传统的滴定疗法作为治疗甲亢的首选.对于是否在ATD治疗过程中合用L-T4及何时加用L-T4疗效更好,目前仍有争论,而免疫抑制剂的广泛使用仍需要更多临床研究来确认其临床疗效及安全性.%The choice of drug,dosage, administration, course of treatment, the combination of L-T4,the application of immunosuppressive agent, and other factors which can influence the remission rate should be considered in the treatment of hyperthyroidism with antithyroid drugs (ATD). Currently, most researchers consider methimazole(MMI) as the first choice used to treat hyperthyroidism, except for the women during pregnancy. The starting dose should be according to the size of thyroid nodules and the severity of the disease. The duration of therapy was 12 to 18 months. Titration regimens have been widely accepted to be the standard therapy for hyperthyroidism nowadays. Should L-T4 be combined with ATD and choice of optimal medication time is controversial. Further clinical research is needed to conform their safety and efficiency for the widely use of immunosuppressive agents.

  4. Determination of endogenous labelling of thyroid hormones during a radioiodide test in euthyroid goiter patients and hyperthyroid patients

    Energy Technology Data Exchange (ETDEWEB)

    Loos, U.; Konrad, F.; Ishihara, A.; Adam, W.E.; Pfeiffer, E.F.

    1981-02-01

    The administration of a diagnostic dose of radioiodide, as in the radioiodide uptake test, results in the formation and secretion of radioactive thyroid hormones (endogenous labelling). In this report a method is described by which thyroid hormones are chromatographically isolated from serum, with the simultaneous assessment of the incorporated radioactivity over a period of time. A low-level counter was used to measure the small amounts of activity present. By this method the hormone phases during a radioiodide uptake test may be better evaluated. The present results show a good diagnostic discrimination between euthyroidism and borderline or definite hyperthyroidism (by a factor of 10 and 40, respectively). The influence of factors such as a small intrathyroidal iodide pool need, of course, to be considered. Hence, by taking into account such parameters as the intrathyroidal iodide pool, the hormone clearance etc, a technique for the measurement of thyroid hormone secretion can be developed.

  5. Analysis of uncertainties in a individualized method of estimation activity of {sup 1}31I for hyperthyroid patient; Analisis de incertidumbres en un metodo individualizado de estimacion de actividad de {sup 1}31I para el paciente hipertiroideo

    Energy Technology Data Exchange (ETDEWEB)

    Orellana Salas, A.; Melgar Perez, J.; Arrocha Acevedo, J. F.

    2013-07-01

    The determination of the activity to prescribe the hyperthyroid patients presented difficult consideration uncertainties. The uncertainties associated with the experimental design can exceed 20%, so it should be valued to customize activity therapy of {sup 1}31 I. (Author)

  6. Simultaneous induction of Graves’ hyperthyroidism and Graves’ ophthalmopathy by TSHR genetic immunization in BALB/c mice

    Science.gov (United States)

    Hu, Xiaohao; Song, Shiyu; Xu, Hui; Niu, Mengyuan; Wang, Hongwei; Wang, Jian

    2017-01-01

    Background Graves’ disease is the most common form of autoimmune thyroid disorder, characterized by hyperthyroidism due to circulating autoantibodies. To address the pathological features and establish a therapeutic approach of this disease, an animal model carrying the phenotype of Graves’ disease (GD) in concert with Graves’ Ophthalmopathy (GO) will be very important. However, there are no ideal animal models that are currently available. The aim of the present study is to establish an animal model of GD and GO disease, and its pathological features were further characterized. Methods A recombinant plasmid pcDNA3.1- T289 was constructed by inserting the TSHR A-subunit gene into the expression vector pcDNA3.1, and genetic immunization was successfully performed by intramuscular injection of the plasmid pcDNA3.1-T289 on female 8-week-old BALB/c mice. Each injection was immediately followed by in vivo electroporation using ECM830 square wave electroporator. Morphological changes of the eyes were examined using 7.0T MRI scanner. Levels of serum T4 and TSHR antibodies (TRAb) were assessed by ELISA. The pathological changes of the thyroid and orbital tissues were examined by histological staining such as H&E staining and Alcian blue staining. Results More than 90% of the immunized mice spontaneously developed goiter, and about 80% of the immunized mice manifested increased serum T4 and TRAb levels, combined with hypertrophy and hyperplasia of thyroid follicles. A significantly increased synthesis of hyaluronic acid was detected in in the immunized mice compared with the control groups. Conclusion We have successfully established an animal model manifesting Graves’ hyperthyroidism and ophthalmopathy, which provides a useful tool for future study of the pathological features and the development of novel therapies of the diseases. PMID:28319174

  7. Study of factors that influence the outcome of (131)I treatment in hyperthyroidism secondary to nodular goitre.

    Science.gov (United States)

    Tabuenca-Dopico, O; Boente-Varela, R; Lamas-Ferreiro, J L

    2017-06-12

    To assess the outcome after (131)I treatment in patients with multinodular (MNG) and nodular toxic goitre (NTG) according to the administered dose and other factors related to the patient, pathology, or previous treatments. A retrospective study was conducted on 108 patients (67 MNG and 41 NTG) treated in our department, with a follow-up period of at least 2 years. Development of hypothyroidism and treatment failure were evaluated along with their relationship with the administered dose and other factors such as age, sex, grade of hyperthyroidism, type of goitre, presence of autoimmunity, or previous antithyroid medication. More than one-third (36.9%) of MNG patients, and even higher proportion of NTG patients (51.2%) developed non-transient hypothyroidism, particularly in those receiving 740MBq (66.7%). No relationship was found with any other variable. The development of early hypothyroidism (before one year) was also not related to any variable. Treatment failure was not related to the dose, but in MNG there was a relationship with male gender, presence of autoimmunity, or previous antithyroid drugs use. The high rate of hypothyroidism obtained with high doses of (131)I in hyperthyroidism secondary to nodular goitre treatment suggests that lower doses might be sufficient to control the disease without an increase in treatment failures. Only patients with positive autoimmunity, in previous anti-thyroid medication, and perhaps male gender in MNG might be given higher doses, as the failure rate increases, but further studies are required. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  8. Effect of hyperthyroidism on circulating levels of free and total IGF-I and IGFBPs in rats.

    Science.gov (United States)

    Frystyk, J; Grønbaek, H; Skjaerbaek, C; Flyvbjerg, A

    1995-11-01

    Thyroid hormones are suggested to have a permissive role in growth hormone (GH) and insulin-like growth factor I (IGF-I) action and a specific effect on plasma levels of some of the GH-independent IGF binding proteins (IGFBPs). We have investigated the effect of thyroxine (T4) administration on circulating levels of free and total (extractable) IGF-I and IGFBPs in 8-wk-old rats treated with 0, 200, 400, and 600 micrograms/kg T4, respectively. Serum free IGF-I was determined by an ultrafiltration method, serum total IGF-I after acid-ethanol extraction, and serum IGFBPs using Western ligand blotting, which yielded four distinct molecular bands: two single bands at 24 and 30 kDa and a double band at 38 and 42 kDa (38-42 kDa). After 13 days of hyperthyroidism, serum total IGF-I and the high-molecular 38-42 kDa IGFBP were unchanged, whereas the 24-kDa IGFBP and 30-kDa IGFBP increased significantly (P < 0.05). Serum free IGF-I was significantly (P < 0.05) decreased in animals treated with 400 and 600 micrograms/kg T4. In addition, free IGF-I correlated inversely (P < 0.005) with the 24-kDa IGFBP, 30-kDa IGFBP, and serum total triiodothyronine. We conclude that hyperthyroidism in rats increases the circulating low-molecular IGFBPs and induces a reduction in free IGF-I. This may provide an important regulation of IGF bioactivity by thyroid hormones.

  9. Effect of hyperthyroidism decoction on thyroid hormone and thyroid pathological changes of experimental hyperthyroid rats%甲亢方对甲亢大鼠甲状腺激素水平和甲状腺病理改变的影响

    Institute of Scientific and Technical Information of China (English)

    朱传湘; 阳春林; 胡方林; 易法银; 张国民

    2009-01-01

    Objective To observe the effect of hyperthyroidism decoction on thyroid hormone and thyroid pathological changes of ex-perimental hyperthyroid rats. Methods 40 rats were randomly divided into four groups: Normal group,hyperthyreosis model group, western drugs control group and hyperthyroidism decoction group. The model rats were constructed by drenching Youjiale. Hyperthyroidism decoction group were given hyperthyroidism decoction of respective dosage, western drugs control group were given propylthiouracil. The serum contents of T3, T4, FT3, FT4 and TSH were determined by radio-immunity method, the thyroid pathological changes effected by hyperthyroidism de-coction were observed. Results Compared with model group, the contents of serum T3, T4, FT3, FT4, of hyperthyroidism decoction group were decreased, while the contents of serum TSH were increased. Hyperthyroidism decoction may improve thyroid pathological changes of ex-perimental hyperthyroid rats. Conclusion Hyperthyroidism decoction can effectively improve the thyroid function of experimental hyperthy-roid rats.%目的 观察甲亢方(益气滋阴方)对实验性甲亢大鼠甲状腺激素水平和甲状腺病理改变的影响.方法 将40只大鼠随机分成正常组、甲亢模型组、甲亢方组、西药对照组,后三组用优甲乐(左甲状腺素钠)灌服建立甲亢大鼠模型,甲亢方组以甲亢方对模型进行干预,西药对照组以丙基硫氧嘧啶对模型进行干预.采用放射免疫法测定血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)含量,用光学显微镜观察甲状腺病理改变.结果 与模型组相比,甲亢方组血清T3、T4、FT3、FT4含量降低(P<0.01),TSH含量增高(P<0.05);甲亢方能改善甲亢大鼠甲状腺病理改变.结论 甲亢方能明显改善甲亢大鼠甲状腺功能.

  10. 76例乳腺癌并发甲状腺功能亢进的围手术期治疗%Perioperative treatment of breast carcinoma complicared with hyperthyroidism:76 cases

    Institute of Scientific and Technical Information of China (English)

    李莹; 王玲; 吕鹏威; 谷元延

    2011-01-01

    Objective To study the perioperative treatment of breast carcinoma complicated with hyperthyroidism.Methods The perioperative treatment of 76 cases of breast carcinoma complicated with hyperthyroidism in the period of 26 years was retrospectively studied.Results Hyperthyroidism was treated by surgical methods or medical methods in perioperative period.73 cases didn't have any correlative postoperative complications related to hyperthyroidism,3 cases showed postoperative thyroid crisis or clinical signs similar to thyroid crisis,and no death happened.Conclusions For breast carcinoma complicated with hyperthyroidism,if clinical symptoms of hyperthyroidism are apparent,hyperthyroidism should be treated first by surgical methods,and then breast surgery can be considered until basal metabolic rate resumes normal.If clinical symptoms of hyperthyroidism aren't remarkable,breast surgery can be performed directly on the premise of heart control.%目的 探讨并发甲状腺功能亢进(甲亢)的乳腺癌的围手术期处理,探讨甲亢和乳腺癌的关系.方法 对26年间76例并发甲亢的乳腺癌围手术期内甲亢的处理进行回顾性分析.结果 73例无甲亢相关并发症,3例出现甲状腺危象和甲状腺危象类似症状,全组无手术死亡.结论 并发甲亢的乳腺癌手术期前,若甲亢症状明显,应首先行甲亢手术,待基础代谢率正常后才行乳腺癌手术;若无甲亢症状,在控制心率的前提下可直接行乳腺癌手术.

  11. Study on Treatment of Hyperthyroidism Combined With Diabetes Mellitus%甲亢合并糖尿病治疗问题研究

    Institute of Scientific and Technical Information of China (English)

    王海霞

    2015-01-01

    Objective To study the clinical treatment of hyperthyroidism combined with diabetes mellitus.Methods According to the 40 cases of hyperthyroidism complicated with diabetes in July 2007 to July 2010, the research and analysis, using the same hypoglycemic drugs, observe the blood glucose control of patients with hyperthyroidism.Results The dosage of hypoglycemic drugs increased in patients with hyperthyroidism complicated with diabetes mellitus. After controlling for the symptoms of hyperthyroidism, the use of hypoglycemic drugs dose reduction. Conclusion Patients with diabetes mellitus combined with hyperthyroidism patients receiving anti thyroid and hypoglycemic drugs combined treatment, the drug dosage is large, so the patients in the treatment process of diet, drugs and other issues must be reasonable adjustments, so as to ensure that patients in vivo glucose metabolism is stable, the patient's condition can be controled.%目的:研究分析甲亢合并糖尿病的临床治疗方法。方法根据2007年7月~2010年7月的40例甲亢合并糖尿病病例来进行研究分析,使用相同的降糖药物,观察对合并甲亢后患者血糖控制情况。结果甲亢合并糖尿病患者使用降糖药物剂量增加。甲亢症状得到控制后,使用的降糖药物剂量减少。结论糖尿病合并甲亢患者接受抗甲状腺和降糖药物联合治疗的过程长,接受的药物剂量大,所以患者治疗过程的饮食、药物等问题必须要合理的调整,这样才能够保证患者体内的糖代谢稳定,患者的病情才能够得到控制。

  12. The functional change of gonad in patients with hyperthyroidism%甲状腺功能亢进症与性腺功能的关系探讨

    Institute of Scientific and Technical Information of China (English)

    王琼; 王莉; 付建芳; 石敏; 翟文松; 姬秋和; 李晓苗

    2013-01-01

    Objective:To explore the illness severity and duration in patients with hyperthyroidism and relationships between gonad function , providing rationale for clinical treatment .Methods :Serum thyroxin , thyroid autoantibody ,follicle-stimulating hormone(FSH) ,leuteinizing hormone(LH ) ,estradoil(E2 ) ,progesterone(P) ,testosterone(T), prolactin(PRL) was detected and Grouped by course length and severity of hyperthyroidism.Results:Addition to the progesterone in male patients with hyperthyroidism ,Severe hyperthyroidism group and moderate , mild hyperthyroidism comparison , FSH ,LH ,E2 ,T ,PRL has significant differences ( P<0 .05 ) , and comparison of course longer and shorter course groups , FSH ,LH ,E2 ,T ,PRL also showed a marked difference(P<0 .05) .Conclusion :Hyperthyroidism more heavy , long course, the greater the degree of inhibition of gonadal function .%目的:探讨甲状腺功能亢进症(甲亢)患者病情的严重程度及病程长短与性腺功能之间的关系.方法:对63例甲亢患者进行实验室检查,按病程长短及甲亢严重程度分组,分别测定血清中甲状腺激素、甲状腺自身抗体、促卵泡成熟激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)、孕酮(P)、睾酮(T)和垂体泌乳素(PRL),判断甲状腺功能与性腺功能状态.结果:除男性甲亢患者P外,重度甲亢组与中度、轻度甲亢组比较,FSH、LH、E2、T、PRL均有显著性差异(P<0.05),而病程较长组与病程较短组比较,FSH、LH、E2、T、PRL亦有显著性差异(P<0.05).结论:甲亢程度越重,病程越长,对性腺功能的抑制程度越大.

  13. A fase estrogênica altera a resposta do osso e do metabolismo mineral de ratas com hipertireoidismo? Does the estrogenic phase modify the bone and mineral metabolism response in rats under hyperthyroidism?

    Directory of Open Access Journals (Sweden)

    N.M. Ocarino

    2003-08-01

    Full Text Available The effect of the estrogenic phase in the bone and in the mineral metabolism was studied in Wistar adult female rats kept under euthyroidism or hyperthyroidism for 60 days. The rats were divided, according to the stage of the estrous cycle, into four groups: 1 euthyroid (proestrus-estrus, 2 euthyroid (metaestrus-diestrus, 3 hyperthyroid (proestrus-estrus, and 4 hyperthyroid (metaestrus-diestrus. After 60 days the blood plasma was collected and the concentrations of free T4, estradiol, progesterone, calcium, phosphorus, and of alkaline phosphatase were determined. The bones (femur and tibia were analysed microscopically. Despite of the functional state of the thyroid, the levels of estrogen were significantly higher in the proestrus-estrus. The estrogenic phase increased the plasmatic concentration of calcium significantly in the euthyroid rats but it did not alter the levels of phosphorus and alkaline phosphatase. In the hyperthyroid state no significant differences in the plasmatic concentrations of calcium, phosphorus and alkaline phosphatase throughout the cycle were found. The phases of the cycle did not also influence the bone morphology in the euthyroid and hyperthyroid states. It was concluded that the estrogenic phase increases the plasmatic concentration of calcium, even without altering the bone morphology of the euthyroid rats. In addition the estrogenic phase does not increase the plasmatic calcium and it does not modify the response of the bone as well as of the mineral metabolism under effect of the hyperthyroidism.

  14. Clinical Study on Serum TGAb, TPOAb, after the Treatment of Graves Hyperthyroidism with131I%Graves甲亢131I治疗后血清TGAb、TPOAb的临床研究

    Institute of Scientific and Technical Information of China (English)

    李运成

    2014-01-01

    目的:研究Graves甲亢131I治疗后血清TGAb、TPOAb的临床意义。方法通过Graves甲亢131I治疗后血清TGAb、TPOAb的检测,分析Graves甲亢经131I治疗后病情转归与血清TGAb、TPOAb的关系。结果 Graves甲亢131I治疗后甲低患者或复发患者的血清TGAb、TPOAb抗体阳性率明显高于痊愈患者。结论 Graves甲亢经131I治疗后,血清TPOAb、TGAb抗体阳性率明显升高常提示并发甲低或甲亢复发。%Objective Study the clinical significance of serum TGAb, TPOAb after the treatment of Graves hyperthyroidism with131I.Method By the detection of serum TGAb, TPOAb, after the treatment of Graves hyperthyroidism with131I ,analysis the relation of Graves hyperthyroidism and serum TGAb, TPOAb.Result After the treatment of Graves hyperthyroidism with131I , serum TGAb, TPOAb antibody positive rate in patients with hypothyroidism or relapse patients was significantly higher than that of cured patients.Conclusion After the treatment of Graves hyperthyroidism with131I ,serum TPOAb, TGAb antibody positive rate often hinted hypothyroidism or hyperthyroidism relapse.

  15. The Clinical Observation hyperthyroid patients with Bio-activeity Peptide in Plasma%甲亢患者血浆中生物活性肽的临床应用

    Institute of Scientific and Technical Information of China (English)

    樊英芳; 任众; 陈乃麟; 李胜昔

    2002-01-01

    Objective Observing the content of ET, CGRP and NT, NPY in plasma, which it affects with hyperthyroidpatients so as to supply sevcral new necessary indexes of observation with clinic. Methods RIA A total of 104 normal people(age from 19 to 46) are examined, among whom 96 are hyperthyroid patients. Results Firstly, the ET of hyperthyroid patientsis obviously twice higher than that of the healthy people with P < 0.01 and with a notable difference. Secondly, the CGRP ofhyperthyroid patients is markedly lower than that of the normal people with P < 0.01 and a marked difference. Thirdly, the NTof hyperthyroid patients is evidently lower than that of the healthy people with P < 0.01 and with a remarkable difference.Fourthly, the NPY of hyperthyroid patients is obviously lower than that of the healthy people with P < 0.01 and a notabledifference. Conclusion CGRP and ET, NT and NPY have stated influences with hyperthyroid patients, which they have anotable difference than healthy people. This pair of CGRP, ET and NT, NPY is a kind negative relative relation. Based on thehyperthyroid patients' clinical symptoms, which restricts with each other to express their strong or weak and recover from stateof an illness of hyperthyroid patients, including the improvement of clinical symptoms lysis and detecting index, which it isimportant for clinical application.

  16. Selective modification of the pyruvate dehydrogenase kinase isoform profile in skeletal muscle in hyperthyroidism: implications for the regulatory impact of glucose on fatty acid oxidation.

    Science.gov (United States)

    Sugden, M C; Lall, H S; Harris, R A; Holness, M J

    2000-11-01

    The pyruvate dehydrogenase kinases (PDK1-4) regulate glucose oxidation through inhibitory phosphorylation of the pyruvate dehydrogenase complex (PDC). Immunoblot analysis with antibodies raised against recombinant PDK isoforms demonstrated changes in PDK isoform expression in response to experimental hyperthyroidism (100 microg/100 g body weight; 3 days) that was selective for fast-twitch vs slow-twitch skeletal muscle in that PDK2 expression was increased in the fast-twitch skeletal muscle (the anterior tibialis) (by 1. 6-fold; P lactate --> glucose (Cori) and glucose --> alanine --> glucose cycles. We also propose that enhanced relative expression of the pyruvate-insensitive PDK isoform (PDK4) in skeletal muscle in hyperthyroidism uncouples glycolytic flux from pyruvate oxidation, sparing pyruvate for non-oxidative entry into the tricarboxylic acid (TCA) cycle, and thereby supporting entry of acetyl-CoA (derived from fatty acid oxidation) into the TCA cycle.

  17. Advances in the treatment of hyperthyroidism with ~(131)Ⅰ%~(131)Ⅰ治疗甲状腺功能亢进症的进展

    Institute of Scientific and Technical Information of China (English)

    邢家骝; 丁勇; 方毅

    2010-01-01

    近年来国内外发表了一些~(131)Ⅰ治疗甲状腺功能亢进症(甲亢)的临床指南.这些指南表明了~(131)Ⅰ治疗甲亢在5方面的进展,包括:(1)~(131)Ⅰ治疗亚临床甲亢;(2)~(131)Ⅰ治疗Graves甲亢合并甲状腺摄碘率升高的慢性淋巴细胞性甲状腺炎;(3)~(131)Ⅰ治疗儿童和青少年甲亢;(4)~(131)Ⅰ治疗Graves眼病;(5)~(131)Ⅰ治疗难治性重度甲亢.本文简要介绍并评价有关内容.%During recent years,some clinical guidelines for ~(131)Ⅰ treatment of hyperthyroidism were published abroad and in China.These guidelines represent the advances in this field.They include:(1)~(131)Ⅰjn the treatment of subclinical hyperthyroidism;(2)~(131)Ⅰ in the treatment of Graves'disease and associated Hashimoto's thyroiditis with high radioactive iodine uptake(RAIU);(3)~(131)Ⅰ treatment in children and adolescents with hyperthyroidism;(4)~(131)Ⅰ in the treatment of Graves'ophthalmopathy;(5)~(131)Ⅰ in the treatment of refractory severe hyperthyroidism.This review briefly introduces and comments these related issues.

  18. Curative effect analysis of hyperthyroidism by operation treatment%手术治疗甲状腺功能亢进症疗效分析

    Institute of Scientific and Technical Information of China (English)

    骆文辉; 练森

    2014-01-01

    目的:探讨手术治疗甲状腺功能亢进疗效情况。方法:分析甲状腺功能亢进症患者72例临床资料,依据治疗措施不同进行临床分组,分为手术治疗组40例和非手术治疗组32例。结果:手术治疗组甲状腺功能亢进临床治疗总有效率明显高于非手术治疗组,差异均有统计学意义( P﹤0.05)。结论:手术治疗甲状腺功能亢进症患者可以明显改善临床症状,恢复甲状腺素水平,值得临床推广应用。%Objective To approach curative effect analysis of hyperthyroidism by operation treatment. Method Analysis of 72 patients clinical data of hyperthyroidism patients,which was to be divided into two groups,non operation treatment group 32 cases and operation treatment group 40 cases. Results The clinical treatment efficiency of hyperthyroidism patients of operation treatment group were higher than non operation treatment group,the difference was statistical significance( P﹤0. 05 ). Conclusion The clinlcal symptom of hyperthy-roidism patients is improved by operation treatment,Thyroid hormone levels is improved,which is to be used.

  19. 131I治疗甲亢时心理干预的价值探讨%Psychological intervention in the course of 131I therapy for hyperthyroidism value

    Institute of Scientific and Technical Information of China (English)

    王长修

    2010-01-01

    目的 探讨心理干预在131I治疗甲亢过程中的应用价值.方法 选取75例要求服131I治疗的甲亢患者分成两组:心理干预组45例,应用131I治疗同时进行心理干预及心理护理;对照组30例,单纯应用131I常规治疗.结果 干预组甲亢复发率明显降低,患者对治疗满意度、症状改善及生活质量明显优于对照组,具有统计学意义(P<0.05).结论 在131I治疗过程中对患者及其家属进行有效的心理干预更符合现代医学的发展,具有重要的临床价值.%Objective To discuss psychological intervention in the course of 13iI therapy for hyperthyroidism value. Methods Select the required 131I treatment of 75 patients with hyperthyroidism were divided into two groups:Psychological intervention group of 45 patients, application of 131I treatment with psychological intervention and nursing; Control group of 30 patients, simple application of 131I treatment. Results Intervention group significantly reduced the recurrence rate of hyperthyroidism, patient treatment satisfaction, symptom improvement and quality of life than the control group was statistically significant (P< 0.05). Conclusion Throughout the course of 131I treatment on hyperthyroid patients and their families on psychological interventions is more in line with the development of modern medicine. Have important clinical significance.

  20. Experience in surgical treatment of hyperthyroidism%甲状腺功能亢进的外科临床治疗观察

    Institute of Scientific and Technical Information of China (English)

    张敏

    2016-01-01

    Objective To summarize the experience of surgical treatment for patients with hyperthyroidism. Methods the clinical data of 47 patients with hyperthyroidism who had been treated in our hospital from June 2014 to June in our hospital were analyzed and summarized. The clinical data of patients with hyperthyroidism were analyzed. Results in 47 cases, 32 cases with thiourea iodine preoperative preparation, 15 cases with single iodine preoperative preparation. All patients were operated with total thyroidectomy, and no complications such as the reduction of the function of the side of the thyroid gland. Conclusion surgical treatment of hyperthyroidism is safe and effective, but it needs to be set up before the operation, and select the appropriate surgical plan.%目的:总结对甲状腺功能亢进患者进行手术治疗体会。方法对2014年6月至2016年6月进入我院治疗的47例甲状腺功能亢进患者进行了外科手术治疗,对患者的临床资料进行总结分析。结果47例患者中有32例采用硫脲类药物加碘进行术前准备,15例单用碘剂术前准备。所有患者都采取甲状腺全切手术,术后无甲状腺旁腺功能降低等并发症。结论通过外科手术治疗甲状腺功能亢进是安全有效的,但需要对手术前准备工作合理设置,并选择恰当的手术方案。

  1. Place of synthesis anti thyroids in the hyperthyroidism treatment by iodine 131; Place des antithyroidiens de synthese dans le traitement par iode 131 des hyperthyroidies

    Energy Technology Data Exchange (ETDEWEB)

    Clerc, J. [Hopital Necker, 75 - Paris (France)

    2000-01-01

    The prescription of synthesis anti thyroids allows to get a fast control of hyperthyroidism when the average time of curing after iodine 131 varies from 6 to 12 weeks, according to the level of radiation doses. It allows to treat the patients in euthyroidism and to avoid aggravation of thyrotoxicosis in the following of the iodine and is particularly useful for the old patients with a cardio vascular risk.

  2. Exceptional hyperthyroidism and a role for both major histocompatibility class I and class II genes in a murine model of Graves' disease.

    Directory of Open Access Journals (Sweden)

    Sandra M McLachlan

    Full Text Available Autoimmune hyperthyroidism, Graves' disease, can be induced by immunizing susceptible strains of mice with adenovirus encoding the human thyrotropin receptor (TSHR or its A-subunit. Studies in two small families of recombinant inbred strains showed that susceptibility to developing TSHR antibodies (measured by TSH binding inhibition, TBI was linked to the MHC region whereas genes on different chromosomes contributed to hyperthyroidism. We have now investigated TSHR antibody production and hyperthyroidism induced by TSHR A-subunit adenovirus immunization of a larger family of strains (26 of the AXB and BXA strains. Analysis of the combined AXB and BXA families provided unexpected insight into several aspects of Graves' disease. First, extreme thyroid hyperplasia and hyperthyroidism in one remarkable strain, BXA13, reflected an inability to generate non-functional TSHR antibodies measured by ELISA. Although neutral TSHR antibodies have been detected in Graves' sera, pathogenic, functional TSHR antibodies in Graves' patients are undetectable by ELISA. Therefore, this strain immunized with A-subunit-adenovirus that generates only functional TSHR antibodies may provide an improved model for studies of induced Graves' disease. Second, our combined analysis of linkage data from this and previous work strengthens the evidence that gene variants in the immunoglobulin heavy chain V region contribute to generating thyroid stimulating antibodies. Third, a broad region that encompasses the MHC region on mouse chromosome 17 is linked to the development of TSHR antibodies (measured by TBI. Most importantly, unlike other strains, TBI linkage in the AXB and BXA families to MHC class I and class II genes provides an explanation for the unresolved class I/class II difference in humans.

  3. Observation on the Therapeutic Effect of Diabetes Mellitus Complicated With Hyperthyroidism%关于糖尿病合并甲亢的治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    刘秀娟; 周晓佳

    2016-01-01

    Objective To investigate the treatment of diabetes mellitus complicated with hyperthyroidism (hyperthyroidism). Methods Combining humulin treatment 50 cases of our hospital treatment of diabetes complicated with hyperthyroidism patients, control group of 25 cases treated with hydrochloric acid metformin tablets in the treatment, the experimental group 25 patients in this foundation, comparative analysis of the therapeutic effect of two groups of patients. Results The effective rate of treatment in the experimental group was 96%, the effective rate of the control group was 56%, the difference between the two groups was statistically signiifcant. Conclusion The combined treatment effect of metformin hydrochloride tablets and the superior and the combined treatment of the patients with diabetes and hyperthyroidism is obvious, which is the ifrst choice for clinical treatment.%目的探讨糖尿病合并甲状腺功能亢进症(甲亢)的治疗。方法选择我院治疗的糖尿病合并甲亢患者50例,对照组25例口服盐酸二甲双胍片治疗,实验组25例患者在此基础上结合优泌林治疗,对比分析两组患者的治疗效果。结果实验组患者治疗有效率是96%,对照组治疗有效率是56%,两组的治疗有效率对比差异具有统计学意义。结论临床中为糖尿病合并甲亢患者采取盐酸二甲双胍片联合优泌林治疗具有非常好的效果,是临床治疗的首选药物。

  4. Reduced cystatin C-estimated GFR and increased creatinine-estimated GFR in comparison with iohexol-estimated GFR in a hyperthyroid patient: A case report

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    Karawajczyk Malgorzata

    2008-02-01

    Full Text Available Abstract Introduction Estimation of the glomerular filtration rate (GFR is essential for the evaluation of patients with kidney disease, and for treating patients with drugs that are eliminated from the circulation by the kidneys. Cystatin C has been shown to be superior to creatinine for estimating GFR in several studies. However, studies showing that thyroid function has an impact on cystatin C have not addressed the question of whether the changes in cystatin C levels are due to changes in GFR or in cystatin C synthesis. Case presentation We report an account of a hyperthyroid patient with a discrepancy between the GFR estimates from cystatin C and creatinine. The cystatin C concentration (1.36 mg/L was higher and gave an estimated GFR which was lower (51 mL/min/1.73 m2, while the creatinine concentration was lower (36 μmol/L and gave a corresponding creatinine-estimated GFR that was higher (145 mL/min/1.73 m2 than the iohexol-estimated GFR (121 mL/min/1.73 m2 during the hyperthyroid period. After thyroidectomy, the creatinine concentration was 36 μmol/L and creatinine-estimated GFR was calculated as 73 mL/min/1.73 m2, while the cystatin C concentration and cystatin C-calculated GFR was 0.78 mg/L and 114 mL/min/1.73 m2, respectively. Conclusion In contrast to creatinine, cystatin C levels rose in the hyperthyroid state as compared to the euthyroid state. The cystatin C-estimated GFR was reduced compared to the iohexol-estimated GFR. This patient case shows that the hyperthyroid-associated changes in cystatin C levels are not due to changes in GFR. Thyroid function should thus be considered when both cystatin C and creatinine are used as markers of kidney function.

  5. Long-term follow-up studies on iodine-131 treatment of hyperthyroid Graves' disease based on the measurement of thyroid volume by ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Tsuruta, Masako; Nagayama, Yuji; Yokoyama, Naokata; Izumi, Motomori; Nagataki, Shigenobu (Nagasaki Univ. (Japan). School of Medicine)

    1993-08-01

    In the present series of studies, the long-term (four year) effect of 80 Gy of [sup 131]I treatment was evaluated in patients with hyperthyroid Graves' disease whose thyroid volumes have been accurately estimated with a high resolution ultrasound scanner. One year after [sup 131]I treatment, 23.1% (3 out of 13 patients) remained hyperthyroid, 69.2% (9 out of 13) became euthyroid, and 7.7% (1 out of 13) were in a hypothyroid state. Since three patients in a hyperthyroid state one year after treatment were subsequently treated with either antithyroid drugs or additional [sup 131]I treatment, the remaining ten patients (9 euthyroid and 1 hypothyroid patients) have been followed up for three more years. Two patients developed a hypothyroid state three years after treatment and one patient four years after treatment. Overall, 60% (6 out of 10 patients) were in a euthyroid state and 40% (4 out of 10) in a hypothyroid state, four years after 80 Gy [sup 131]I treatment. There was no significant difference between eu- and hypo-thyroid groups in the sex ratio, age, radiation doses, therapeutic dose, thyroid gland volume, 24-hr [sup 131]I uptake, the effective half-life of [sup 131]I in the thyroid or the duration of hyperthyroidism. In our preliminary studies, the incidence of late hypothyroidism in our [sup 131]I treatment is similar to those previously reported. These suggest that uncertain factor(s), such as inhomogeneity of iodine distribution in the thyroid, unequal sensitivity of the thyroid cells to the radiation, and/or persistent destructive effects of the autoimmune process may influence the long-term effect of [sup 131]I treatment of Graves' disease. (author).

  6. An improved Graves' disease model established by using in vivo electroporation exhibited long-term immunity to hyperthyroidism in BALB/c mice.

    Science.gov (United States)

    Kaneda, Toshio; Honda, Asako; Hakozaki, Atsushi; Fuse, Tetsuya; Muto, Akihiro; Yoshida, Tadashi

    2007-05-01

    In Graves' disease, the overstimulation of the thyroid gland and hyperthyroidism are caused by autoantibodies directed against the TSH receptor (TSHR) that mimics the action of TSH. The establishment of an animal model is an important step to study the pathophysiology of autoimmune hyperthyroidism and for immunological analysis. In this study, we adopted the technique of electroporation (EP) for genetic immunization to achieve considerable enhancement of in vivo human TSHR (hTSHR) expression and efficient induction of hyperthyroidism in mice. In a preliminary study using beta-galactosidase (beta-gal) expression vectors, beta-gal introduced into the muscle by EP showed over 40-fold higher enzymatic activity than that introduced via previous direct gene transfer methods. The sustained hTSHR mRNA expression derived from cDNA transferred by EP was detectable in muscle tissue for at least 2 wk by RT-PCR. Based on these results, we induced hyperthyroidism via two expression vectors inserted with hTSHR or hTSHR289His cDNA. Consequently, 12.0-31.8% BALB/c mice immunized with hTSHR and 79.2-95.7% immunized with hTSHR289His showed high total T(4) levels due to the TSHR-stimulating antibody after three to four times repeated immunization by EP, and thyroid follicles of which were hyperplastic and had highly irregular epithelium. Moreover, TSHR-stimulating antibody surprisingly persisted more than 8 months after the last immunization. These results demonstrate that genetic immunization by in vivo EP is more efficient than previous procedures, and that it is useful for delineating the pathophysiology of Graves' disease.

  7. The psychological characteristics and related nursing on patients with hyperthyroidism%甲亢患者的心理特点及相关护理对策

    Institute of Scientific and Technical Information of China (English)

    凌秋平

    2011-01-01

    Objective: To explore the psychological characteristics of patients with hyperthyroidism and it' s clinical effect of psychological nursing.Methods : 97 cases of patients with hyperthyroidism were given targeted psychological nursing according to psychological characteristics.Results: The psychological states of patients improved significantly after targeted nursing ( P < 0.05 ).Conclusion: Targeted psychological nursing used for recovery of hyperthyroidism patients, can enhance clinical effect and improve life quality of patients, so it deserved application and promotion in clinical work.%目的:探讨甲亢患者的心理特点及心理护理的临床效果.方法:对97例甲亢患者的心理特点进行分析并给予针对性的心理护理.结果:给予针对性护理后,患者心理状态与护理前有显著性改善(P<0.05).结论:针对性的心理干预应用于甲亢患者的康复,能显著改善临床效果,提高患者生活质量,值得在临床上应用和推广.

  8. 甲状腺功能亢进的手术前后护理体会%Nursing Realize Before and After Surgery of Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    孙小丽

    2014-01-01

    目的:探讨甲状腺功能亢进患者手术前后护理方法要点。方法选取40例甲状腺功能亢进患者手术前后护理资料进行分析。结果所有患者全部治愈治疗效果满意,无甲亢复发、永久性甲状旁腺功能减退。结论手术前完善术前各项检查,加强术后观察和护理及术后并发症的防治与护理工作。%Objective Key points of nursing methods before and after surgery of hyperthyroidism are to be investigated. Methods Nursing data before and after surgery of 40 cases of patients with hyperthyroidism were selected for analysis. Results All of patients were cured with satisfactory treatment effects without recurrence of hyperthyroidism and permanent hypoparathyroidism. Conclusion Before surgery,every preoperative text should be completed.After surgery,postoperative observation and nursing need to be strengthen as wel as prevention and nursing of complication.

  9. Long-Term Follow-Up of a Child with Autoimmune Thyroiditis and Recurrent Hyperthyroidism in the Absence of TSH Receptor Antibodies

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    Christopher Dunne

    2014-01-01

    Full Text Available Hashitoxicosis is an initial, transient, hyperthyroid phase that rarely affects patients with Hashimoto thyroiditis. We present here an unusual case of a child with Hashimoto thyroiditis and recurrent hyperthyroidism. A 4 yr 6/12 old male was diagnosed by us with autoimmune subclinical hypothyroidism (normal free T4, slightly elevated TSH, and elevated TG antibody titer. Two years and 6/12 later he experienced increased appetite and poor weight gain; a laboratory evaluation revealed suppressed TSH, elevated free T4, and normal TSI titer. In addition, an I123 thyroid uptake was borderline-low. A month later, the free T4 had normalized. After remaining asymptomatic for 3 years, the patient presented again with increased appetite, and he was found with low TSH and high free T4. Within the following 3 months, his free T4 and TSH normalized. At his most recent evaluation, his TSH was normal and the free T4 was borderline-high; the TG antibody titer was still elevated and the TSI titer was negative. To our knowledge, this is the first patient reported with Hashimoto thyroiditis and recurrent hyperthyroidism. This case exemplifies the variability of the manifestations and natural history of Hashimoto thyroiditis and supports the need for a long-term evaluation of patients with autoimmune thyroid disease.

  10. 甲状腺功能亢进症心动过缓9例分析%Hyperthyroidism presenting as bradycardia:a report of 9 cases

    Institute of Scientific and Technical Information of China (English)

    赫萍; 赵令君; 史蕴萍

    2001-01-01

    Objective To report hyperthyroidism also possessing bradycardia. Methods 9 patients with hyperthyroidism were performed thyroid function test,electrocardioagram,holter monitor ECG and the sinoatrial node function test.They are treated with the tapazole. Results All patients heart rate recovered to normol after treatment. Conclusion Hyperthyroidism presenting as bradycardia is related to the sinoatrial node function.%目的了解甲状腺功能亢进症也存在心动过缓的临床表现。方法 9例甲亢患者进行甲状腺功能测定,心电图描记,动态心电图监测,窦房结功能检测,应用抗甲状腺药物治疗。结果经抗甲状腺药物治疗后,心率正常。结论甲亢可影响窦房结功能使其心动过缓。

  11. Effect on thyroid function and serum PTH, BGP, CT of small dose of iodine 131 combined with Methimazole in patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    Jia-Yin Qiu; Yan Zhu; Qing-Hong Xi

    2016-01-01

    Objective:To observe the effect Effect on thyroid function and serum PTH, BGP, CT of small dose of iodine 131 combined with Methimazole in patients with hyperthyroidism. Methods:A total of 104 patients with hyperthyroidism willing be incorporated into the study were randomly divided into the observation group (54 cases) and the control group (50 cases). The control group was treated with Methimazole, and the observation group was given a small dose of iodine 131 the basised on the control group. For 2 months, to observe the changes of thyroid function (TT3, TT4, FT3, FT4 and TSH) and bone metabolism related indexes (PTH, BGP and CT) of the two groups. Results:(1) After treatment, TT3, FT3, TT4 and FT4 of the two groups decreased with before, and the observation group improved more significantly than the control group, with statistical difference;TSH of the two groups had no significant change. (2) After treatment, BGP and CT of the two groups decreased and PTH increased, the observation group improved more significantly than the control group, with statistical difference. Conclusion:small dose of iodine 131 combined with Methimazole can correct thyroid function and bone metabolism quickly in patients with hyperthyroidism.

  12. Misdiagnosis Analysis of 29 Cases of Hyperthyroid Heart Disease in Elderly%老年甲亢性心脏病29例误诊分析

    Institute of Scientific and Technical Information of China (English)

    刘央

    2009-01-01

    Objective To discuss the misdiagnosis causes of hypcrlhyroid heart disease in elderly. Methods 29 cases of hyperthyroid heart disease in el-derly were analyzed retrospectively. Results The clinical manifestations of hyperthyroid heart disease in elderly are untypical and diverse, which were easily misdiagnosed as other cardiovascular diseases. Conclusion To increase awareness of hyperthyroid heart disease in elderly, it is the key to avoid misdiagnosis by inquiring history systematically, doing medical examination carefully, analyzing pathogenetic condition correctly and carrying on thyroid function tests in time.%目的 探讨老年甲亢性心脏病的误诊原因.方法 对29例老年甲亢性心脏病患者临床资料进行回顾分析.结果 老年甲亢性心脏病的临床表现不典型且多样化,易误诊为其他心血管疾病.结论 提高对老年甲亢性心脏病的认识,详细问诊,仔细体检,正确分析病情,及时进行甲状腺功能检查是避免误诊的关键.

  13. A two-day-old hyperthyroid neonate with thyroid hormone resistance born to a mother with well-controlled Graves’ disease: a case report

    Directory of Open Access Journals (Sweden)

    Yatsuga Shuichi

    2012-08-01

    Full Text Available Abstract Introduction Resistance to thyroid hormone is a syndrome caused by thyroid hormone receptor β mutations, which are usually inherited in an autosomal-dominant pattern. Case presentation Our patient, a Japanese neonate boy, showed hyperthyroid symptoms at age two days. Although our patient was diagnosed as having resistance to thyroid hormone, his hyperthyroid symptoms continued for two weeks. Therefore, our patient was treated with methimazole and iodine for two weeks from birth, showing no side effects and no symptoms upon treatment. At age 70 days, an R243W mutation in thyroid hormone receptor β was detected in our patient; while absent in his mother, the mutation was present in his father, who never showed any symptoms. Conclusions To the best of our knowledge this is the first case report of a resistance to thyroid hormone in a neonate presenting with hyperthyroid symptoms born to a mother with Graves’ disease and treated with methimazole and iodine. These results suggest that methimazole and iodine may be a good short-term option for treatment.

  14. Thyroid-stimulating hormone-secreting pituitary adenoma presenting with recurrent hyperthyroidism in post-treated Graves’ disease: a case report

    Directory of Open Access Journals (Sweden)

    Ogawa Yoshikazu

    2013-01-01

    Full Text Available Abstract Introduction The coexistence of autoimmune hyperthyroid disease and thyroid-stimulating hormone-secreting pituitary adenoma is rare. The simple presumption of coincidence of these two diseases has a calculated incidence of less than one/several hundred million, and only four cases with histological confirmation have been reported. A rapid decrease in thyroid-stimulating hormone level after pituitary tumor removal may induce subsequent activation of autoimmune responses against the thyroid gland. We report the first case of a sequential and paradoxical occurrence of Graves’ disease and a thyroid-stimulating hormone-secreting pituitary adenoma. Case presentation A 32-year-old Japanese woman had recurrent hyperthyroidism. She had a history of Graves’ hyperthyroidism, which had been successfully treated with propylthiouracil. A head magnetic resonance imaging showed a less enhanced area in the left lateral wing of her sella turcica. Transsphenoidal surgery was performed, and the diagnosis was established as thyroid-stimulating hormone-secreting plurihormonal adenoma. A rapid reduction in thyroid hormone levels was achieved, and her blood pressure was normalized after the operation. Conclusion Although incidental occurrence is the most probable etiology, long and repeated followup examinations of both thyroid and pituitary gland should be performed in patients with an atypical clinical course.

  15. Caracterização vocal de pacientes com hipertireoidismo e hipotireoidismo Vocal characterization of patients with hyperthyroidism and hypothyroidism

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    Roberta Werlang Isolan-Cury

    2007-06-01

    Full Text Available OBJETIVO: Caracterizar a qualidade vocal, por meio de análise computadorizada e perceptivo-auditiva, de pacientes com hipertireoidismo (grupo A e hipotireoidismo (grupo B. MÉTODOS: Vinte mulheres não fumantes, com idades entre 18 e 55 anos, atendidas no Ambulatório de Endocrinologia da instituição, foram avaliadas após o diagnóstico clínico e laboratorial de hipertireoidismo ou hipotireoidismo. Os parâmetros investigados foram: tempo da doença, presença de queixa vocal, tempos máximos de fonação /a/, /s/ e /z/, freqüência fundamental (F0, ruído glótico (GNE. Os aspectos avaliados na análise perceptivo-auditiva, foram: coordenação pneumo-fonoarticulatória (coordenada ou incoordenada, pitch, loudness, ataque vocal, ressonância, velocidade de fala e qualidade vocal, que poderia ter até duas das seguintes classificações: neutra, rouca, soprosa, áspera ou tensa, e grau: leve, moderado ou severo. Os dados foram tabulados e analisados estatisticamente através do programa EPI-INFO 6.04b, método qualitativo Fisher, com nível de significância menor do que 0.05. RESULTADOS: A análise perceptivo-auditiva mostrou que sete pacientes hipotireoideos e nove pacientes hipertireoideos apresentaram alteração na qualidade vocal. Oito pacientes em ambos os grupos apresentaram incoordenação pneumo-fonoarticulatória. Oito pacientes do grupo A e seis pacientes do grupo B referiam queixas vocais como rouquidão e voz grossa, respectivamente. Na análise acústica, nove pacientes apresentaram o ruído glótico alterado. CONCLUSÃO: Os resultados evidenciaram grande incidência de alteração vocal nos grupos estudados (grupos dos pacientes com hipertireoidismo e com hipotireoidismo, o que demonstra a relação entre disfonia e disfunções tireoideanas.PURPOSE: To characterize the vocal quality of subjects with hyperthyroidism (group A, and hypothyroidism (group B through a computer-aided and auditory-perceptive analysis. METHODS

  16. Drug application of hyperthyroidism%甲状腺功能亢进症的药物应用

    Institute of Scientific and Technical Information of China (English)

    徐海燕; 邵迎新

    2011-01-01

    治疗甲状腺功能亢进症(甲亢)的药物主要包括抗甲状腺药(ATD)甲巯咪唑(MMI)和丙基硫氧嘧啶(PTU),β受体阻滞剂盐酸普萘洛尔,碘剂复方碘溶液,糖皮质激素泼尼松等,如何合理应用这些药物是临床医生应慎重考虑的问题.笔者认为药物选择的最佳方案要从药物的安全性、剂量、给药方式、激素伍用时机等方面进行综合考虑.通过查阅文献得出,与PTU相比,MMI不良反应显著低于PTU,而且MMI的不良反应大多与剂量有关,而PTU的不良反应与剂量无显著相关性,特别是PTU可能导致致命性肝损害,因此,笔者认为治疗甲亢应首选MMI,尤其对儿童和青少年甲亢患者,而PTU主要应用于孕妇和甲亢危象;盐酸普萘洛尔可按说明书服用;碘剂用于甲状腺术前准备和甲亢危象;糖皮质激素泼尼松在严重甲亢、肝功能损害、白细胞减少、皮肤过敏时可小剂量应用2~8周.%Drugs application in hyperthyroidism therapy mainly including following kinds of drugs, MMI and PTLJ are the common antithyroid drugs using for hyperthyroidism therapy and β receptor blockers usually chooses Propranolol, compound iodine solution and glucocorticoid Prednisone are also often used for hyperthyroidism. Doctors should consider care -fully about how to choose these drugs reasonably. Best drug usage plan should consider drug safety, dosage, drug delivery and the time of hormone compatibility. According to literature, compared with PTLJ, the adverse reaction incidence of MMI is obvious lower than PTLJ and the adverse reaction of MMI manifests dose relation but PTLJ has no dose relation. More -over, PTLJ can lead to fatal liver damage. Therefore, MMI is a preferred choice especially for children and young people. PTLJ is mainly used for pregnant woman and thyroid crisis. Administration of Propranolol is according to drug manual. Io -dine is used for thyroid preoperative preparation and thyroid crisis. Prednisone

  17. Avances en cirugia ortopedica y traumatologica- Siglo XXI

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín del Gordo D´Amato

    2013-10-01

    Full Text Available En décadas anteriores la cirugía ortopédica y traumatológica constituía la excepción a la regla en el tratamiento de estas lesiones en razón a la preferencia de los tratamientos conservadores tales como los yesos y tracciones. Resulta innegable que muchos de estos tratamientos mostraban resultados satisfactorios en cuanto a la consolidación de la fractura1, sin embargo, los problemas de consolidación en posición no adecuada resultaban altamente frecuentes con el tratamiento ortopédico.

  18. CIRUGIA DEL CANCER DE RECTO EN PACIENTES DE EDAD AVANZADA.

    Directory of Open Access Journals (Sweden)

    Dr. Gino Caselli M.

    2007-12-01

    Full Text Available INTRODUCTION:

  19. LIGADURA DE LAS ARTERIAS ILIACAS INTERNAS (HIPOGASTRICAS) EN CIRUGIA OBSTETRICA

    OpenAIRE

    Torres A,Octavio; Bueno N,Francisco; González R,Reinaldo; Bronda M.,Alessandro

    2002-01-01

    Se presentan diez casos de ligadura de arteria hipogástrica de causa obstétrica. Describimos la técnica, se analiza las indicaciones, riesgos y complicaciones quirúrgicas. El procedimiento fue efectivo en controlar la hemorragia en todos los casos. La principal indicación fue la inercia uterina.

  20. Development of a methodology to determine optimized therapeutic doses of {sup 131}I for the treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, F.; Moura, M.B.; Pereira, A.C., E-mail: faraujo@ird.gov.br [Instituto de Medicna Nuclear (IMEN), Goiania, GO (Brazil); Dantas, B.M.; Dantas, A.L.A.; Lucena, E.A. [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Melo, R.C.; Rebelo, A.M.O. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    2008-07-01

    Several methods can be used to determine the activity of {sup 131}I to be administered for the treatment of hyperthyroidism. However, some of them do not take into consideration the dose absorbed by the thyroid, while others do not consider all the parameters necessary for dose calculation. The relationship between the dose absorbed by the thyroid and the activity administered depends basically on three parameters: mass of the organ, iodine uptake and effective half-life of iodine in the thyroid. Such parameters should be individually determined for each patient in order to optimize the administered activity. The objective of this work is to develop a methodology for individualized treatment with {sup 131}I in patients with hyperthyroidism of the Grave's Disease. A neck-thyroid phantom developed at the In Vivo Monitoring Laboratory of IRD, containing a known amount of {sup 131}I, was used to calibrate a scintillation camera and a uptake probe available at the Nuclear Medicine Center of the University Hospital of Rio de Janeiro and Instituto de Medicina Nuclear - IMEN, of Goiania. The optimization of the counting geometry was carried out by the determination of the characteristic curves of the view angle of the collimator-detector assembly. The view angle of the collimator-detector assembly presented values compatible with the size of the organ for distances of 25 cm (uptake probe) and 45.8 cm (scintillation camera). The calibration factors (in cpm/kBq) and the associated uncertainty related to these distances were (39.3 ± 0.78), (58.1 ± 2.38) to uptake probe SCT-13004 e 13002, respectively and 4.3 ± 0.17 to scintillation camera. The time period between 14 and 30 hours of the retention curve allows the calculation of the activity between those two points. It is concluded that the use of diagnose equipment available at the hospital (scintillation camera and uptake probe) has shown to be a suitable procedure in terms of effectiveness, simplicity and cost

  1. Development of a methodology to determine optimized therapeutic doses of {sup 131}I for the treatment of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Araujo, Francisco de; Santas, Bernardo Maranhao; Dantas, Ana Leticia Almeida; Lucena, Eder Augusto [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)]. E-mail: faraujo@ird.gov.br; Melo, Rossana Corbo de; Rebelo, Ana Maria de Oliveira [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina

    2007-07-01

    Several methods can be used to determine the activity of {sup 131}I to be administered for the treatment of hyperthyroidism. However, some of them do not take into consideration the dose absorbed by the thyroid, while others do not consider all the parameters necessary for dose calculation. The relationship between the dose absorbed by the thyroid and the activity administered depends basically on three parameters: mass of the organ, iodine uptake and effective half-life of iodine in the thyroid. Such parameters should be individually determined for each patient in order to optimize the administered activity. The objective of this work is to develop a methodology to evaluate therapeutic doses through the determination of biokinetic parameters and the activity of {sup 131}I deposited in the thyroid of patients submitted to the treatment of hyperthyroidism with {sup 131}I. A neck-thyroid phantom developed at the In Vivo Monitoring Laboratory of IRD, containing a known amount of {sup 131}I, was used to calibrate a scintillation camera and a uptake probe available at the Nuclear Medicine Center of the University Hospital of Rio de Janeiro. The optimization of the counting geometry was carried out by the determination of the characteristic curves of the view angle of the collimator-detector assembly. The calculation of the calibration factor of the scintillation camera allows the determination of activities in the thyroid of patients in pre-established time periods through a 48-hours uptake curve. The view angle of the collimator-detector assembly presented values compatible with the size of the organ for distances of 25 cm (uptake probe) and 45.8 cm (scintillation camera). The calibration factors (in cpm/kBq) and the associated uncertainty related to these distances were 39.3 {+-} 0.8 and 4.3 {+-} 0.2 respectively. The time period between 14 and 30 hours of the retention curve allows the calculation of the activity between those two points. It is concluded that the use

  2. 甲状腺功能亢进症合并骨质疏松症药物治疗的特殊性%The Specificity of the Treatment of Hyperthyroidism with Osteoporosis

    Institute of Scientific and Technical Information of China (English)

    夏维波

    2016-01-01

    甲亢和骨质疏松之间密切相关,严重和持久的甲亢必然会导致骨质疏松症。随着抗甲状腺药物和放射性碘用于治疗甲亢后,绝大多数甲亢患者的病情得以及时控制,从而显著减少了严重的骨质疏松症和骨折的出现。本文通过分析甲状腺相关激素对骨骼的调控作用,长期严重甲亢对骨密度和骨折的影响,以及亚临床甲亢对骨骼的长期影响,来阐述甲亢合并骨质疏松治疗的特殊性。%The close correlation between hyperthyroidism and osteoporosis, severe and persistent hyperthyroidism is bound to lead to osteoporosis. With the use of anti thyroid drugs and radioactive iodine for the treatment of hyperthyroidism, the severity of osteoporosis and fracture was improved in the vast majority of patients with hyperthyroidism and time control. Through analysis of the regulatory effect of thyroid hormone on bone, long-term effects of severe hyperthyroidism on bone density and fracture, and subclinical hyperthyroidism on the skeleton of the long-term effects, the particularity of hyperthyroidism with osteoporosis treatment was elaborated.

  3. 甲状腺功能亢进症治疗中含碘方药的合理应用%Reasonable Application of Iodine Containing Prescriptions in Treatment of Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    裴迅; 向楠

    2015-01-01

    s:The iodine containing prescriptions is applied to the treatment of hyperthyroidism in the formulas for a long time, however, modern medicine thinks there are many defects in using iodine containing prescriptions to treat hyperthyroidism, do not advocate using it as the conventional therapy for hyperthyroidism.By making objective analysis to hyperthyroidism, iodine and commonly used to treat hyperthy-roidism iodine content and function , it should dialectical view of TCM and its compound contains iodine, and combined disease, reasonable application of play to the advantages and characters of traditional Chinese medicine in the treatment of hyperthyroidism, improve clinical cura-tive effect for the treatment of hyperthyroidism.%含碘方药应用于甲状腺功能亢进症的治疗古来已久,然而现代医学认为使用碘剂治疗甲亢存在诸多弊病,不提倡使用碘剂作为甲亢的常规治疗。通过对碘与甲亢,以及常用治疗甲亢方药的碘含量及功能的客观分析,认为应该辩证地看待中药及其复方中所含的碘,病证结合,合理应用,发挥中医药治疗甲亢的特色和优势,提高临床治疗甲亢的疗效。

  4. Serum CNP Concentration in patients with Hyperthyroid heart diseases%甲亢性心脏病患者CNP的变化及临床意义

    Institute of Scientific and Technical Information of China (English)

    李恒星

    2013-01-01

    目的:探讨了甲亢性心脏病患者治疗前后血清CNP水平的变化及临床意义。方法应用放射免疫分析法和化学发光法对31例甲亢性心脏病患者进行了治疗前后血清CNP和FT3、FT4水平检测,并与35名正常健康人作比较。结果甲亢性心脏病患者在治疗前血清CNP水平非常显著地高于正常人组(P0.05)且血清CNP水平与FT3、FT4水平呈显著正相关(r=0.5921,0.6012 p<0.01)。结论甲亢性心脏病患者血清CNP水平升高,可能与FT3、FT4水平升高有关,血清CNP可作为甲亢性心脏病的一个观察指标。%Objective: To explore the clinical significance of measurement the changes of serum levels of CNP in patients With Hyperthyroid heart diseases. Methods: Serum CNP (With RIA).serum FT3、FT4(With CILA) Levels were determined in 31 patients with hyperthyroid heart diseases and 35 Controls. Results: compared with the control group. the serum CNP level in patients with hyperthyroid heart diseases was increased (P<0.01).apparent, and CNP showed significantly positively correlated to FT3、FT4 (r=0.5921,0.6012 ,p<0.01),Conclusions:serum CNP concentration was prominently increased in patients with hyperthyroid heart diseases ,the cause of increase maybe closely related to the increase of FT3、FT4. Serum CNP could be used as an auxiliary index in the diagnosis of hyperthyroid heart diseases.

  5. 甲状腺功能亢进性心脏病76例临床分析%The clinical analysis of 76 cases hyperthyroidism heart disease

    Institute of Scientific and Technical Information of China (English)

    祁朝阳

    2012-01-01

    目的 分析甲状腺功能亢进性心脏病患者的临床特点.方法 选择2001年2月至2008年2月间内分泌科诊治的甲状腺功能亢进性心脏病患者76例为观察组,另选择98例单纯甲状腺功能亢进患者为对照组,分析甲状腺功能亢进性心脏病危险因素.应用碘剂治疗,根据患者病情不同辅以β-受体阻滞剂(如普萘洛尔)、利尿剂及洋地黄类药物,治疗周期为6个月.结果 观察组患者年龄大于对照组,病程长于对照组,其差异均有统计学意义(P<0.01).观察组患者血FT4平均为(63.85±13.76)pmol/L,明显高于对照组,差异有统计学意义(P<0.05).两组患者性别构成比、血FT3及TSH水平间无统计学差异(P>0.05).经6个月规范治疗,76例甲状腺功能亢进性心脏病患者痊愈54例(71.1%),缓解15例(19.7%),无效7例(9.2%).其中5例无效患者经二次治疗后获得缓解,2例治愈.结论 甲状腺功能亢进性心脏病发病与患者年龄、病程及FT4水平有关,碘剂(I131)对甲状腺功能亢进性心脏病具有较好的疗效.%Objective To analyze the clinical features of hyperthyroidism heart disease. Methods Seventy - six hyperthyroidism heart disease patients treated from February 2001 to February 2008 were chosen as the observation group, 98 patients with simple hyperthyroidism were chosen as the control. The risk factors were analyzed, and iodine treatment were performed. Results The patients were older and had longer disease duration than the control group ( P 0.05 ). After 6 months of standard treatment, 54 hyperthyroidism heart disease patients ( 71. 1% ) were cured, 15 ( 19.7% ) had remission, 7(9.2% ) were invalid. After secondary treatment, 5 hyperthyroidism heart disease patients had remission , 2 patients were cured. Conclusion Hyperthyroidism heart disease relates with age, disease duration and the level of FT4 of the patients. Iodine ( 1131 ) has good effect in the treatment of hyperthyroidism heart disease.

  6. Treatment of hyperthyroidism by 131-iodine; Traitement des hyperthyroidies par l'iode 131: dose calculee versus dose fixe

    Energy Technology Data Exchange (ETDEWEB)

    Fieffe, S.; Cuif-Joba, A.; Testard, A.; Fortuna, I.; Pocharta, J.M.; Papathanassioua, D.; Schvartz, C. [Service d' endocrinologie et medecine nucleaires, institut Jean-Godinot, 1, rue du General Koeing, 51056 Reims, (France)

    2009-05-15

    In a first time, we chose to modify the dose to be administered, on using always the Marinelli formula but on increasing the absorbed dose. In a second time, we wanted to simplify the determination of the dose to be administered by modulating it only in function of the thyroid volume. Two groups of patients were managed for hyperthyroidism recurrence. In a first group the iodine dose ({sup 131}I) was determined with the help of the simplified Marinelli formula: chosen absorbed dose was 150 Gy, gland volume determined by echography, measurement of the fixation at the sixth hour. In the second group, the thyroid volume was determined by echography. The patients with a thyroid from 5 to 30 g received 185 MBq, from 30 to 50 g 370 MBq and superior to 50 g 555 MBq of iodine 131. The two groups of patients have the same characteristics. the results of treatment by iodine 131, evaluated on the dosages of T4L and TSH at three and six months, show the preservation of euthyroidism or the passage in hypothyroidism among 94% of patients in the group 1 and 80% of patients in the group 2. These results are not significantly different. The easiness of the realisation of the treatment in the group 2 lead us to continue this simplified therapy scheme that allows equally to improve the radiation protection of medical personnel by avoiding the use of iodine 131. (N.C.)

  7. Primary Hyperparathyroidism and Hyperthyroidism in a Patient with Myotonic Dystrophy: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Yosra Cherif

    2015-01-01

    Full Text Available Various endocrine manifestations are commonly described in myotonic dystrophy (MD, including primary hypogonadism, diabetes mellitus, and thyroid and parathyroid dysfunction. We describe a 46-year-old woman with a family history of MD with her son. She was diagnosed with cardiac arrhythmia and required the implantation of a pacemaker. She was noted to have a bilateral cataract. She complained of muscle weakness, diffuse myalgia, and palpitation. The electromyography (EMG showed myotonic discharges. Laboratory tests showed high serum calcium 2.83 mmol/L, serum phosphate 1.2 mmol/L, parathormone 362.5 pg/mL, thyroid stimulating hormone TSH 0.02 mIU/L (normal range: 0.34–5.6 mIU/L, FT4 21.17 ng/mL, and negative anti-thyroperoxidase antibodies. Cervical ultrasound revealed a multinodular goiter. The 99mTc-MIBI scintigraphy localized a lower right parathyroid adenoma. The clinical data, the family history of MD, EMG data, and endocrine disturbances were strongly suggestive of MD associated with hyperthyroidism and primary hyperparathyroidism.

  8. Thermographic image analysis for classification of ACL rupture disease, bone cancer, and feline hyperthyroid, with Gabor filters

    Science.gov (United States)

    Alvandipour, Mehrdad; Umbaugh, Scott E.; Mishra, Deependra K.; Dahal, Rohini; Lama, Norsang; Marino, Dominic J.; Sackman, Joseph

    2017-05-01

    Thermography and pattern classification techniques are used to classify three different pathologies in veterinary images. Thermographic images of both normal and diseased animals were provided by the Long Island Veterinary Specialists (LIVS). The three pathologies are ACL rupture disease, bone cancer, and feline hyperthyroid. The diagnosis of these diseases usually involves radiology and laboratory tests while the method that we propose uses thermographic images and image analysis techniques and is intended for use as a prescreening tool. Images in each category of pathologies are first filtered by Gabor filters and then various features are extracted and used for classification into normal and abnormal classes. Gabor filters are linear filters that can be characterized by the two parameters wavelength λ and orientation θ. With two different wavelength and five different orientations, a total of ten different filters were studied. Different combinations of camera views, filters, feature vectors, normalization methods, and classification methods, produce different tests that were examined and the sensitivity, specificity and success rate for each test were produced. Using the Gabor features alone, sensitivity, specificity, and overall success rates of 85% for each of the pathologies was achieved.

  9. 青春期甲状腺功能亢进患者骨龄及骨代谢的特点分析%Characteristics of bone metabolism and bone age in adolescent patients with hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    廖珂华; 李妮; 卢桂南

    2013-01-01

    Objective To characterize the bone metabolism and bone age (BA) of adolescent patients with hyperthyroidism. Methods Serum free T3 (FT3), free T4, growth hormone, alkaline phosphatase, osteocalcin and BA in 60 adolescent patients with hyperthyroidism (hyperthyroidism group) and 50 healthy controls (control group) were detected. Results Compared to those in control group, BA was significantly backward, level of GH was lower, and bone metabolic markers were higher in hyperthyroid group. In hyperthyroid group, level of FT3 was positively correlated with BA backward, and was negatively correlated with GH level. As compared to those in patients with hyperthyroidism more than 1 year, BA backward difference and ALP level were significantly lower and GH level was higher in patients with hyperthyroidism less than 1 year. Conclusion BA of adolescent patients with hyperthyroidism was lagged. FT3 and BA backwark were more closely correlated. The longer the duration of hyperthyroidism, the more obvious BA backward was. The increased bone metabolism and GH reduction may be the important factors in causing BA backward.%目的:探讨甲状腺功能亢进症(甲亢)对青春期甲亢患者骨龄及骨代谢的影响.方法:检测60例青春期甲亢患者及50例健康受试者的血清游离甲状腺激素、生长激素(GH)、碱性磷酸酶(ALP)、骨钙素(BPG)及骨龄测定.结果:甲亢组骨龄明显落后于对照组,GH明显低于对照组,骨代谢指标高于对照组;甲亢组FT3与骨龄落后差值呈正相关,与GH呈负相关;甲亢病程≤1年组骨龄落后差值及ALP均明显低于病程>1年组,GH高于病程>1年组.结论:青春期甲亢患者骨龄发育落后;FT3与骨龄落后关系更为密切;甲亢病程越长,骨龄落后程度越明显;骨代谢增高及GH减少可能是引起骨龄落后的重要因素.

  10. 甲状腺功能亢进致肝损伤32例临床及相关因素分析%Analysis of Hyperthyroidism Induced Liver Injury in 32 Cases and Related Factors

    Institute of Scientific and Technical Information of China (English)

    万晓霞

    2014-01-01

    目的:探讨甲状腺功能亢进致肝损伤的临床特点及相关因素。方法对32例甲亢性肝损伤患者(肝损伤组)以及同期40例无肝损伤的甲亢患者(甲亢组)临床资料进行回顾性分析。结果肝损伤组年龄及甲亢病程均较甲亢组长,两组差异均有统计学意义(<0.001)。肝损伤组治疗前ALT、AST、GGT、TB、ALP、TSH、FT3、FT4等指标值均高于甲亢组(<0.001)。过抗甲亢及保肝治疗,肝损伤组ALT、AST、GGT、TB、ALP、TSH、FT3、FT4均改善。结论年龄较大、甲亢病程较长的患者,发生肝损害的可能性更大。甲亢性肝损伤诊断要注意与其他肝损伤相区别,应早期积极给予合理的抗甲亢治疗,同时辅以保肝治疗。%Objective To investigate the clinical and related factors of liver injury induced by hyperthyroidism. Methods The clinical data of 32 patients with hyperthyroidism liver injury (injury group) and 40 cases without liver injury (hyperthyroidism group) were retrospectively analyzed. Results The age and course of hyperthyroidism disease of liver injury group and was longer the hyperthyroidism group, the dif erences were statistical y significant ( <0.001). AST, GGT, ALT, TB, ALP, TSH, FT3 and FT4 values of Liver injury group before treatment were higher than hyperthyroid group ( <0.001). After anti-hyperthyroidism and liver protection therapy, ALT, AST, GGT, TB, ALP, TSH, FT3 and FT4 of liver injury group significantly improved. Conclusion Older age, longer duration of hyperthyroidism patients, the possibility of greater liver damage. The diagnosis should pay attention to distinguish from other liver injury, and positive rational anti hyperthyroidism therapy should be early to give, and supplemented by the treatment of liver.

  11. CT Diagnosis of Thymic Hyperplasia in Patients with Hyperthyroidism%甲状腺功能亢进症合并胸腺增生CT观察

    Institute of Scientific and Technical Information of China (English)

    周全; 李洁; 陈金城; 杨侃荣; 康举龄

    2011-01-01

    目的 通过CT追踪观察甲状腺功能亢进症合并胸腺增大患者诊治过程中胸腺的改变,提高对该病的诊断及鉴别诊断水平,以避免不必要的创伤性活组织检查及外科手术.资料与方法 对7例甲状腺功能亢进患者并发胸腺增生的临床表现、诊疗过程及CT追踪观察胸腺病变的变化进行回顾性分析.结果 7例中,2例行胸腺手术治疗(1例因误诊胸腺瘤行胸腺手术,术后症状未改善,短期内复查见胸腺增生).7例行抗甲状腺药物治疗后临床症状好转,复查CT显示6例胸腺较前减小[体积平均减小(9.32±1.60)cm3],CT值密度降低[平均降低(53±11)HU],1例术后未见胸腺增生.结论 部分患者的胸腺增大可能与甲状腺功能亢进相关,通过抗甲状腺药物治疗后,胸部CT可以显示增生胸腺变小及密度减低.甲状腺功能亢进症合并前纵隔的肿块没有必要立即进行穿刺活检及手术切除.通过观察临床表现,完善相关的实验室检查及追踪病变的CT变化可以对甲状腺功能亢进合并胸腺增生进行定性诊断,从而避免创伤性的活组织检查及开胸手术.%Objective To investigate the dynamic changes of CT manifestations of thymic hyperplasia in patients with hyperthyroidism before and after antithyroid therapy in order to guide clinical diagnosis, therapy and follow-up.Materials and Methods Clinical manifestations, treatment and CT followed for changes in the seven cases of hyperthyroidism with thymic hyperplasia were retrospectively analyzed.Results Seven cases of hyperthyroidism with thymic hyperplasia, two cases was treated by surgical excision(including one patient misdiagnosed as thymoma, symptoms and thymus hyperplasia did not improved after surgical treatment, but thymic hyperplasia appeared again shortly) After giving antithyroid drug therapy, the clinical symptoms of all cases were improved, CT showed the size of thymus was decreased [the average volume decreased (9

  12. Metastatic vesicular thyroid cancer associated to an hyperthyroidism: about two cases; Cancer thyroidien vesiculaire metastatique associe a une hyperthyroidie: a propos de deux cas

    Energy Technology Data Exchange (ETDEWEB)

    Bertrand, S.; Kelly, A.; Merlin, C.; Aubert, B.; Mestas, D.; Cachin, F.; Veyre, A.; Dejax, C. [CRLCC Jean-Perrin, Service de medecine nucleaire, 63 - Clermont-Ferrand (France)

    2010-07-01

    We report the observation of two patients suffering of vesicular thyroid cancers, immediately metastatic, revealed by second bone injuries of the skull. At the time of diagnosis, these two patients were in clinical and biological hyperthyroidism. This hyperthyroidism continued after complete thyroidectomy, without hormonal substitution and needed the implementation of a treatment by synthetic antithyroid drugs. Every patient received after complete thyroidectomy ablative doses of {sup 131}I. the whole body scintigraphy and conventional imaging enlightened a major extension: big size bone and lungs injuries. Ira-therapy and other therapy lead a partial improvement or a relatively prolonged stabilisation. A moderated biological hypothyroidism was got in the first case after 5.55 GBq of {sup 131}I administration. and in the second case after 3.7 GBq of {sup 131}I administration. Allowing to stop synthesis antithyroid drugs. The death came three years after the diagnosis for the first case and was in relation with a cardiovascular disease. In the second case, the patient died two years after the diagnosis because a hemorrhage on a second injury on the 'falx cerebri'. We emphasize the late diagnosis in these patients; the rarity of the clinic presentation; the very good uptake of {sup 131}I on the second injuries in spite of a reduced TSH, because the very well differentiated character of metastases; unfavourable final evolution. It exists a relative uncertainty about etiology of these persistent hyperthyroidism after complete thyroidectomy in patients with multiple metastases of a differentiated thyroid cancer. Were evoked the presence of antibodies anti receptors of TSH, missing in our two patients and a hormonal hyper-secretion linked to a very important metastases volume, the neoplasms tissue staying well differentiated. (N.C.)

  13. Clinical Study on Qingre Xiehuo Treatment Hyperthyroidism%清热泻火治疗甲状腺功能亢进症的临床研究

    Institute of Scientific and Technical Information of China (English)

    张进进

    2015-01-01

    目的:探讨清热泻火法在治疗甲状腺功能亢进症过程中的临床效果。方法选择2013年4月~2015年4月于我院接受治疗的80例甲状腺功能亢进患者临床资料作为研究对象,并随机将其分为实验组和对照组,每组40例,其中实验组接受清热泻火法,对照组接受常规性的西药治疗。结果对照组总有效率为75%,实验组总有效率为95%,P<0.05,差异具有统计学意义。结论清热泻火在甲状腺功能亢进临床治疗活动能够缓解症状。%Objective To explore the clinical effect of qingre xiehuo treatment hyperthyroidism. Methods Selected 80 cases with hyperthyroidism clinical data from April 2013 to April 2015 in our hospital as research object. Randomly divided into the experimental group and the control group, each group had 40 cases. The experimental group received the method of eliminating heat and purging fire, while the control group accepted routine western medicine treatment. Results The total effective rate of control group and the experimental group patients were 75% and 95%, P<0.05, had difference statistically significance. Conclusion The clinical treatment of clearing heat and purging ifre in hyperthyroidism can relieve the symptoms of the patients.

  14. Observation of Suanzaoren Decoction in Treating Hyperthyroidism Insomnia Effect%酸枣仁汤治疗甲亢失眠的效果观察

    Institute of Scientific and Technical Information of China (English)

    韩知

    2015-01-01

    Objective To observe the clinical effect on the study of suanzaoren decoction in the treatment of hyperthyroidism, insomnia. MethodsSelected in 2014 January~December in our hospital treated 60 cases of hyperthyroidism patients with insomnia were randomly divided into two groups on the clinical effects of estazolam tablets and of suanzaoren decoction for comparative study.Results In the treatment of patients in the treatment group total effective rate was signiifcantly higher than that in the control group, the Pittsburgh sleep quality index was significantly lower than the control group, SDRS reduced the total efifciency was signiifcantly higher than the control group, the difference was signiifcant, with statistical signiifcance (P<0.05) treatment.Conclusion Suanzaoren decoction for the treatment of hyperthyroidism is a signiifcant clinical effect, can signiifcantly improve the sleep quality of patients.%目的:对酸枣仁汤治疗甲亢失眠的临床效果进行观察研究。方法选取于2014年1~12月期间在我院接受治疗的60例甲亢失眠患者随机分成两组对舒乐安定片和酸枣仁汤的临床效果进行对照研究。结果治疗组患者的治疗总有效率高于对照组,匹兹堡睡眠质量指数低于对照组,SDRS减分总有效率高于对照组,差异有统计学意义(P<0.05)。结论酸枣仁汤用于治疗甲亢失眠具有显著的临床效果,能够改善患者的睡眠质量。

  15. 甲亢合并糖尿病临床诊治分析%Clinical Analysis of Diagnosis and Treatment of Hyperthyroidism With Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    张青

    2016-01-01

    Objective To analyse the clinical diagnosis and treatment of hyperthyroidism patients with diabetes mellitus.Methods From January 2014 and January 2016, 40 cases of hyperthyroidism patients with diabetes mellitus were selected as the research object, to retrospectively analyze the clinical diagnosis and treatment of two groups.Results After treatment, the value of fasting blood glucose and blood glucose postprandial 2h in patients were lower than those before treatment; FT3 and FT4 were lower than before treatment, the value of TSH were higher than those before treatment, the difference was statistically significant (P<0.05).Conclusion The improvement of the diagnosis rate of hyperthyroidism complicated with diabetes mellitus, after diagnosis, to take timely and effective treatment measures for two kinds of diseases.%目的:分析甲亢合并糖尿病患者的临床诊断及治疗方法。方法选取2014年1月~2016年1月我院收治的甲亢合并糖尿病患者40例作为研究对象,对其临床诊断及治疗方法进行回顾性分析。结果治疗后,患者的空腹血糖及餐后2 h血糖低于治疗前,FT3、FT4低于治疗前, TSH值高于治疗前(P<0.05)。结论临床上应该不断提高甲亢合并糖尿病的确诊率,确诊后,对两种疾病采取及时、有效的治疗措施。

  16. Graves' Disease Patients with Persistent Hyperthyroidism and Diffuse Lymphoplasmacytic Infiltration in the Thyroid Show No Histopathological Compatibility with IgG4-Related Disease.

    Directory of Open Access Journals (Sweden)

    Eijun Nishihara

    Full Text Available IgG4-related disease is a novel disease entity characterized by diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells and fibrosis into multiple organs. There is still controversy over whether some thyroid diseases are actually IgG4-related disease. The objective of this study was to elucidate the clinicopathological features of Graves' disease with diffuse lymphoplasmacytic infiltration in the thyroid.Among 1,484 Graves' disease patients who underwent thyroidectomy, we examined their histopathological findings including the degree of lymphoplasmacytic and fibrotic infiltration and levels of IgG4-positive plasma cells in the thyroid. Their clinical pictures were defined by laboratory and ultrasonographic evaluation.A total of 11 patients (0.74% showed diffuse lymphoplasmacytic infiltration in the stroma of the thyroid gland. Meanwhile, other patients showed variable lymphoid infiltration ranging from absent to focally dense but no aggregation of plasma cells in the thyroid gland. Based on the diagnostic criteria of IgG4-related disease, 5 of the 11 subjects had specifically increased levels of IgG4-positive plasma cells in the thyroid. Fibrotic infiltration was present in only 1 patient developing hypothyroidism after anti-thyroid drug treatment for 4 years, but not in the other 10 patients with persistent hyperthyroidism. Obliterative phlebitis was not identified in any of the 11 subjects. Thyroid ultrasound examination showed 1 patient developing hypothyroidism who had diffuse hypoechogenicity, but the other hyperthyroid patients had a coarse echo texture.In our study, Graves' disease patients with persistent hyperthyroidism who had diffuse lymphoplasmacytic infiltration rich in IgG4-positive plasma cells in the thyroid showed no concomitant fibrosis or obliterative phlebitis.

  17. Contribution of local thyroxine monodeiodination to intracellular 3,5, 3'-triiodothyronine in several tissues of hyperthyroid rats at isotopic equilibrium

    Energy Technology Data Exchange (ETDEWEB)

    van Doorn, J.; van der Heide, D.; Roelfsema, F.

    1984-07-01

    The local conversion of T4 as a source of intracellular T3 in several organs of both hypothyroid and euthyroid rats has recently been recognized to be an important phenomenon. In the present study the source and quantity of T3 in various peripheral tissues of hyperthyroid rats were investigated. Athyreotic rats received a continuous iv infusion of T4 over a prolonged period in order to attain hyperthyroid conditions. At the same time, the animals also received a continuous iv infusion of (/sup 125/I)T4 and (/sup 131/I)T3 until isotopic equilibrium was achieved. After the animals were bled and perfused, the source and quantity of T3 in various tissue homogenates and subcellular preparations of liver, kidney, and the anterior pituitary gland were analyzed. In spite of the elevated plasma T3 and T4 levels, the concentration of T3 in the cerebral cortex and cerebellum was within the normal range. The contribution of T3 derived from local T4 to T3 conversion (Lc T3(T4)) was rather low in both parts of the brain when compared with values previously determined for euthyroid rats. Whereas previous studies revealed that Lc T3(T4) contributes significantly to the T3 in the pituitary glands of both hypothyroid and euthyroid rats, this was not the case for the hyperthyroid animals; virtually all T3 was derived from plasma. It was found that the T3 in muscle was derived exclusively from plasma. Both the liver and kidney showed high concentrations of T3. Whereas Lc T3(T4) was the main source of T3 in the liver, it contributed only a minor fraction of the total T3 content in the kidney.

  18. Clinical Observation on Effect of Bicyclol on Liver Injury Induced by Hyperthyroidism%双环醇治疗甲亢性肝损害疗效观察

    Institute of Scientific and Technical Information of China (English)

    李江雄

    2013-01-01

      目的观察双环醇片治疗甲亢性肝损伤临床疗效。方法将47例甲亢性肝损伤患者随机分为两组,均常规选择抗甲状腺药物甲巯咪唑治疗,试验组24例,加用双环醇片治疗;对照组23例,口服甘草酸二铵胶囊,两组疗程均为4周。观察治疗前后的疗效。结果治疗4周后,两组肝功能均有不同程度改善,但试验组更为明显(P<0.05),治疗期间未发现药物相关的不良事件。结论双环醇片能有效治疗甲亢性肝损伤。%Objective To observate the clinical efficacy of bicyclol on liver injury induced by hyperthyroidism.Method 47 cases of hyperthyroidism patients were divided into treatment group and control group by randomized,treatment group 24 cases and control group 23 cases.Both groups received oral anti-thyroid drug tapazole.Patients in treatment group were orally treated with bicyclol,and in control group received diammonium glycyrrhizinate capsules orally.Curative effect after the treatment was observed after 4 weeks.Results After treatment for 4 weeks,liver function in both groups were improved,which were more significant in treatment group compared with the control group (P<0.05).No drug-related adverse events detected during the treatment. Conclusions Bicyclol is effective and reliable in the treatment of liver injury induced by hyperthyroid.

  19. Clinical research on treating hyperthyroidism plus leucopenia by acupuncture%针刺治疗甲亢合并白细胞减少的临床研究

    Institute of Scientific and Technical Information of China (English)

    李洁

    2015-01-01

    目的:分析针刺治疗甲亢合并白细胞减少的临床治疗效果。方法:选取2013年2月-2014年5月来我院就诊的甲亢合并白细胞减少的病患42例作为研究对象,随机平均分成针刺组和对照组。两组患者均服用同种升白药物,4周为1个疗程,针刺组在此基础上加以针刺膈俞、脾俞、肾俞、三阴交、关元、气海、足三里、血海。结果:经过1个疗程的治疗,针刺组病患的疗效以及白细胞数量明显优于对照组,数据差异具有统计学意义。结论:针刺治疗能够有效地提高甲亢病患体内的白细胞数量。%Objective: To analyze clinical effects of acupuncture on hyperthyroidism plus leucopenia. Methods: 42 cases of hyperthyroidism plus leucopenia were averagely divided into the acupuncture group and the control group. Two groups were given drugs, which could increase the number of leukocytes. The acupuncture group received acupuncture treatment more. A course of treatment was 4 weeks. Results:In a course of treatment, efficacy and white blood cell count in the acupuncture group were better than those in the control group. Difference between the two groups was statistically significant. Conclusion:Acupuncture was effective on increasing the number of leukocytes of patients with hyperthyroidism.

  20. Emerging Role of Angiotensin Type 2 Receptor (AT2R)/Akt/NO Pathway in Vascular Smooth Muscle Cell in the Hyperthyroidism

    Science.gov (United States)

    Carrillo-Sepúlveda, Maria Alícia; Ceravolo, Graziela S.; Furstenau, Cristina R.; Monteiro, Priscilla de Souza; Bruno-Fortes, Zuleica; Carvalho, Maria Helena; Laurindo, Francisco R.; Tostes, Rita C.; Webb, R. Clinton; Barreto-Chaves, Maria Luiza M.

    2013-01-01

    Hyperthyroidism is characterized by increased vascular relaxation and decreased vascular contraction and is associated with augmented levels of triiodothyronine (T3) that contribute to the diminished systemic vascular resistance found in this condition. T3 leads to augmented NO production via PI3K/Akt signaling pathway, which in turn causes vascular smooth muscle cell (VSMC) relaxation; however, the underlying mechanisms involved remain largely unknown. Evidence from human and animal studies demonstrates that the renin-angiotensin system (RAS) plays a crucial role in vascular function and also mediates some of cardiovascular effects found during hyperthyroidism. Thus, in this study, we hypothesized that type 2 angiotensin II receptor (AT2R), a key component of RAS vasodilatory actions, mediates T3 induced-decreased vascular contraction. Marked induction of AT2R expression was observed in aortas from T3-induced hyperthyroid rats (Hyper). These vessels showed decreased protein levels of the contractile apparatus: α-actin, calponin and phosphorylated myosin light chain (p-MLC). Vascular reactivity studies showed that denuded aortic rings from Hyper rats exhibited decreased maximal contractile response to angiotensin II (AngII), which was attenuated in aortic rings pre-incubated with an AT2R blocker. Further study showed that cultured VSMC stimulated with T3 (0.1 µmol/L) for 24 hours had increased AT2R gene and protein expression. Augmented NO levels and decreased p-MLC levels were found in VSMC stimulated with T3, both of which were reversed by a PI3K/Akt inhibitor and AT2R blocker. These findings indicate for the first time that the AT2R/Akt/NO pathway contributes to decreased contractile responses in rat aorta, promoted by T3, and this mechanism is independent from the endothelium. PMID:23637941