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Sample records for hyperthyroidism ocena wybranych

  1. Interaktywna prezentacja zagadnień środowiskowych za pomocą Google Fusion Tables na przykładzie zdjęć fitosocjologicznych wybranych okolic Tenczynka

    Directory of Open Access Journals (Sweden)

    Karol Król

    2017-09-01

    Full Text Available W ostatnich latach zaobserwować można dynamiczny rozwój interaktywnych form przekazu, w tym kartografii internetowej i geowizualizacji. Celem pracy jest charakterystyka i ocena wybranych technik i narzędzi komputerowych wykorzystanych do utworzenia interaktywnej mapy zjawisk przestrzennych prezentującej wyniki obserwacji florystycznych przeprowadzonych w sołectwie Tenczynek (woj. małopolskie. Na badanym obszarze zidentyfikowano dwa szczególnie cenne przyrodniczo gatunki: kłokoczki południowej (Staphylea pinnata L., krzewu spotykanego jedynie w południowej części Polski, w żyznych lasach liściastych oraz przylaszczki pospolitej (Hepatica nobilis Schreb., gatunku wskaźnikowego klasy Querco-Fagetea obszarów najcieplejszych. W konkluzji wykazano, że narzędzie Fusion Tables jest użyteczne i stosunkowo proste w obsłudze przy relatywnie niewielkich nakładach pracy pozwala utworzyć interaktywną mapę dowolnego zjawiska o charakterze przestrzennym. Zwrócono również uwagę, że aplikacje internetowe mogą pełnić funkcję informacyjno-edukacyjną poprzez ukierunkowany i odpowiednio zredagowany przekaz.

  2. Ocena wpływu relaksacji poizometrycznej na napięcia mięśniowe u chorych z zawrotami głowy typu szyjnego

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    Hanna Zielińska-Bliźniewska

    2012-11-01

    Full Text Available Wprowadzenie: Celem pracy była ocena wpływu relaksacji poizometrycznej na napięcia mięśniowe u chorych z zawrotami głowy typu szyjnego. Materiał i metody: Badania przeprowadzono na grupie losowo wybranych 100 chorych, w tym 65 kobiet w wieku 20–76 lat i 35 mężczyzn w wieku 20–73 lat, leczonych w Klinice Otolaryngologii i Onkologii Laryngologicznej Uniwersyteckiego Szpitala Klinicznego im. WAM w Łodzi. Pacjentów podzielono na 2 grupy: I – badaną, liczącą 50 chorych z zawrotami głowy pochodzenia szyjnego, II – porównawczą, składającą się z 50 zdrowych osób, bez zawrotów głowy. U wszystkich chorych przeprowadzono szczegółowy wywiad, badanie przedmiotowe otolaryngologiczne, otoneurologiczne, fizykalne oraz rutynowe badania laboratoryjne. Każdy chory był konsultowany neurologicznie, okulistycznie i internistycznie oraz miał wykonywane USG naczyń doczaszkowych, tomografię komputerową odcinka szyjnego kręgosłupa i głowy. U wszystkich pacjentów zastosowano indywidualnie dobrany cykl ćwiczeń, uwzględniający dotychczasowy przebieg choroby oraz ewentualne przeciwwskazania, obejmujący relaksację poizometryczną mięśni okołokręgosłupowych w odcinku szyjnym przez okres 2 miesięcy. Obiektywna ocena skuteczności zastosowanej terapii odbywa- ła się (przed rozpoczęciem terapii oraz po 2 tygodniach, po miesiącu i po 2 miesiącach za pomocą liniowych pomiarów czynnego zakresu ruchomości szyjnego odcinka kręgosłupa oraz siły mięśniowej według testu Lovetta w skali punktowej i oceny zawrotów głowy według kryteriów Silvoniemiego. Wyniki: Na podstawie przeprowadzonych badań stwierdzono, że pod wpływem kompleksowych ćwiczeń w grupie badanej nastąpiła znaczna poprawa ruchomości odcinka szyjnego kręgosłupa oraz siły mięśniowej. Wnioski: Zarówno w badaniach obiektywnych (pomiar ruchomości czynnej szyjnego odcinka kręgosłupa oraz siły mięśniowej, jak i subiektywnych (ocena wg

  3. Dobrowolne stosowanie MSSF przez spółki giełdowe w wybranych krajach Europy Zachodniej

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    MARCIN KĘDZIOR

    2015-04-01

    Full Text Available Celem artykułu jest weryfikacja faktycznego, dobrowolnego stosowania MSSF w wybranych krajach Europy Zachodniej w przekroju branżowym. W artykule zaprezentowano zarówno wady, jak i zalety stosowania MSSF. Przedstawiono najważniejsze prace naukowe w ramach omawianej problematyki. Analizie poddano 1252 spółki z Niemiec, Wielkiej Brytanii, Holandii, Luksemburga, Portugalii, Irlandii w zakresie dobrowolnego stosowania MSSF. Badaną zbiorowość podzielono na sektory gospodarki na podstawie klasyfikacji NACE Code. W wybranych krajach w roku 2010 31,7% spółek giełdowych stosowało dobrowolnie MSSF. W większości branż w latach 2005–2010 zaobserwowano stały wzrost stosowania MSSF, jednak dynamika ich wdrażania ulega zahamowaniu.

  4.  Dobrowolne stosowanie MSSF przez spółki giełdowe w wybranych krajach Europy Zachodniej

    Directory of Open Access Journals (Sweden)

    MARCIN KĘDZIOR

    2015-03-01

    Full Text Available  Celem artykułu jest weryfikacja faktycznego, dobrowolnego stosowania MSSF w wybranych krajach Europy Zachodniej w przekroju branżowym. W artykule zaprezentowano zarówno wady, jak i zalety stosowania MSSF. Przedstawiono najważniejsze prace naukowe w ramach omawianej problematyki. Analizie poddano 1252 spółki z Niemiec, Wielkiej Brytanii, Holandii, Luksemburga, Portugalii, Irlandii w zakresie dobrowolnego stosowania MSSF. Badaną zbiorowość podzielono na sektory gospodarki na podstawie klasyfikacji NACE Code. W wybranych krajach w roku 2010 31,7% spółek giełdowych stosowało dobrowolnie MSSF. W większości branż w latach 2005–2010 zaobserwowano stały wzrost stosowania MSSF, jednak dynamika ich wdrażania ulega zahamowaniu.

  5. 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. ME...... Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA)....

  6. Hyperthyroidism

    Science.gov (United States)

    ... how fast your heart beats. All of these activities are your body's metabolism. If your thyroid is too active, it makes more thyroid hormones than your body needs. This is called hyperthyroidism. Hyperthyroidism is more common in women, people with ...

  7. 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.

  8. Ocena potresne odpornosti družinske hiše v Grosuplju

    OpenAIRE

    Žitnik, Luka

    2017-01-01

    V diplomski nalogi je predstavljena ocena potresne odpornosti zidane hiše v Grosuplju. Potresno analizo smo izvedli z metodo horizontalnih sil na podlagi zahtev, ki jih podajata standarda Evrokod 6 in Evrokod 8. Diploma je razdeljena na teoretični in praktični del. V teoretičnem delu so predstavljeni postopki za določitev potresne obtežbe, račun nosilnosti posameznih zidov ter oceno odpornosti celotne konstrukcije. Povečanje obremenitve zaradi vpliva slučajne ekscentričnosti smo upoštevali na...

  9. 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...

  10. 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...

  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. Atrial Fibrillation and Hyperthyroidism

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    Jayaprasad N

    2005-10-01

    Full Text Available Atrial fibrillation occurs in 10 – 15% of patients with hyperthyroidism. Low serum thyrotropin concentration is an independent risk factor for atrial fibrillation. Thyroid hormone contributes to arrythmogenic activity by altering the electrophysiological characteristics of atrial myocytes by shortening the action potential duration, enhancing automaticity and triggered activity in the pulmonary vein cardio myocytes. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. Incidence of cerebral embolism is more in hyperthyroid patients with atrial fibrillation, especially in the elderly and anti-coagulation is indicated in them. Treatment of hyperthyroidism results in conversion to sinus rhythm in up to two-third of patients. Beta-blockers reduce left ventricular hypertrophy and atrial and ventricular arrhythmias in patients with hyperthyroidism. Treatment of sub clinical hyperthyroidism is controversial. Optimizing dose of thyroxine treatment in those with replacement therapy and beta-blockers is useful in exogenous subclinical hyperthyroidism.

  13. Autonomy and hyperthyroidism

    International Nuclear Information System (INIS)

    Emrich, D.; Schicha, H.; Baehre, M.

    1986-01-01

    The significance of autonomy in iodine-deficiency goiter for the development of hyperthyroidism was investigated. (1) In 171 of 426 consecutive patients high-resolution quantitative scintiscans showed signs suggestive of autonomy. With increasing 99mTc uptake by the thyroid their TT3 levels were found to rise progressively during suppression, while their pre-suppression TSH levels dropped progressively. This suggests global sup(99m)Tc uptake by the thyroid during suppression to be a useful indicator of the functional significance of autonomy. (2) Based on 326 patients with hyperthyroidism a system for differentiating between autonomy-related and immunogenic disease was developed and validated prospectively in another 162 patients with hyperthyroidism by assaying for thyroid stimulating antibodies (TSAb). TSAb was found to be present in 82% of the 77 patients diagnosed as having immunogenic hyperthyroidism and in only 8% of the 85 patients with autonomy-related hyperthyroidism. Our results support the assumption that autonomy in iodine-deficiency goiter plays a major role in the development of hyperthyroidism, while autoimmune processes appear to be of secondary importance. (Author)

  14. Hyperthyroidism in pregnancy.

    OpenAIRE

    Drury, M I

    1986-01-01

    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.

  15. Hyperthyroidism

    OpenAIRE

    De Leo, Simone; Lee, Sun Y; Braverman, Lewis E

    2016-01-01

    Hyperthyroidism is characterised by increased thyroid hormone synthesis and secretion from the thyroid gland, whereas thyrotoxicosis refers to the clinical syndrome of excess circulating thyroid hormones, irrespective of the source. The most common cause of hyperthyroidism is Graves’ disease, followed by toxic nodular goitre. Other important causes of thyrotoxicosis include thyroiditis, iodine-induced and drug-induced thyroid dysfunction, and factitious ingestion of excess thyroid hormones. T...

  16. 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....

  17. 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.......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....

  18. Zysk na jedną akcję i jego determinanty w publicznych spółkach produkcyjnych w wybranych państwach Europy Środkowo-Wschodniej

    Directory of Open Access Journals (Sweden)

    Marcin Kędzior

    2017-12-01

    Full Text Available Celem artykułu jest próba oceny kształtowania się wartości wskaźnika EPS oraz jego determinantów w giełdowych spółkach produkcyjnych w wybranych państwach Europy Środkowo-Wschodniej, w tym Polski. Badania empiryczne przeprowadzono na podstawie 110 publicznych spółek produkcyjnych z Polski, Litwy, Łotwy, Słowacji i Słowenii. Zaobserwowano istotne statystycznie różnice między wartościami wskaźnika EPS w przedsiębiorstwach z wybranych państw Europy Środkowo-Wschodniej. Analizowano wpływ płynności finansowej, intensywności kapitałowej, obrotowości aktywów, zadłużenia, ryzyka, stoso- wania MSSF, wielkości jednostki gospodarczej, wieku przedsiębiorstwa, możliwości wzrostu, działalno- ści międzynarodowej, koncentracji udziałów rynkowych oraz udziałów rynkowych na wskaźnik EPS. Za najważniejsze czynniki uznano wielkość przedsiębiorstwa, działalność międzynarodową, stosowanie MSSF i zadłużenie. W pracy wykorzystywano metody statystyki opisowej: analizę struktury, analizę korelacji i regresji oraz metody statystyki matematycznej: wybrane testy nieparametryczne. W artykule przedsta- wiono jedne z pierwszych wyników empirycznych dotyczących wartości wskaźnika EPS i jego czynni- ków w wybranych państwach Europy Środkowo-Wschodniej.

  19. Atrial fibrillation and hyperthyroidism: A literature review.

    Science.gov (United States)

    Reddy, Vivek; Taha, Wael; Kundumadam, Shanker; Khan, Mazhar

    Atrial fibrillation is the most common arrhythmia worldwide with increasing frequency noted with age. Hyperthyroidism is a well-known cause of atrial fibrillation with a 16%-60% prevalence of atrial fibrillation in patients with known hyperthyroidism Ross et al. (2016). While hyperthyroidism as a causative factor of atrial fibrillation is well established, this literature review aims to answer several questions on this topic including: 1. The relationship of atrial fibrillation to hyperthyroidism 2. Atrial fibrillation as a predictor of hyperthyroidism 3. The pathophysiology of thyrotoxic atrial fibrillation 4. Subclinical hyperthyroidism and the relationship with atrial fibrillation 5. Cardioversion and Catheter ablation of hyperthyroid patients with atrial fibrillation 6. Thrombotic risk of hyperthyroid patients with atrial fibrillation 7. Management of Thyrotoxic Atrial fibrillation 8. Pharmacological rhythm control in patients with hyperthyroidism and atrial fibrillation 9. Treatment of Hyperthyroidism to prevent atrial fibrillation 10. Clinical Implications of Hyperthyroidism and Atrial Fibrillation. Copyright © 2017 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  20. The treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Klopper, J.F.

    1991-01-01

    The clinical picture of hyperthyroidism varies considerably and the diagnosis can easily be missed. The treatment of hyperthyroidism needs to be individualized, taking the patient's condition and preferences into account. There are three possible methods of treating hyperthyroidism, namely, medical treatment, including the use of beta-blockers and other antithyroid medications; surgery, and radio-iodine treatment. These three methods are briefly discussed. 3 refs., 3 tabs

  1. Platysmal myoclonus in subclinical hyperthyroidism.

    Science.gov (United States)

    Teoh, Hock-Luen; Lim, Erle Chuen-Hian

    2005-08-01

    Hyperthyroidism is associated with various movement disorders, such as chorea and tremors. We report on a young Chinese woman with an unusual presentation of myoclonus, involving both platysmal muscles, in association with subclinical hyperthyroidism. The myoclonus was preceded by symptoms of hyperthyroidism, namely weight loss, menstrual disturbances, and heat intolerance. The movements abated with clonazepam and hyperthyroidism was treated with carbimazole. The myoclonus recurred briefly when she stopped taking clonazepam, but she has since remained well and euthyroid. Copyright 2005 Movement Disorder Society

  2. Hyperthyroidism in pregnancy.

    Science.gov (United States)

    Nygaard, Birte

    2015-01-21

    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. 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 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 Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found no studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: antithyroid drugs (carbimazole/thiamazole and propylthiouracil).

  3. Depression and anxiety in hyperthyroidism.

    Science.gov (United States)

    Demet, Mehmet Murat; Ozmen, Bilgin; Deveci, Artuner; Boyvada, Sibel; Adigüzel, Hakan; Aydemir, Omer

    2002-01-01

    Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients. Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features. Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group. Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.

  4. [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.

  5. [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).

  6. 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.

  7. Atypical Manifestations of Hyperthyroidism

    Science.gov (United States)

    Boxall, E. A.; Lauener, R. W.; McIntosh, H. W.

    1964-01-01

    Patients with hyperthyroidism usually present with symptoms of hypermetabolism with or without goitre and/or eye signs. Occasionally, however, the chief complaints are not immediately suggestive of hyperthyroidism. Patients with hyperthyroidism are described who presented with such atypical manifestations as periodic muscular paralysis, myasthenia, myopathy, encephalopathy, psychosis, angina pectoris, atrial fibrillation, heart failure without underlying heart disease, skeletal demineralization, pretibial myxedema, unilateral eye signs, and pitting edema of the ankles. ImagesFig. 2Fig. 3Fig. 5Fig. 7Fig. 8Fig. 9Fig. 10 PMID:14178405

  8. 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.

  9. Subclinical Hyperthyroidism-A Cohort Study

    International Nuclear Information System (INIS)

    Hashim, R.; Anwer, M. S.; Khan, F. A.; Ijaz, A.

    2013-01-01

    Objective: To compare the development of overt hyperthyroidism in a cohort of patients of subclinical hyperthyroidism (SCR) and in subjects with normal thyroid function tests. Study Design: A cohort study. Place and Duration of study: The study was conducted in the department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi from Sept 2006 to Sept 2007. Patients and Methods: Fifty patients of SCR and almost equal number of age and sex-matched subjects with normal Thyroid function test (TFT) were included in the study as controls. Subclinical hyperthyroid patients and controls were followed for a period of one year on a six monthly basis. The patients were examined for signs and symptoms of hyperthyroidism and serum TSH, total T3 and free T4 were estimated. The clinical history, physical examination and TFT results were recorded. Five ml of blood was collected for serum thyroid profile in plain tube. Hormonal analysis(TSH, T4 and T3) was done for the patients and the controls enrolled in the study. The TFTs was analyzed using Chemiluminescence Immunoassay technique on Immulite 2000 an automated, random access, immunoassay analyzer. Results: Six (12%) out of 50 cases of the SCR patients and 2 (4%) out of 50 controls developed overt hyperthyroidism. SCR had no significant risk for conversion to overt hyperthyroidism as compared to healthy controls in this study. In addition to initial levels of serum TSH were one of important predictor for conversion of SCR to overt hyperthyroidism. Conclusion: Patients with SCR have no significant risk but showed an increase in frequency of conversion to overt hyperthyroidism (12% in this study) as compared to controls. (author)

  10. Transient hyperthyroidism of hyperemesis gravidarum.

    Science.gov (United States)

    Tan, Jackie Y L; Loh, Keh Chuan; Yeo, George S H; Chee, Yam Cheng

    2002-06-01

    To characterise the clinical, biochemical and thyroid antibody profile in women with transient hyperthyroidism of hyperemesis gravidarum. Prospective observational study. Hospital inpatient gynaecological ward. Women admitted with hyperemesis gravidarum and found to have hyperthyroidism. Fifty-three women were admitted with hyperemesis gravidarum and were found to have hyperthyroidism. Each woman was examined for clinical signs of thyroid disease and underwent investigations including urea, creatinine, electrolytes, liver function test, thyroid antibody profile and serial thyroid function test until normalisation. Gestation at which thyroid function normalised, clinical and thyroid antibody profile and pregnancy outcome (birthweight, gestation at delivery and Apgar score at 5 minutes). Full data were available for 44 women. Free T4 levels normalised by 15 weeks of gestation in the 39 women with transient hyperthyroidism while TSH remained suppressed until 19 weeks of gestation. None of these women were clinically hyperthyroid. Thyroid antibodies were not found in most of them. Median birthweight in the infants of mothers who experienced weight loss of > 5% of their pre-pregnancy weight was lower compared with those of women who did not (P = 0.093). Five women were diagnosed with Graves' disease based on clinical features and thyroid antibody profile. In transient hyperthyroidism of hyperemesis gravidarum, thyroid function normalises by the middle of the second trimester without anti-thyroid treatment. Clinically overt hyperthyroidism and thyroid antibodies are usually absent. Apart from a non-significant trend towards lower birthweights in the infants of mothers who experienced significant weight loss, pregnancy outcome was generally good. Routine assessment of thyroid function is unnecessary for women with hyperemesis gravidarum in the absence of any clinical features of hyperthyroidism.

  11. Hyperthyroidism and cerebral venous thrombosis.

    Science.gov (United States)

    Mouton, S; Nighoghossian, N; Berruyer, M; Derex, L; Philippeau, F; Cakmak, S; Honnorat, J; Hermier, M; Trouillas, P

    2005-01-01

    The demonstration of an underlying prothrombotic condition in cerebral venous thrombosis (CVT) may have important practical consequences in terms of prevention. Thyrotoxicosis through a hypercoagulable state may be a predisposing factor for CVT. The authors present the cases of 4 patients who developed CVT and hyperthyroidism. At the acute stage, hyperthyroidism was associated with an increase in factor VIII (FVIII). At follow-up, FVIII level remained increased in 2 patients. Hyperthyroidism may have an impact on FVIII level. Accordingly in patients with hyperthyroidism and neurological symptoms, the diagnosis of CVT should be considered and an exhaustive coagulation screening may be appropriate. (c) 2005 S. Karger AG, Basel.

  12. Conversion of autoimmune hypothyroidism to hyperthyroidism.

    Science.gov (United States)

    Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

    2014-08-03

    Graves' disease and Hashimoto's thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. We are reporting three cases of middle aged Asian females who presented with classical symptoms of hypothyroidism and the investigations showed elevated thyroid stimulating hormone with positive thyroid antibodies. Diagnosis of autoimmune hypothyroidism was made and thyroxine replacement therapy was initiated. Patients became asymptomatic with normalization of thyroid stimulating hormone level. After few years they developed symptoms of hyperthyroidism with suppressed thyroid stimulating hormone level. Over replacement of thyroxine was considered and the dose of thyroxine was decreased, but they remain symptomatic. After gradual decrease in the dose of thyroxine it was stopped finally. Even after few months of stopping thyroxine, the symptoms of hyperthyroidism did not improve and the biochemical and imaging modalities confirmed that the patients have developed hyperthyroidism. Anti-thyroid treatment was then started and the patients became symptom free. High index of suspicion should be there for possible conversion of hypothyroidism to hyperthyroidism if a patient with primary hypothyroidism develops persistent symptoms of hyperthyroidism. Otherwise it can be missed easily considering it as an over replacement with thyroid hormone.

  13. Hyperthyroiditis

    International Nuclear Information System (INIS)

    Luft, D.

    1982-01-01

    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. (orig.) [de

  14. Hyperthyroidism

    Science.gov (United States)

    ... calcium supplement. Thyrotoxic crisis. A sudden worsening of hyperthyroidism symptoms that leads to a fever, rapidpulse, and delirium. Signs of delirium include decreased awareness, confusion, and restlessness. ...

  15. ETIOLOGY OF HYPERTHYROIDISM IN PREGNANCY.

    OpenAIRE

    Fayal El Guendouz; Hicham Boussouf; Nabil Hammoune.

    2017-01-01

    Hyperthyroidism is a common endocrine disorder in young women of childbearing age. Approximately one to three cases of gestational hyperthyroidism occur per 1000 pregnancies. All etiologies of hyperthyroidism may be encountered during pregnancy but they are dominated by Graves\\\\\\' disease and gestational transient thyrotoxicosis. The first requires an antithyroid drug treatment and the second progresses well under symptomatic treatment. Hence the interest of the Establishment of the cause of ...

  16. Inheritable and sporadic non-autoimmune hyperthyroidism.

    Science.gov (United States)

    Ferraz, Carolina; Paschke, Ralf

    2017-03-01

    Hyperthyroidism is a clinical state that results from high thyroid hormone levels which has multiple etiologies, manifestations, and potential therapies. Excluding the autoimmune Graves disease, autonomic adenomas account for the most import cause of non-autoimmune hyperthyroidism. Activating germline mutations of the TSH receptor are rare etiologies for hyperthyroidism. They can be inherited in an autosomal dominant manner (familial or hereditary, FNAH), or may occur sporadically as a de novo condition, also called: persistent sporadic congenital non-autoimmune hyperthyroidism (PSNAH). These three conditions: autonomic adenoma, FNAH and PSNAH constitute the inheritable and sporadic non-autoimmune hyperthyroidism. Particularities in epidemiology, etiology, molecular and clinical aspects of these three entities will be discussed in this review in order to guide to an accurate diagnosis allowing among others genetic counseling and presymptomatic diagnosis for the affected families. The optimal treatment based on the right diagnosis will avoid consequences of a persistent or relapsing hyperthyroidism. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  17. Ocena tačnosti sistema samovođenja rakete zemlja-vazduh / Evaluation accuracy for homing system of ground-air missile

    Directory of Open Access Journals (Sweden)

    Stevan Boarov

    2006-04-01

    Full Text Available U ovom članku razmatra se ocena tačnosti sistema samovođenja raketa zemlja-vazduh računarskim simulacijama OFF-LINE. Izvršena je ocena zakona raspodele verovatnoće promašaja, za dva režima gađanja pod različitim početnim uglovima preticanja, kada na sistem deluju poremećaji izazvani slučajnim šumom u glavi za samovođenje. Simulacija je izvedena primenom metode Monte Carlo. Model koji je korišćen za simulacije uključuje linearizovani model kretanja rakete i glavne nelinearnosti sistema vođenja i upravljanja. / In this paper approach of evaluation accuracy for homing system of ground - air missile is showed by OFF-LINE computer simulations. Two ranges of action under different angles of approach are appraised in the case of the presence of the seeker noise. The probability density function and the root-mean-square estimation of the miss distance are realised by Monte - Carlo methods, using linearized model only of the missiles flight and main nonlinearity of guidance and control systems.

  18. Temporary hyperthyroidism (hypertriiodothyroninemia) to be evoked by stress

    International Nuclear Information System (INIS)

    Ehni, A.; Kampmann, H.

    1982-01-01

    From patients of intensive care unit suffering from acute myocardial infarction, decompensated hypertension with left heart insufficiency, severe coronary heart disease, pulmonary infarction, cerebral ischemia 102 were selected with suspicion of hyperthyroidism because of clinical signs. 12 patients fulfilled the criteria of temporary hyperthyroidism, 6 patients revealed persistent hyperthyroidism. Excluding other causes for evoked hyperthyroidism as common etiological factor psychogenic stress is discussed. It is concluded, that increased thyroid hormone concentration in patients of intensive care units should be controlled within a short time in order to delineate temporary hyperthyroidism against permanent hyperthyroidism. (orig.) [de

  19. Temporary hyperthyroidism (hypertriiodothyroninemia) to be evoked by stress

    Energy Technology Data Exchange (ETDEWEB)

    Ehni, A.; Kampmann, H.

    1982-10-01

    From patients of intensive care unit suffering from acute myocardial infarction, decompensated hypertension with left heart insufficiency, severe coronary heart disease, pulmonary infarction, cerebral ischemia 102 were selected with suspicion of hyperthyroidism because of clinical signs. 12 patients fulfilled the criteria of temporary hyperthyroidism, 6 patients revealed persistent hyperthyroidism. Excluding other causes for evoked hyperthyroidism as common etiological factor psychogenic stress is discussed. It is concluded, that increased thyroid hormone concentration in patients of intensive care units should be controlled within a short time in order to delineate temporary hyperthyroidism against permanent hyperthyroidism.

  20. Ocena zastosowania wybranych metod taksonomicznych do klasyfikacji zjawisk społeczno-gospodarczych

    Directory of Open Access Journals (Sweden)

    Barbara Prus

    2017-06-01

    Full Text Available Metody taksonomiczne służą do opisu i klasyfikacji złożonych zjawisk społeczno-gospodarczych wyrażonych przy pomocy licznego zestawu zmiennych. Metody te dają różne wyniki, pomimo przyjętego jednakowego zestawu wyjściowych cech badawczych. Celem pracy było przedstawienie wyników klasyfikacji wielocechowej powiatów województwa małopolskiego przy użyciu trzech metod taksonomicznych oraz dokonanie oceny przeprowadzonego podziału. Do badań przyjęto zestaw zmiennych definiujących warunki rozwoju społeczno-gospodarczego. Ocenie poddano trzy metody taksonomiczne – taksonomii przestrzennej, aglomeracyjną metodę Warda oraz metodę Czekanowskiego. Do oceny wykorzystano mierniki oceny klasyfikacji jednostek: indywidualne, homogeniczności oraz heterogeniczności, obliczone dla wydzielonych w wyniku analizy skupień, a także mierniki poprawności skupień. Obliczenia wykonano w programie Taksonomia Numeryczna. W pracy posłużono się metodą opisowo-porównawczą oraz analizą logiczną. Najlepsze wskaźniki homogeniczności świadczące o poprawności wykonania klasyfikacji otrzymano w przypadku metody Warda. Warunek heterogeniczności został najlepiej spełniony w przypadku metody taksonomii przestrzennej. Najsłabsze mierniki klasyfikacji, zarówno te świadczące o homogeniczności, jak i heterogeniczności, otrzymano po zastosowaniu metody Czekanowskiego. Przeprowadzone badania potwierdziły najlepszą skuteczność w przypadku metody Warda.

  1. Graves hyperthyroidism and pregnancy: a clinical update.

    Science.gov (United States)

    Patil-Sisodia, Komal; Mestman, Jorge H

    2010-01-01

    To provide a clinical update on Graves' hyperthyroidism and pregnancy with a focus on treatment with antithyroid drugs. We searched the English-language literature for studies published between 1929 and 2009 related to management of hyperthyroidism in pregnancy. In this review, we discuss differential diagnosis of hyperthyroidism, management, importance of early diagnosis, and importance of achieving proper control to avoid maternal and fetal complications. Diagnosing hyperthyroidism during pregnancy can be challenging because many of the signs and symptoms are similar to normal physiologic changes that occur in pregnancy. Patients with Graves 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. Thyroid receptor antibodies should be assessed in all women with hyperthyroidism to help predict and reduce the risk of fetal or neonatal hyperthyroidism or hypothyroidism. The maternal thyroxine level should be kept in the upper third of the reference range or just above normal, using the lowest possible antithyroid drug dosage. Hyperthyroidism may recur in the postpartum period as Graves disease or postpartum thyroiditis; thus, it is prudent to evaluate thyroid function 6 weeks after delivery. Preconception counseling, a multidisciplinary approach to care, and patient education regarding potential maternal and fetal complications that can occur with different types of treatment are important. Preconception counseling and a multifaceted approach to care by the endocrinologist and the obstetric team are imperative for a successful pregnancy in women with Graves hyperthyroidism.

  2. 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.

  3. Influence of hyperthyroidism on growth hormone secretion.

    Science.gov (United States)

    Valcavi, R; Dieguez, C; Zini, M; Muruais, C; Casanueva, F; Portioli, I

    1993-05-01

    Hyperthyroidism is associated with altered GH secretion. Whether this is due to changes of somatotroph responsiveness or reflects an alteration in negative feedback signals at the hypothalamic level is unknown. We therefore performed a series of studies to shed some light onto this issue. Study 1: GHRH (1 microgram/kg b.w.) was injected i.v. in 38 hyperthyroid patients and in 30 normal subjects; in 11 of the patients the GHRH test was repeated following methimazole-induced remission of hyperthyroidism. Study 2: hGH (2 U i.v.) or saline were administered 3 hours prior to GHRH; six hyperthyroid patients and six normal subjects were studied. Study 3: ten normal subjects and ten hyperthyroid patients were given 75 g oral glucose or water 30 minutes before GHRH. Study 4: 11 normal subjects and eight hyperthyroid patients were studied. TRH or vehicle were dissolved in 250 ml of saline solution and infused at a rate of 400 micrograms/h for 150 minutes. Thirty minutes after the beginning of the infusions, L-arginine (30 g infused over 45 min i.v.) was administered. Hyperthyroid patients were compared to normal subjects. Growth hormone was measured by RIA at 15-minute intervals. GH responses to GHRH were subnormal in hyperthyroid patients. Following antithyroid drug treatment with methimazole, GH responses to GHRH increased in these patients in comparison to pretreatment values. Serum IGF-I levels, which were elevated before treatment, decreased after methimazole administration. Exogenous GH administration induced a clear decrease of GH responses to GHRH in both control and hyperthyroid subjects. On the other hand, oral glucose load decreased the GH responses to GHRH in normal but not in hyperthyroid subjects. TRH administration did not modify the GH responses to arginine in either normal subjects or hyperthyroid patients. Hyperthyroidism is associated with increased serum IGF-I levels and marked alterations in the neuroregulation of GH secretion. These changes involve

  4. Hyperthyroidism

    Science.gov (United States)

    ... many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. Most people feel better within hours of taking beta blockers. Antithyroid medicines. Antithyroid therapy is the simplest way ...

  5. [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.

  6. 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...

  7. Incidence of hyperthyroidism in Sweden.

    Science.gov (United States)

    Abraham-Nordling, Mirna; Byström, Kristina; Törring, Ove; Lantz, Mikael; Berg, Gertrud; Calissendorff, Jan; Nyström, Helena Filipsson; Jansson, Svante; Jörneskog, Gun; Karlsson, F Anders; Nyström, Ernst; Ohrling, Hans; Orn, Thomas; Hallengren, Bengt; Wallin, Göran

    2011-12-01

    The incidence of hyperthyroidism has been reported in various countries to be 23-93/100,000 inhabitants per year. This extended study has evaluated the incidence for ~40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows: clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100,000 inhabitants per year. The incidence of GD was 21.0/100,000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100,000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.

  8. [Isolated thyroid gland sarcoidosis and hyperthyroidism].

    Science.gov (United States)

    Langsteger, W; Lind, P; Beham, A; Költringer, P; Eber, O

    1989-04-29

    A case of isolated sarcoidosis of the thyroid gland, associated with hyperthyroidism, is reported in a 28-year-old male patient whose thyroid was removed for hyperthyroid multinodular goitre. Histology revealed a regressive adenoma and sarcoidosis in non-adenomatous thyroid residue. Further diagnosis, therapeutic management and a 3-year follow-up did not disclose any specific changes or involvement of other tissues. Isolated thyroidal sarcoidosis with hyperthyroid alterations are extremely rare and mostly chance findings; simultaneous occurrence of thyroid sarcoidosis and hyperthyroidism may be a symptom of gland infiltration for which an adequate explanation is still lacking.

  9. Teenage hyperthyroidism and radioiodine therapy

    International Nuclear Information System (INIS)

    Hussain, F.A.; Nisa, L.; Hoque, M.; Jehan, A.H.

    2007-01-01

    Full text: Objective: To assess the efficacy of radioiodine therapy in teenage patients with hyperthyroidism. Method: The medical records of 28 patients (age range 16 -18 years) were purposely selected from a pool of 3637 hyperthyroid patients treated with radioiodine during the period January 1982 to December 2006. Data for analysis included the age, sex, clinical symptoms, type of hyperthyroidism, antithyroid medications received, doses of radioiodine therapy given and the outcome of the therapy after one and five years. Results: The mean age of the patients treated for hyperthyroidism was 17.60 ± 0.73 years and 82 % were females. The most common type of hyperthyroidism was Graves' disease (75%). All patients were pre-treated with antithyroid drugs for variable duration periods (6 months to 2 years). The mean administered dose of radioiodine was 10.69 ± 2.77 mCi. The dose of I-131 was calculated on the basis of gland size and morphology (assessment by palpation and scintigraphy) and percentage of radioactive iodine uptake. Effective control of hyperthyroidism after radioiodine treatment occurred in 60.72% patients with a single dose, 35.71% required a second dose and 3.57% required more than two doses. Frequency of early hypothyroidism within one year was 38.09 % in Graves' disease and 33.33% in toxic multinodular goiter. Most patients (66.66%) in the toxic nodule group remained euthyroid up to one year after I-131 therapy. Overall incidence rates of hypothyroidism after 1 year and 5 years of radioiodine therapy were 32.14% and 75%, respectively. Conclusion: Hyperthyroidism in the teen group of patients was effectively controlled with radioiodine. There were no early side effects. The only long-term effect was hypothyroidism. Appearance of early/late hypothyroidism showed a direct relationship with the type of hyperthyroidism and the dose of radioiodine administered. In general, patients with Graves' disease showed a greater tendency in the evolution of early

  10. Management of hyperthyroidism during pregnancy and lactation.

    Science.gov (United States)

    Azizi, Fereidoun; Amouzegar, Atieh

    2011-06-01

    Poorly treated or untreated maternal overt hyperthyroidism may affect pregnancy outcome. Fetal and neonatal hypo- or hyper-thyroidism and neonatal central hypothyroidism may complicate health issues during intrauterine and neonatal periods. To review articles related to appropriate management of hyperthyroidism during pregnancy and lactation. A literature review was performed using MEDLINE with the terms 'hyperthyroidism and pregnancy', 'antithyroid drugs and pregnancy', 'radioiodine and pregnancy', 'hyperthyroidism and lactation', and 'antithyroid drugs and lactation', both separately and in conjunction with the terms 'fetus' and 'maternal.' Antithyroid drugs are the main therapy for maternal hyperthyroidism. Both methimazole (MMI) and propylthiouracil (PTU) may be used during pregnancy; however, PTU is preferred in the first trimester and should be replaced by MMI after this trimester. Choanal and esophageal atresia of fetus in MMI-treated and maternal hepatotoxicity in PTU-treated pregnancies are of utmost concern. Maintaining free thyroxine concentration in the upper one-third of each trimester-specific reference interval denotes success of therapy. MMI is the mainstay of the treatment of post partum hyperthyroidism, in particular during lactation. Management of hyperthyroidism during pregnancy and lactation requires special considerations and should be carefully implemented to avoid any adverse effects on the mother, fetus, and neonate.

  11. Recurrent severe vomiting due to hyperthyroidism

    Science.gov (United States)

    Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

    2010-01-01

    Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no relief. His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data. After a month of propylthiouracil therapy, his symptoms were relieved. It should be noted that hyperthyroidism patients can have unexplained vomiting, and that hyperthyroidism may coexist with peptic ulcer in rare cases. Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis. PMID:20205308

  12. Hyperthyroidism

    Science.gov (United States)

    ... where your collarbones meet. The gland makes the hormones that control the way every cell in the body uses energy. This process is called metabolism . Many diseases and conditions can cause hyperthyroidism, including: ...

  13. Effect of hypo- and hyperthyroidism on gastric myoelectrical activity.

    Science.gov (United States)

    Gunsar, Fulya; Yilmaz, Sema; Bor, Serhat; Kumanlioğlu, Kamil; Cetinkalp, Sevki; Kabalak, Taylan; Ozutemiz, Omer Ahmet

    2003-04-01

    Although hypo- and hyperthyroid patients have different symptoms in the gastrointestinal tract, the mechanism of thyroid action on the gut remains poorly understood. Thus the aim of this study was to investigate the effect of hypo- and hyperthyroidism on gastric myoelectrical activity, gastric emptying, dyspeptic symptoms. Twenty-two hyperthyroid (median age 45, 15 females) and 11 hypothyroid (median age 42, 10 females) patients were included into the study. Dyspepsia score, hypo- and hyperthyroid symptom scale, abdominal ultrasonography and upper gastrointestinal endoscopy were performed. Gastric myoelectrical activity was measured by electrogastrograpy (EGG) before and after therapy both preprandially and postprandially and compared with age, gender, and body-matched controls (12 for hypothyroid, 15 for hyperthyroid patients). Radionuclide gastric emptying studies were performed with a solid meal. Hypothyroid patients revealed a significant increase in preprandial tachygastria as compared with controls (12.3% vs 4.8%). The percentage of preprandial normal slow waves (2.4-3.7 cpm) was below 70% (dysmotility) in 7 of 11 hypothyroid patients versus 2 of 12 controls (P Hyperthyroid patients revealed a significantly higher preprandial (3.1 vs 2.8) and postprandial (3.4 vs 3) DF when compared with the controls (P hyperthyroid patients than in the controls (P hyperthyroid group and 1 in controls (P hyperthyroid patients vs 1 of 15 controls (P hyperthyroid symptom scale correlated to dyspepsia score. Dyspepsia score in hyperthyroidism correlated to power ratios in hyperthyroid patients. We detected some correlations between serum levels of fT3 or fT4 and some EGG parameters in hypo- and hyperthyroidism. Dyspepsia score and hypo- and hyperthyroid symptom scale were improved significantly after therapy in the euthyroid state. In conclusions, we showed gastric dysrhythmia by EGG in both hypo- and hyperthyroid patients. Dyspeptic symptoms correlated to the activity of

  14. Rare presentations of hyperthyroidism--Basedow's paraplegia and pancytopenia.

    Science.gov (United States)

    Chen, Yi-Hsien; Lin, Hung-Jung; Chen, Kuo-Tai

    2009-02-01

    Typical presentations of hyperthyroidism are palpitation, nervousness, tremor, malaise, and weight loss. Hyperthyroidism affects nearly every system in the body, and some patients may manifest neurologic or hematologic symptoms. Atypical presentations of hyperthyroidism often pose a great challenge in diagnosis and treatment. We report a case of Basedow's paraplegia and pancytopenia that was precipitated by hyperthyroidism. The unusual manifestations led to unnecessary examinations and delayed the treatment of hyperthyroidism. The classical symptoms of Basedow's paraplegia are subacute symmetric weakness of the lower extremities with areflexia and sparing sensation or sphincter involvement. Control of the hyperthyroidism mitigated the neurologic and hematologic complications and prevented unnecessary studies.

  15. Radioactive Iodine Treatment for Hyperthyroidism

    Science.gov (United States)

    ... Balance › Radioactive Iodine for Hyperthyroidism Fact Sheet Radioactive Iodine for Hyperthyroidism April, 2012 Download PDFs English Zulu ... prepare for RAI or surgery. How does radioactive iodine treatment work? Iodine is important for making thyroid ...

  16. Radioiodine treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Becker, D.V.; Hurley, J.R.

    1988-01-01

    Hyperthyroidism is a clinical symptom complex caused by elevated thyroid hormone levels. Of the disorders in which it appears, the most common is Graves' disease; toxic nodular goiter (Plummer's disease) is considerably less frequent. Recent studies suggest that Graves' disease is autoimmune in origin and is probably caused by a genetic defect in immunoserveillance in which thyroid-stimulating antibodies interact with thyroid-stimulating hormone (TSH) receptor sites on thyroid follicular cell membranes to increase synthesis and secretion of thyroid hormones. Toxic nodular goiter is characterized by the secretion of increased amounts of thyroid hormone by localized autonomous areas of increased function within the thyroid gland. Other forms of hyperthyroidism are discussed. Radioiodine treatment of hyperthyroidism is described

  17. Interventional therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Liang Jun; Yang Shibin; Yue Yu; Chen Tingcong

    2001-01-01

    Objective: To evaluate clinical application of arterial embolotherapy on hyperthyroidism. Methods: 11 patients with hyperthyroidism were performed with thyroid superior and inferior arterial super-selective arteriography and interventional embolization by polyvinyl alcohol (PVA), gelfoam particles and wool coil. Results: The procedures were succeeded in 11 patients. After the embolotherapy, the thyroid function gradually returned to normal level in 10 patients. The symptom was not controlled satisfactorily in 1 patient, who underwent the right thyroid inferior arteries super selective arteriography and interventional embolization, and then the thyroid function gradually returned to normal level. No serious complications occurred in all patients. Conclusions: Arterial embolotherapy is a safe, simple, symptomless, reliable and very effective for treatment of hyperthyroidism

  18. [Prevention and multimodal therapy of hyperthyroidism].

    Science.gov (United States)

    Palitzsch, K-D

    2008-12-01

    Subclinical and overt hyperthyroidism have been associated with various negative clinical outcomes as for example an increased risk of atrial fibrillation or increased cardiovascular mortality, especially in old age. In order to avoid hyperthyroidism it is strongly recommended not to start any iodine containing drug therapy or to avoid application of contrast agents unless the patient presents with an unremarkable clinical course. TSH suppressive therapy for the treatment of endemic goiter or differentiated low risk thyroid carcinoma is unnecessary, since it favours the development of subclinical hyperthyroidism. Overt hyperthyroidism is treated with antithyroid drugs and/or radioiodine therapy or surgery according to the underlying disease (toxic nodular goiter, Graves' disease).

  19. Hemostasis in Overt and Subclinical Hyperthyroidism

    OpenAIRE

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hyperthyroidism on hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). The present review focuses on hemostatic changes in overt and subclinical hyperthyroidism. Methods A systematic literature search was conducted employing MEDLINE database. The following words were used for the search: Hyperthyroidism; thyrotoxicosis; Graves disease; goiter, nodular; ...

  20. 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.

  1. Pregnancy outcome in hyperthyroidism: a case control study.

    Science.gov (United States)

    Aggarawal, Neelam; Suri, Vanita; Singla, Rimpi; Chopra, Seema; Sikka, Pooja; Shah, Viral N; Bhansali, Anil

    2014-01-01

    Data comparing pregnancy outcome in hyperthyroid women with euthyroid women are scarce. Hence, this study was carried out to assess the maternal and fetal outcome in pregnant women with hyperthyroidism to ascertain the effect of disease on pregnancy. This retrospective study was conducted over a period of 28 years. We compared the maternal and fetal outcomes of 208 hyperthyroid women with 403 healthy controls, between women with well-controlled and uncontrolled disease and amongst women diagnosed with hyperthyroidism before and during pregnancy. Maternal outcome: women with hyperthyroidism were at increased risk for preeclampsia (OR = 3.94), intrauterine growth restriction (OR = 2.16), spontaneous preterm labor (OR = 1.73), preterm birth (OR = 1.7), gestational diabetes mellitus (OR = 1.8), and cesarean delivery (OR = 1.47). Hyperthyroid women required induction of labor more frequently (OR = 3.61). Fetal outcome: newborns of hyperthyroid mothers had lower birth weight than normal ones (p = 0.0001). Women with uncontrolled disease had higher odds for still birth (OR = 8.42; 95% CI: 2.01-35.2) and lower birth weight (p = 0.0001). Obstetrical complications were higher in women with hyperthyroidism than normal women. Outcome was worsened by uncontrolled disease. Women with pregestational hyperthyroidism had better outcomes than those diagnosed with it during pregnancy. © 2014 S. Karger AG, Basel.

  2. Treatment of hyperthyroidism in community hospital

    International Nuclear Information System (INIS)

    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

  3. [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.

  4. Conversion of autoimmune hypothyroidism to hyperthyroidism

    OpenAIRE

    Furqan, Saira; Haque, Naeem-ul; Islam, Najmul

    2014-01-01

    Background Graves’ disease and Hashimoto’s thyroiditis are the two autoimmune spectrum of thyroid disease. Cases of conversion from hyperthyroidism to hypothyroidism have been reported but conversion from hypothyroidism to hyperthyroidism is very rare. Although such cases have been reported rarely in the past we are now seeing such conversions from hypothyroidism to hyperthyroidism more frequently in clinical practice. Case presentation We are reporting three cases of middle aged Asian female...

  5. Thyroid artery embolization for hyperthyroidism

    International Nuclear Information System (INIS)

    Li Jingyu; Zhang Xinguo; Xu Liyang; Liu Ming; Zhang Yongtian; Jin Weiya

    2001-01-01

    Objective: To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods: Twenty-two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results: Serum level of thyroid hormones dropped significantly [median T3 from 8.8 nmol/L (4.3-43.0 nmol/L) to 4.0 nmol/L (1.1-9.2 nmol/L), median T4 from 206.4 nmol/L (77.4-748.2 nmol/L) to 144.5 nmol/L (25.8-279.9 nmol/L), P 131 I treatment of hyperthyroidism. A long term follow-up study is still needed

  6. Hemostasis in Overt and Subclinical Hyperthyroidism

    Science.gov (United States)

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hyperthyroidism on hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). The present review focuses on hemostatic changes in overt and subclinical hyperthyroidism. Methods A systematic literature search was conducted employing MEDLINE database. The following words were used for the search: Hyperthyroidism; thyrotoxicosis; Graves disease; goiter, nodular; hemostasis; blood coagulation factors; blood coagulation disorders; venous thromboembolism; bleeding; fibrinolysis. The articles that were related to hyperthyroidism and hemostasis are used in this manuscript. Results Hyperthyroidism, either overt or subclinical, renders a hypercoagulable state, although there are several studies with contradictory findings in the literature. Hypercoagulability may be caused by an increase in the level of various coagulation factors such as factor (F) VIII, FX, FIX, von Willebrand F (vWF), and fibrinogen, while hypofibrinolysis by changes in coagulation parameters such as a decrease in plasmin and plasmin activator or an increase in α2-antiplasmin, plasminogen activator inhibitor-1 and thrombin activatable fibrinolysis inhibitor Conclusions Although many reports are in favor of a hypercoagulable state in overt hyperthyroidism but this finding at the biochemical level and its clinical implication, on the occurrence of VTE, has yet to be confirmed. PMID:29201071

  7. Hyperthyroidism: diagnosis and treatment.

    Science.gov (United States)

    Reid, Jeri R; Wheeler, Stephen F

    2005-08-15

    The proper treatment of hyperthyroidism depends on recognition of the signs and symptoms of the disease and determination of the etiology. The most common cause of hyperthyroidism is Graves' disease. Other common causes include thyroiditis, toxic multinodular goiter, toxic adenomas, and side effects of certain medications. The diagnostic workup begins with a thyroid-stimulating hormone level test. When test results are uncertain, measuring radionuclide uptake helps distinguish among possible causes. When thyroiditis is the cause, symptomatic treatment usually is sufficient because the associated hyperthyroidism is transient. Graves' disease, toxic multinodular goiter, and toxic adenoma can be treated with radioactive iodine, antithyroid drugs, or surgery, but in the United States, radioactive iodine is the treatment of choice in patients without contraindications. Thyroidectomy is an option when other treatments fail or are contraindicated, or when a goiter is causing compressive symptoms. Some new therapies are under investigation. Special treatment consideration must be given to patients who are pregnant or breastfeeding, as well as those with Graves' ophthalmopathy or amiodarone-induced hyperthyroidism. Patients' desires must be considered when deciding on appropriate therapy, and dose monitoring is essential.

  8. The methods and options of the treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Tang Jianlin; Li Yuying; Gao Liuyan; Tang Xiuping; Hu Hongyong

    2009-01-01

    Hyperthyroidism is a frequently-occurring endocrine disease. Aantithyroid drugs, surgery and radioactive iodine therapy are currently accepted and effective methods of treatment for hyperthyroidism. Years of clinical practices and a lot o[ researches on each of the three treatment methods to further deepen the understanding of the characteristics, the choice of treatment for hyperthyroidism tend to have a new change. After comparing and evaluating the three treatments for hyperthyroidism, most scholars believe that radioactive iodine therapy to treat hyperthyroidism will maintain its unique position before the physiological treatment for hyperthyroidism is uncertainly discoveried in the future. (authors)

  9. Chronic severe axonal polyneuropathy associated with hyperthyroidism and multivitamin deficiency.

    Science.gov (United States)

    Sugie, Kazuma; Umehara, Fujio; Kataoka, Hiroshi; Kumazawa, Aya; Ueno, Satoshi

    2012-01-01

    Hyperthyroidism is often associated with various neuromuscular disorders, most commonly proximal myopathy. Peripheral nerve involvement in hyperthyroidism is very uncommon and has rarely been reported. We describe a 29-year-old woman with untreated hyperthyroidism who presented with chronic severe axonal sensory-motor polyneuropathy. Peripheral nerve involvement developed together with other symptoms of hyperthyroidism 2 years before presentation. She also had anorexia nervosa for the past 6 months, resulting in multivitamin deficiency. Electrophysiological and pathological findings as well as clinical manifestations confirmed the diagnosis of severe axonal polyneuropathy. Anorexia nervosa has been considered a manifestation of untreated hyperthyroidism. We considered hyperthyroidism to be an important causal factor in the polyneuropathy in our patient, although peripheral nerve involvement in hyperthyroidism is rare. To our knowledge, this is the first documented case of chronic severe axonal polyneuropathy ascribed to both hyperthyroidism and multivitamin deficiency. Our findings strongly suggest that not only multivitamin deficiency, but also hyperthyroidism can cause axonal polyneuropathy, thus expanding the clinical spectrum of hyperthyroidism.

  10. 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

  11. Gynecomastia as the initial manifestation of hyperthyroidism.

    Science.gov (United States)

    Gordon, D L; Brown, J L; Emanuele, N V; Hall, L

    1997-01-01

    To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. We describe detailed case reports of two men with breast enlargement who were found to have hyperthyroidism, and we review the related literature. Two men sought medical assistance because of unilateral tender gynecomastia. In one of these patients, thyroid, gonadal, and prostate examinations showed normal findings at the time of initial assessment, and symptoms of hyperthyroidism developed later. In our other patient with gynecomastia, other symptoms of hyperthyroidism--for example, nervousness, irritability, palpitations, and fatigue--had been present for a prolonged period but had been considered "normal" by the patient. In both patients, the hyperthyroidism was treated with radioiodine. Breast pain disappeared in both patients, and breast enlargement disappeared in one patient and was decreased in the other patient after euthyroidism was achieved. Review of the literature disclosed only two similar cases. Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.

  12. Influence of subclinical hyperthyroidism on the cardiovascular system

    OpenAIRE

    T Y Demidova; I N Drozdova

    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...

  13. Hyperthyroidism with metastatic follicular thyroid carcinoma

    International Nuclear Information System (INIS)

    Chapman, C.N.; Sziklas, J.J.; Spencer, R.P.; Bower, B.F.; Rosenberg, R.J.

    1984-01-01

    A 70-yr-old woman presented with hyperthyroidism and metastatic follicular carcinoma of the thyroid. The blood level of thyroid stimulating immunoglobulin (TSIg) was elevated. A total thyroidectomy was performed. One month later she remained hyperthyroid. Three weeks after therapy with 218 mCi of I-131 sodium iodide, the patient was euthyroid. Six months after the initial radioiodide therapy, she was again hyperthyroid and was given a second oral treatment dose of I-131 (220 mCi). Five months later, the patient had again become euthyroid. It is likely that initially the woman's metastases were producing sufficient hormone to render her hyperthyroid. After thyroidectomy and two large doses of radioiodide, she has remained euthyroid without having to take exogenous hormone

  14. Hyperthyroidism complicating asthma treatment.

    Science.gov (United States)

    Zacharisen, M C; Fink, J N

    2000-01-01

    Asthma is one of the most common chronic medical conditions. The usual treatment includes quick relief bronchodilator medications of the sympathomimetic class and controller medications that may include the long-acting inhaled bronchodilator salmeterol. Mild adverse cardiac and central nervous system effects are common with these medications, requiring modifications in dose or occasionally switching to a different medication. Both asthma and thyroid disease are common disorders that occasionally occur together. Hyperthyroidism may exacerbate asthma. Many symptoms of hyperthyroidism are identical to the adverse effects of the commonly used inhaled bronchodilators and include tremor, nervousness, tachycardia, wide pulse pressure, palpitations, emotional lability, agitation, nightmares, aggressive behavior, and diarrhea. In this report we describe a patient with hyperthyroidism whose symptoms initially were thought to be adverse effects of the inhaled bronchodilator medications.

  15. Clinical application of interventional therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Yang Wei; Liu Qiyu; Wang Zhong; Lin Hua; Xie Budong; Zhou Xi

    2010-01-01

    Objective: To study the safety and efficiency of interventional therapy of hyperthyroidism. Methods: 70 cases of hyperthyroidism were selected and treated with embolization of the thyroid gland artery. The efficacy and complications of the therapy were observed. Results: The therapy was effect in 60 of all the 70 patients, while failed in 1 patient and relapsed in 9 cases. Specifically speaking, 2 of them hyperthyroidism crisis occurred in 2 cases, hypoparathyroidism occurred in 1 case and hypothyroidism occurred in 2 cases. Conclusion: Intervention therapy of hyperthyroidism is of advantage such as good effect, safety, microtrauma, little complication. (authors)

  16. 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.

  17. 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.

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

    International Nuclear Information System (INIS)

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

    2011-01-01

    Serum levels of thyroid stimulating hormone (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 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. (author)

  19. Hyperthyroidism increases brown fat metabolism in humans.

    Science.gov (United States)

    Lahesmaa, Minna; Orava, Janne; Schalin-Jäntti, Camilla; Soinio, Minna; Hannukainen, Jarna C; Noponen, Tommi; Kirjavainen, Anna; Iida, Hidehiro; Kudomi, Nobuyuki; Enerbäck, Sven; Virtanen, Kirsi A; Nuutila, Pirjo

    2014-01-01

    Thyroid hormones are important regulators of brown adipose tissue (BAT) development and function. In rodents, BAT metabolism is up-regulated by thyroid hormones. The purpose of this article was to investigate the impact of hyperthyroidism on BAT metabolism in humans. This was a follow-up study using positron emission tomography imaging. Glucose uptake (GU) and perfusion of BAT, white adipose tissue, skeletal muscle, and thyroid gland were measured using [18F]2-fluoro-2-deoxy-D-glucose and [15O]H2O and positron emission tomography in 10 patients with overt hyperthyroidism and in 8 healthy participants. Five of the hyperthyroid patients were restudied after restoration of euthyroidism. Supraclavicular BAT was quantified with magnetic resonance imaging or computed tomography and energy expenditure (EE) with indirect calorimetry. Compared with healthy participants, hyperthyroid participants had 3-fold higher BAT GU (2.7±2.3 vs 0.9±0.1 μmol/100 g/min, P=.0013), 90% higher skeletal muscle GU (Phyperthyroidism, serum free T4 and free T3 were strongly associated with EE and lipid oxidation rates (Pmetabolism (PHyperthyroidism had no effect on BAT perfusion, whereas it stimulated skeletal muscle perfusion (P=.04). Thyroid gland GU did not differ between hyperthyroid and euthyroid study subjects. Hyperthyroidism increases GU in BAT independently of BAT perfusion. Hyperthyroid patients are characterized by increased skeletal muscle metabolism and lipid oxidation rates.

  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. 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.

  2. 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...... and after the diagnosis of hyperthyroidism....

  3. 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...

  4. 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.

  5. Clinical management of patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Cooper, D.S.; Ridgway, E.C.

    1985-01-01

    The clinical management of the hyperthyroid patient is controversial, because there is no perfect treatment. Factors that influence the choice of therapy include the patient's age, sex, and type of hyperthyroidism, as well as patient and physician preference

  6. Fetuin-A levels in hyperthyroidism.

    Science.gov (United States)

    Pamuk, Bariş Onder; Yilmaz, Hamiyet; Topcuoglu, Tugba; Bilgir, Oktay; Çalan, Ozlem; Pamuk, Gulseren; Ertugrul, Derun Taner

    2013-01-01

    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. 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. 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, phyperthyroidism influences fetuin-A levels.

  7. [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. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Unilateral exophthalmos in primary hyperthyroidism

    International Nuclear Information System (INIS)

    Park, C. Y.; Kim, Y. J.; Choi, K. O.

    1980-01-01

    The exophthalmos of Graves' disease remains a pathophysiologic and therapeutic puzzle. Its relation to the hyperthyroidism of Grave's disease is far from clarified. It is a common clinical observation that exophthalmos does not often relate temporally with the onset of hyperthyroidism. Furthermore, exophthalmos may occur in patients who have no evidence of thyroid disease. Pathologically, exophthalmos is characterized by marked lymphocytic infiltration of the retro-orbital muscles, with edema and mucopolysaccharide deposition. Recently, cellular immunity in response to retro-orbital antigens and abnormal humoral immunity are suggested for the pathogenesis of exophthalmos. We experienced 2 patients with hyperthyroidism and unilateral exophthalmos. The clinical and laboratory features of the patients are presented with review of articles, with emphasis on pathogenesis.

  9. Medical therapeutic effect of hyperthyroidism

    International Nuclear Information System (INIS)

    Lee, K.B.

    1980-01-01

    In order to compare the therapeutic effect as well as side effects between antithyroid therapy and radioiodine therapy in hyperthyroidism, the author evaluated 111 cases of hyperthyroidism which were composed of 57 patients with antithyroid treatment, 23 patients with combined treatment comprising of antithyroid and radioactive iodine ( 131 I) and 31 patients with treatment of 131 I alone. (author)

  10. 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.

  11. Effect of hyperthyroidism and its treatment on bone mineral content

    International Nuclear Information System (INIS)

    Toh, S.H.; Claunch, B.C.; Brown, P.H.

    1985-01-01

    Patients with hyperthyroidism may develop osteopenia associated with fractures; however, there has been no general agreement on the incidence of osteopenia in hyperthyroidism or the recovery of the mineral loss after treatment of hyperthyroidism. The authors conducted a longitudinal prospective study on the effect of hyperthyroidism and its treatment on bone mineral content (BMC) using photon absorptiometry. They observed that both young and older hyperthyroid patients showed a significantly decreased baseline BMC compared with age- and sex-matched controls. They also observed a slight recovery of BMC in hyperthyroid patients at the two-year interval after a euthyroid state had been achieved. However, the BMC was still much lower than that of controls, and they did not find any significant restoration of BMC following ''cure'' of hyperthyroidism

  12. Metabolic and Clinical Consequences of Hyperthyroidism on Bone Density

    OpenAIRE

    Gorka, Jagoda; Taylor-Gjevre, Regina M.; Arnason, Terra

    2013-01-01

    In 1891, Von Recklinghausen first established the association between the development of osteoporosis in the presence of overt hyperthyroidism. Subsequent reports have demonstrated that BMD loss is common in frank hyperthyroidism, and, to a lesser extent, in subclinical presentations. With the introduction of antithyroid medication in the 1940s to control biochemical hyperthyroidism, the accompanying bone disease became less clinically apparent as hyperthyroidism was more successfully treated...

  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: diagnosis and management of Graves' disease.

    Science.gov (United States)

    Schilling, J S

    1997-06-01

    Hyperthyroidism, or thyrotoxicosis, results when the body's tissues are exposed to excessive levels of thyroid hormone. Hyperthyroidism affects 2% of women but only one-tenth as many men. Graves' disease is the most common form of hyperthyroidism, often occurring in young adults. It is an autoimmune disorder with an important genetic component. Hyperthyroidism's hallmarks include goiter and myriad signs and symptoms related to increased metabolic activity in virtually all body tissues. Increased sensitivity to circulating catecholamines adds to the clinical picture. Diagnosed by patient history, physical examination, and laboratory tests, Graves' disease is treated with antithyroid drugs, radioactive iodine, and/or surgery, plus supportive therapy. A good treatment outcome can be expected; long-term follow-up is indicated.

  15. Immunogenic hyperthyroidism following radioiodine ablation of focal autonomy

    International Nuclear Information System (INIS)

    Boddenberg, B.; Voth, E.; Schicha, H.

    1993-01-01

    Immunogenic hyperthyroidism rarely develops after radioiodine elimination of focal autonomous thyroid tissue. We observed this phenomenon in 8 patients between 1989 and 1992. The occurrence of immunogenic hyperthyroidism shortly after elimination of autonomous nodules has not been studied nor is it properly understood. Most studies known today describe the development of autonomous nodules in the course of immunogenic hyperthyroidism or ignore the chronologic order of occurrence. The possibility that immunogenic hyperthyroidism may occur after radioiodine therapy of autonomous nodules, makes a consequent follow-up within the first year following radioiodine therapy mandatory. (orig.) [de

  16. Prognosis and life expectancy in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Horster, F.A.

    1982-01-01

    The term 'hyperthyroidism' comprises several different diseases of which two have to be distinguished particularly: 1. hyperthyroidism with Graves' disease: the immunopathogenesis of Grave's disease allows a symptomatic therapy only; therefore its prognosis is not as good as for the 2. autonomous hyperthyroidism ('toxic goiter'), which can be cured definitely by operation or radioiodine therapy. Both diseases may aggravate under iatrogenic iodine exposure (iodine-containing drugs or X-ray contrast media) to a thyroid storm; this most severe kind of hyperthyroidism still leads to death in almost 40% of the patients. (orig.) [de

  17. Therapy of hyperthyroidism in pregnancy and breastfeeding.

    Science.gov (United States)

    Fumarola, Angela; Di Fiore, Agnese; Dainelli, Michela; Grani, Giorgio; Carbotta, Giovanni; Calvanese, Anna

    2011-06-01

    Uncontrolled hyperthyroidism in pregnancy is associated with an increased risk of perinatal complications. The state of the art discussed here has been derived through a wide MEDLINE search throughout English-language literature by using a combination of words such as hyperthyroidism, propylthiouracil (PTU), methimazole, rituximab, and pregnancy to identify original related works and review articles. Thioamides are the main first-line therapeutic options, whereas beta-blockers and iodine are second-choice drugs; surgery is resorted to only in exceptional cases. Methimazole and PTU reduce the production of thyroid hormones by selectively inhibiting thyroid peroxidase. PTU was once considered to be the first-choice drug in the treatment of gestational hyperthyroidism; however, the United States Food and Drug Administration now recommends it as a second-line thioamide, which should be used solely by women in their first trimester of pregnancy. Thyroidectomy is to be carried out only in pregnant women affected by life-threatening, uncontrollable hyperthyroidism, or in cases with thioamide intolerance. Obstetricians & Gynecologists, Family Physicians After completion of this article, the physician should be better able to choose appropriate therapies for hyperthyroidism in pregnant women, assess the risk of possible complications due to maternal hyperthyroidism, and evaluate strategies for patient follow-up.

  18. Case Report: Recurrent severe vomiting due to hyperthyroidism.

    Science.gov (United States)

    Chen, Li-ying; Zhou, Bo; Chen, Zhou-wen; Fang, Li-zheng

    2010-03-01

    Thyrotoxicosis may present in many ways; severe vomiting as a prominent symptom of thyrotoxicosis is uncommon. In this paper, we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting. The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight. Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer. He was treated with antacid and proton pump inhibitors, but his symptoms had no relief. His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data. After a month of propylthiouracil therapy, his symptoms were relieved. It should be noted that hyperthyroidism patients can have unexplained vomiting, and that hyperthyroidism may coexist with peptic ulcer in rare cases. Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis.

  19. Bone mineral density and metabolic indices in hyperthyroidism.

    Science.gov (United States)

    Al-Nuaim, A; El-Desouki, M; Sulimani, R; Mohammadiah, M

    1991-09-01

    Hyperthyroidism can alter bone metabolism by increasing both bone resorption and formation. The increase in bone resorption predominates, leading to a decrease in bone mass. To assess the effect of hyperthyroidism on bone and mineral metabolism, we measured bone density using single photon absorptiometry in 30 untreated hyperthyroid patients. Patients were categorized into three groups based on sex and alkaline phosphatase levels: 44 sex- and age-matched subjects were used as controls. Bone densities were significanlty lower in all patient groups compared with controls. Alkaline phosphatase was found to be a useful marker for assessing severity of bone disease in hyperthyroid patients as there is significant bone density among patients with higher alkaline phosphatase value. Hyperthyroidism should be considered in the differential diagnosis of unexplained alkaline phophatase activity.

  20. HYPERTHYROIDISM AND HYPERPROLACTINEMIA: IS THERE ANY ASSOCIATION?

    Science.gov (United States)

    Sanjari, Mojgan; Safi, Zohreh; Tahroodi, Khatereh Mohammadi

    2016-12-01

    To compare the serum prolactin level in hyperthyroid and normal control females. Hyperthyroidism is a common disease. Although a direct association has been demonstrated between hypothyroidism and increased prolactin levels, this association has not been established for hyperthyroidism. Cross-sectional study in cases and control groups. Control subjects were chosen from those participating in the Kerman Coronary Artery Disease Risk Factors study. To select the cases, all women referred to the laboratories of Kerman with a thyroid-stimulating hormone (TSH) level ≤0.5 mIU/L who met the inclusion criteria were entered in the study. A total of 231 women aged 15 to 50 years were enrolled. The case group included 71 hyperthyroid women, and the control group included 160 women with normal thyroid function matched by age. The mean (SD) serum level of prolactin was 16.56 (0.97) ng/mL (95% confidence interval [CI], 15.41 ng/mL to 15.71 ng/mL) in the controls and 23.07 (1.49) ng/mL (95% CI, 22.7 ng/mL to 23.4 ng/mL) in the case subjects. Hyperprolactinemia was more common in the hyperthyroid group (16.5 [0.97] ng/mL versus 23.07 [1.49] ng/mL; PHyperthyroidism and estradiol increased the prolactin level. After adjusting for age and estradiol, hyperthyroidism increased the serum prolactin level (Phyperthyroid females. Serum prolactin level can be increased in hyperthyroidism. PRL = prolactin T4 = thyroxine TRH = thyrotropin-releasing hormone TSH = thyroid-stimulating hormone.

  1. Management of hyperthyroidism

    International Nuclear Information System (INIS)

    Poshyachinda, M.

    2001-01-01

    There are many clinical form of hyperthyroidism. It is necessary to determine the specific cause in order to direct the treatment strategy accordingly. The most common form is Graves' disease, an autoimmune disorder characterized by the presence of thyroid stimulating immunoglobulin that bind to and stimulate the thyrotropin receptor resulting in thyroid overactivity. Toxic nodular goitres, the next in prevalence, is more common in iodine deficient region and causes by autonomous hyperfunctioning thyroid nodules. The therapeutic approaches to treat hyperthyroidism are 1) antithyroid drugs to block hormones synthesis and release, 2) surgery and 3) radioiodine ablation of thyroid tissue. All therapeutic modalities are effective but the latter two methods are most probably the definitive means to achieve remission of the hyperthyroidism. Antithyroid drug therapy is the preferred treatment for all children with Graves' disease and patients with small goitres and short duration. However, a long term remission from antithyroid drug treatment is approximately 50%. Surgery is appropriate treatment for patient who has a very large goitre with symptoms of compression in the neck or patient with a cold nodule on thyroid scan. Currently radioiodine therapy is the most common therapy for Graves' disease. It is increasingly used as first-line therapy especially in elderly patients. It is the treatment of choice for patients with recurrent hyperthyroidism after antithyroid drug or surgical treatment. Radioiodine is also the preferred treatment for toxic nodular goitre. It is effective, safe and low cost. However it may aggravated Graves' ophthalmopathy. The only major disadvantage is high incidence of hypothyroidism. It is crucial that the patient be followed annually post treatment so that hypothyroidism can be detected early and proper treatment initiated. (author)

  2. Severe hyperthyroidism: aetiology, clinical features and treatment outcome.

    Science.gov (United States)

    Iglesias, P; Dévora, O; García, J; Tajada, P; García-Arévalo, C; Díez, J J

    2010-04-01

    Severe hyperthyroidism (SH) is a serious medical disorder that can compromise life. There have not been systematic studies in which SH has been evaluated in detail. Here, our aims were: (1) to analyse both clinical and analytical features and outcome in patients with SH and (2) to compare these data with those found in more usual forms of hyperthyroidism. Patients and methods All patients diagnosed of SH (free thyroxine, FT4 > 100 pmol/l, NR: 11-23) seen in our endocrinology clinic in the last 15 years were studied and compared with a sample of patients with mild (mH; FT4, 23-50 pmol/l) and moderate (MH; FT4, 51-100 pmol/l) hyperthyroidism. Aetiology, clinical analytical and imaging data at diagnosis, therapeutic response and outcome were registered. Results A total of 107 patients with overt hyperthyroidism (81 females, mean age +/- SD 46.9 +/- 16.1 years) were evaluated. We studied a historic group with SH (n = 21; 14 females, 40.9 +/- 17.2 years) and, as a comparator group, we analyszed the data of 86 hyperthyroid patients (67 females, 48.4 +/- 15.5.6 years, NS) comparable in age and gender. The comparator group was classified in MH (n = 37, 26 females, 47.2 +/- 16.6 years) and mH (n = 49, 41 females, 49.4 +/- 14.8 years). In comparison with mH group, SH patients were significantly (P hyperthyroidism. FT4 was the only independent predictor of cure [OR 0.98 (CI 95%, 0.97-0.99), P hyperthyroidism is usually de novo and is accompanied by more clinical signs, symptoms, and analytical derangements, as well as higher titres of TRAb at diagnosis than milder forms of hyperthyroidism. The present data are not able to show differences in treatment modality, time to achieve cure, and remission rate among patients with mild, moderate and severe hyperthyroidism.

  3. Changes of hepatofibrosis markers in hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Wang Linglong; Zhang Chunyan; Tu Liping; Yu Yuefang; Zhu Weijie

    2005-01-01

    Objective: To study the changes of hepatofibrosis markers in hyperthyroidism and hypothyroidism. Methods: The indicators of thyroid function (TT 3 , TT 4 , FT 3 , FT 4 , sTSH, TG-Ab, TM-Ab) and hepatofibrosis markers (IV-C, PCIII, HA, LN) were assayed with RIA in 57 patients with hyperthyroidism, 43 patients with hypothyroidism, 39 euthyroid patients after hyperthyroidism treated and 50 controls. Results: The serum IV-C and PC III levels in hyperthyroid patients were significantly higher than those in controls and hypothyroid patients (P<0.01). In the euthyroid subjects after successful treatment, the IV-C and PC III levels dropped markedly (vs before treatment, P<0.01). However, there were no significant differences among the serum HA, LN levels in all the subjects tested. Conclusion: Serum levels of IV-C and PC III increased markedly during hyperthyroidism. When IV-C and PC III levels were taken for judgement of degree of hepatofibrosis, hyperthyroidism must be ruled out first. The HA and LN levels were not related to the status of thyroid function. (authors)

  4. 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.

  5. Left ventricular systolic and diastolic function in hyperthyroidism

    International Nuclear Information System (INIS)

    Friedman, M.J.; Okada, R.D.; Ewy, G.A.; Hellman, D.J.

    1982-01-01

    In order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle

  6. 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.

  7. A Clinical Report of Psychosis Associated with Hyperthyroidism.

    OpenAIRE

    Asagami, Yoshifumi

    1996-01-01

    A case of hyperthyroidism associated with psychosis of a 49-year-old housewife was reported. A pararell relationship between the hyperthyroidism and the associated psychotic symptoms was observed. The psychotic symptoms was improved by treatment of hyperthyroidism and by administration of psychotonica. It might be noted that the patient in the present report has a predisposition to psychosis.

  8. Work capacity and oxygen uptake abnormalities in hyperthyroidism.

    Science.gov (United States)

    Irace, L; Pergola, V; Di Salvo, G; Perna, B; Tedesco, M A; Ricci, C; Tuccillo, B; Iacono, A

    2006-06-01

    The aim of our study was to evaluate the haemodynamic and the respiratory response to exercise in patients with hyperthyroidism before and 30 days after normalized thyroid hormones levels. These findings were compared with those of 10 control patients. Thirty patients (23 women, aged 34.3 +/- 12 years) with untreated hyperthyroidism were studied. Twenty-four patients were treated with methimazole, 13 of which were also treated with propranolol. Six patients underwent surgery. A symptom-limited cardiopulmonary exercise test and an echocardiography were performed in all patients. At rest patients with hyperthyroidism showed at echocardiography an increased cardiac index (P = 0.006 vs euthyroid, P = 0.007 vs normal) and a higher ejection fraction (P = 0.008 vs euthyroid, P = 0.007 vs normal). The duration of the exercise was lower in hyperthyroid patients (P = 0.006 vs euthyroid; P = 0.0068 vs normal). Anaerobic threshold was reached at 49.6% of peak VO2 during hyperthyroidism, at 60.8% during euthyroidism (P = 0.01) and at 62% in normal (P = 0.01). Work rate was lower in patients with hyperthyroidism at anaerobic threshold (P = 0.01 vs euthyroid, P = 0.03 vs normal) and at maximal work (P = 0.001 vs euthyroid, P = 0.01 vs normal). Patients in hyperthyroidism showed a lower increment of heart rate between rest and anaerobic threshold (P = 0.021 vs euthyroid, P hyperthyroidism (P = 0.04 vs euthyroid, P = 0.005 vs normal). The mean result is that after only 30 days of appropriate antithyroid treatment there was an appreciable improvement of exertion capacity.

  9. Effects of hyperthyroidism on hand grip strength and function

    OpenAIRE

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

    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 w...

  10. Results of radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Gabriel, A.

    1980-01-01

    Between 1971 and 1977, 102 hyperthyroidism patients were treated with 131 I. The average age of the patients was 64 years. In 78 patients, hyperthyroidism was due to decompensated autonomous adenoma, 24 patients presented with diffuse hyperthyroidism. The patients were observed for 14 to 24 months. Until early 1976, diagnosis and therapy success assessment were based on thyroid scintiscanning, radioiodine two-phase tests, PBI 131 , T 4 tests, and T 3 tests. Since 1976, the radioiodine two-phase test has been replaced by the TRH test, the TRH-RIA, and the T 4 -RIA. The patients were given 3 to 25 mCi 131 I. In 88 cases, euthyroidism was reached after a single therapy; in 8 cases, after two therapies; in 1 case, after three therapies; in 4 cases, after 4 therapies; in 1 case, after 5 therapies. Euthyroidism was thus reached in 96% of all cases after 131 I therapy of hyperthyroidism. (orig./MG) [de

  11. [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.

  12. Hyperthyroidism and pulmonary hypertension: an important association.

    Science.gov (United States)

    Vallabhajosula, Sailaja; Radhi, Saba; Cevik, Cihan; Alalawi, Raed; Raj, Rishi; Nugent, Kenneth

    2011-12-01

    Pulmonary hypertension is a complex disorder with multiple etiologies. The World Health Organization Group 5 (unclear multifactorial mechanisms) includes patients with thyroid disorders. The authors reviewed the literature on the association between hyperthyroidism and pulmonary hypertension and identified 20 publications reporting 164 patients with treatment outcomes. The systolic pulmonary artery (PA) pressures in these patients ranged from 28 to 78 mm Hg. They were treated with antithyroid medications, radioactive iodine and surgery. The mean pretherapy PA systolic pressure was 39 mm Hg; the mean posttreatment pressure was 30 mm Hg. Pulmonary hypertension should be considered in hyperthyroid patients with dyspnea. All patients with pulmonary hypertension should be screened for hyperthyroidism, because the treatment of hyperthyroidism can reduce PA pressures, potentially avoid the side-effects and costs with current therapies for pulmonary hypertension and limit the consequences of untreated hyperthyroidism. However, the long-term outcome in these patients is uncertain, and this issue needs more study. Changes in the pulmonary circulation and molecular regulators of vascular remodeling likely explain this association.

  13. Sympathetic skin responses in patients with hyperthyroidism.

    Science.gov (United States)

    Gozke, E; Ozyurt, Z; Dortcan, N; Ore, O; Kocer, A; Ozer, E

    2007-01-01

    The aim of this study was to investigate the disorders of sympathetic nervous system in patients with hyperthyroidism using sympathetic skin response (SSR). Twenty-two newly diagnosed cases with hyperthyroidism were included in the study. The results were compared with those of 20 healthy controls. SSR was recorded with the contralateral electrical stimulation of the median nerve (of the upper extremities) and tibial nerve (of the lower extremities) with active electrodes placed on palms and soles and reference electrodes attached on the dorsal aspects of hands and feet. Ages of the cases with hyperthyroidism and controls ranged between 15-65 years (mean: 46.7 +/- 15.0 years) and 24-62 years (mean: 39.6 +/- 9.8 years) respectively (p > 0.05). In all the control subjects SSR could be obtained, while from the lower extremities of 4 cases with hyperthyroidism (18.0%) SSR could not be elicited. Mean SSR latencies of lower extremities were found significantly longer than control group (p nervous system involvement in cases with hyperthyroidism.

  14. Radiation associated hyperthyroidism in patients with gynecological malignancies

    International Nuclear Information System (INIS)

    Katayama, S.; Shimaoka, K.; Piver, M.S.; Osman, G.; Tsukada, Y.; Suh, O.

    1985-01-01

    To determine the effect of abdominal and/or pelvic irradiation for gynecological malignancies on the later development of hyperthyroidism, 1,884 medical records of the patients diagnoses as carcinomas of cervix and corpus uteri, and of ovary were reviewed. Among 1,269 patients with radiation therapy, 5 patients developed hyperthyroidism after irradiation to the abdomen and/or pelvis. This is a statistically significant increase when compared with an epidemiological study. Radiation dose to the thyroid was estimated to be 30 to 200 rads. Two other patients who were irradiated to the nose or supraclavicular region in addition to the abdomen also developed hyperthyroidism. However, none of 581 patients without radiation therapy became hyperthyroid. The results indicate that radiation therapy for treatment of gynecological malignancy gives a significant radiation exposure with an increase in the incidence of subsequent hyperthyroidism

  15. Hyperthyroidism

    OpenAIRE

    Sharma, Mala; Aronow, Wilbert S.; Patel, Laxesh; Gandhi, Kaushang; Desai, Harit

    2011-01-01

    Summary Hyperthyroidism is a pathological syndrome in which tissue is exposed to excessive amounts of circulating thyroid hormone. The most common cause of this syndrome is Graves? disease, followed by toxic multinodular goitre, and solitary hyperfunctioning nodules. Autoimmune postpartum and subacute thyroiditis, tumors that secrete thyrotropin, and drug-induced thyroid dysfunction, are also important causes.

  16. 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

  17. Chinese herbal medicines for hyperthyroidism.

    Science.gov (United States)

    Zen, X X; Yuan, Y; Liu, Y; Wu, T X; Han, S

    2007-04-18

    Hyperthyroidism is a disease in which excessive amounts of thyroid hormones circulate in the blood. Patients, among other things suffer from tachycardia, warm moist skin and raised body temperature. The treatment of hyperthyroidism includes symptom relief and therapy with antithyroid medications, radioiodine and thyroidectomy. Medicinal herbs are used alone or in combination with antithyroid agents to treat hyperthyroidism in China and some other countries. To assess the effects of Chinese herbal medicines for treating hyperthyroidism. Studies were obtained from computerised searches of MEDLINE, EMBASE, The Cochrane Library, the Chinese Biomedical Database. Randomised controlled trials comparing the effects of Chinese herbal medicines alone with Chinese herbal medicines combined with antithyroid drugs, radioiodine or both. Three authors interviewed authors of all potentially relevant studies by telephone to verify randomisation procedures. One author entered data into a data extraction form and another author verified the results of this procedure. Thirteen relevant trials with 1770 participants were included. All of them were of low quality. Fifty-two studies still need to be assessed because the original authors could not be interviewed. None of these trials analysed mortality, health related quality of life, economic outcomes or compliance. Compared to antithyroid drugs alone the results showed that Chinese herbal medicines combined with antithyroid drugs may offer benefits in lowering relapse rates, reducing the incidence of adverse effects, relieving symptoms, improving thyroid antibody status and thyroid function. Two trials investigated Chinese herbal medicine versus radioiodine and reported improvements in anxiety, tachycardia and heat intolerance. However, thyroid function - with the exception of restored thyroid stimulating hormone (TSH) - was not significantly altered. The results suggest that traditional Chinese herbal medicines added to other routine

  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. 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

  20. 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.

  1. Pediatric pulmonary arterial hypertension and hyperthyroidism: a potentially fatal combination.

    Science.gov (United States)

    Trapp, Christine M; Elder, Robert W; Gerken, Adrienne T; Sopher, Aviva B; Lerner, Shulamit; Aranoff, Gaya S; Rosenzweig, Erika B

    2012-07-01

    Patients with pulmonary arterial hypertension (PAH) who develop hyperthyroidism are at risk for acute cardiopulmonary decompensation and death. We present a series of eight idiopathic PAH/heritable PAH pediatric patients who developed hyperthyroidism between 1999 and 2011. Institutional Review Board approval was obtained; informed consent was waived due to the retrospective nature of the series. All eight patients were receiving iv epoprostenol; five of the eight patients presented with acute cardiopulmonary decompensation in the setting of hyperthyroidism. In the remaining three patients, hyperthyroidism was detected during routine screening of thyroid function tests. The one patient who underwent emergency thyroidectomy was the only survivor of those who presented in cardiopulmonary decline. Aggressive treatment of the hyperthyroid state, including emergency total thyroidectomy and escalation of targeted PAH therapy and β-blockade when warranted, may prove lifesaving in these patients. Prompt thyroidectomy or radioactive iodine ablation should be considered for clinically stable PAH patients with early and/or mild hyperthyroidism to avoid potentially life-threatening cardiopulmonary decompensation. Although the association between hyperthyroidism and PAH remains poorly understood, the potential impact of hyperthyroidism on the cardiopulmonary status of PAH patients must not be ignored. Hyperthyroidism must be identified early in this patient population to optimize intervention before acute decompensation. Thyroid function tests should be checked routinely in patients with PAH, particularly those on iv epoprostenol, and urgently in patients with acute decompensation or symptoms of hyperthyroidism.

  2. Pediatric Pulmonary Arterial Hypertension and Hyperthyroidism: A Potentially Fatal Combination

    Science.gov (United States)

    Trapp, Christine M.; Elder, Robert W.; Gerken, Adrienne T.; Sopher, Aviva B.; Lerner, Shulamit; Rosenzweig, Erika B.

    2012-01-01

    Context: Patients with pulmonary arterial hypertension (PAH) who develop hyperthyroidism are at risk for acute cardiopulmonary decompensation and death. Cases and Setting: We present a series of eight idiopathic PAH/heritable PAH pediatric patients who developed hyperthyroidism between 1999 and 2011. Institutional Review Board approval was obtained; informed consent was waived due to the retrospective nature of the series. All eight patients were receiving iv epoprostenol; five of the eight patients presented with acute cardiopulmonary decompensation in the setting of hyperthyroidism. In the remaining three patients, hyperthyroidism was detected during routine screening of thyroid function tests. The one patient who underwent emergency thyroidectomy was the only survivor of those who presented in cardiopulmonary decline. Evidence Synthesis: Aggressive treatment of the hyperthyroid state, including emergency total thyroidectomy and escalation of targeted PAH therapy and β-blockade when warranted, may prove lifesaving in these patients. Prompt thyroidectomy or radioactive iodine ablation should be considered for clinically stable PAH patients with early and/or mild hyperthyroidism to avoid potentially life-threatening cardiopulmonary decompensation. Conclusions: Although the association between hyperthyroidism and PAH remains poorly understood, the potential impact of hyperthyroidism on the cardiopulmonary status of PAH patients must not be ignored. Hyperthyroidism must be identified early in this patient population to optimize intervention before acute decompensation. Thyroid function tests should be checked routinely in patients with PAH, particularly those on iv epoprostenol, and urgently in patients with acute decompensation or symptoms of hyperthyroidism. PMID:22622024

  3. The long-term consequences of previous hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans

    2015-01-01

    Thyroid hormones affect every cell in the human body, and the cardiovascular changes associated with increased levels of thyroid hormones are especially well described. As an example, short-term hyperthyroidism has positive chronotropic and inotropic effects on the heart, leading to a hyperdynamic...... 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....... vascular state. While it is biologically plausible that these changes may induce long-term consequences, the insight into morbidity as well as mortality in patients with previous hyperthyroidism is limited. The reasons for this are a combination of inadequately powered studies, varying definitions...

  4. 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.

  5. Interventions for preventing and treating hyperthyroidism in pregnancy.

    Science.gov (United States)

    Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

    2010-09-08

    Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 July 2010). We intended to include randomised controlled trials comparing antithyroid treatments in pregnant women with hyperthyroidism. Two review authors would have assessed trial eligibility and risk of bias, and extracted data. No trials were located. As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid drugs for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil.

  6. Diagnosis and Management of Hyperthyroidism in Pregnancy: A Review.

    Science.gov (United States)

    King, Jennifer Renae; Lachica, Ruben; Lee, Richard H; Montoro, Martin; Mestman, Jorge

    2016-11-01

    Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations. Review of published articles on PubMed and guidelines by recognized governing organizations regarding the diagnostic and management considerations for hyperthyroidism in pregnancy, from preconception to the postpartum period. Diagnosis of maternal hyperthyroidism involves both clinical symptoms and laboratory findings. Antithyroid medications are the mainstay of therapy, with trimester-specific pregnancy goals. Hyperthyroidism due to Graves disease has important diagnostic and management considerations for the fetus and neonate. Hyperthyroidism in pregnancy affects mother, fetus, and neonate. Interpretation of thyroid tests and understanding the appropriate use of antithyroid drugs are fundamental. Proper education of physicians providing care to women with hyperthyroidism is essential and starts before pregnancy. Postpartum follow-up is an essential part of the care. A systematic approach to management will ensure optimal pregnancy outcomes.

  7. P-wave dispersion in endogenous and exogenous subclinical hyperthyroidism.

    Science.gov (United States)

    Gen, R; Akbay, E; Camsari, A; Ozcan, T

    2010-02-01

    The aim of this study was to measure maximum P wave duration (Pmax) and P wave dispersion (PWD), which can be indicators for the risk of paroxysmal atrial fibrillation when increased, and to reveal their relationship with thyroid hormone levels in patients with endogenous and exogenous subclinical hyperthyroidism. Seventy-one patients with sublinical thyrotoxicosis (34 endogenous, 37 exogenous) and 69 healthy individuals were enrolled in the study. Pmax and minimum P wave duration (Pmin) on electrocardiogram recordings were measured and PWD was calculated as Pmax-Pmin. Pmax (pendogenous subclinical hyperthyroidism compared with the control group. Pmax (pexogenous subclinical thyrotoxicosis compared with the control group. Pmax (p=0.710) and PWD (p=0.127) were not significantly different in patients with endogenous subclinical hyperthyroidism compared with exogenous subclinical hyperthyroid patients. Pmax and PWD negatively associated with TSH in endogenous and exogenous subclinical hyperthyroidism. In the present study, we observed that Pmax and PWD were longer in patients with endogenous and exogenous subclinical hyperthyroidism. Lack of a difference in Pmax and PWD between patients with endogenous and exogenous subclinical hyperthyroidism seems to support the idea that hormone levels rather than the etiology of thyrotoxicosis affect the heart.

  8. Elevated Serum Fibroblast Growth Factor 21 Levels in Patients With Hyperthyroidism.

    Science.gov (United States)

    Xiao, Fangsen; Lin, Mingzhu; Huang, Peiying; Zeng, Jinyang; Zeng, Xin; Zhang, Huijie; Li, Xiaoying; Yang, Shuyu; Li, Zhibin; Li, Xuejun

    2015-10-01

    Recent evidence from animal studies indicates that fibroblast growth factor 21 (FGF21), an endocrine hormone that regulates glucose, lipid metabolism, and energy homeostasis, is regulated by T3. However, the role of FGF21 in hyperthyroid patients is unknown. The objective was to study serum FGF21 levels in hyperthyroid patients and the association of serum FGF21 levels with hyperthyroidism. This was a case-control study. A total of 119 hyperthyroid patients and 108 healthy subjects were recruited. Of them, 41 hyperthyroid patients received thionamide treatment for 3 months until euthyroidism was obtained. Serum FGF21 levels were determined using the ELISA method. Serum FGF21 levels were significantly elevated in hyperthyroid patients as compared with normal subjects [median 290.67 (interquartile range, 156.60-502.33) vs 228.10 (169.85.25-320.10) pg/mL; P treatment, serum FGF21 levels in hyperthyroid patients declined markedly from 249.10 (139.10-444.00) to 106.90 (38.70-196.15) pg/mL (P hyperthyroidism. With adjustment for potential confounders, serum FGF21 remained independently associated with hyperthyroidism, with an adjusted odds ratio of 3.123 (95% confidence interval, 1.306-7.468) (P = .010). Serum FGF21 levels were elevated in patients with hyperthyroidism and declined after thionamide treatment. And serum FGF21 level was independently associated with hyperthyroidism.

  9. Thyroid Hemiagenesis Associated with Hyperthyroidism

    OpenAIRE

    Gurleyik, Gunay; Gurleyik, Emin

    2015-01-01

    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 no...

  10. 31P-magnetic resonance spectroscopy: Impaired energy metabolism in latent hyperthyroidism

    International Nuclear Information System (INIS)

    Theissen, P.; Kaldewey, S.; Moka, D.; Bunke, J.; Voth, E.; Schicha, H.

    1993-01-01

    31 Phosphorous magnetic resonance spectroscopy allows an in vivo examination of energy metabolism. The present study was designed to evaluate whether in patients with latent hyperthyroidism alterations of muscle energy metabolism could be found similar to those observed in patients with overt hyperthyroidism. In 10 patients with overt hyperthyroidism before therapy and 20 with latent hyperthyroidism (also without therapy) and in 24 healthy volunteers magnetic resonance spectroscopy of the calf muscle was performed within a 1.5-Tesla magnet. Muscle concentrations of phosphocreatine, inorganic phosphate, and ATP were quantified compared to an external standard solution of K 2 HPO 4 . In the patients with overt hyperthyroidism and with latent hyperthyroidism a significant decrease of phosphocreatine was found. Further, the ATP concentration in patients with latent and manifest hyperthyroidism tended towards lower values. There were no significant differences in the decrease of phosphocreatine and ATP between both patient groups. Therefore, this study for the first time shows that alterations of energy metabolism in latent hyperthyroidism can be measured and that they are similar to those observed in overt hyperthyroidism. (orig.) [de

  11. 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. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Remarkable Presentation: Anaplastic Thyroid Carcinoma Arising from Chronic Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Habib G. Zalzal

    2018-01-01

    Full Text Available Background. Undifferentiated anaplastic carcinoma rarely develops from chronic hyperthyroidism. Although acute hyperthyroidism can develop prior to anaplastic transformation, chronic hyperthyroidism was thought to be a protective measure against thyroid malignancy. Methods. A 79-year-old female presented acutely to the hospital with dyspnea. She had been taking methimazole for chronic hyperthyroidism due to toxic thyroid nodules, previously biopsied as benign. Upon admission, imaging showed tracheal compression, requiring a total thyroidectomy with tracheostomy for airway management. Results. Pathology demonstrated undifferentiated anaplastic thyroid carcinoma. The patient passed away shortly after hospital discharge. Despite treatment with methimazole for many years, abrupt enlargement of her toxic multinodular goiter was consistent with malignant transformation. Chronic hyperthyroidism and toxic nodules are rarely associated with thyroid malignancy, with only one previous report documenting association with anaplastic thyroid carcinoma. Conclusion. Progressive thyroid enlargement and acute worsening of previously controlled hyperthyroidism should promote concern for disease regardless of baseline thyroid function.

  13. 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.

  14. Both experimental hypothyroidism and hyperthyroidism increase cardiac irisin levels in rats.

    Science.gov (United States)

    Atici, E; Menevse, E; Baltaci, A K; Mogulkoc, R

    2018-01-01

    Irisin is a newly discovered myokine and adipokine that increases total body energy expenditure. The aim of this study was to determine the effect of experimental hypothyroidism and hyperthyroidism on the levels of irisin in heart tissue in rats. The study was performed on the 40 male Sprague-Dawley rats. Experimental groups were designed as; Control, Hypothyroidism, Hypothyroidism+L-Thyroxine, Hyperthyroidism and Hyperthyroidism + PTU. Following 3 weeks experimental period, irisin levels were determined in heart tissues. Hypothyroidism group values of irisin were higher than in the control group, but lower than in the hyperthyroidism group. The hyperthyroidism group had the highest levels of cardiac irisin. The results of the study showed that the experimental hypothyroidism and hyperthyroidism increased the heart irisin levels, but the increase in the hyperthyroidism group was much higher than in the hypothyroidism group. However, treatment of hypothyroidism and hyperthyroidism corrected cardiac irisin levels (Fig. 1, Ref. 28).

  15. 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.

  16. A Study on the Clinical Diagnosis of Hyperthyroidism

    International Nuclear Information System (INIS)

    Ku, In Soo; Koh, Chang Soon; Lee, Mun Ho

    1973-01-01

    To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: l. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7. 6% of the patients were male and 92. 4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91. 3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight low, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyapnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid function tests was as follows: T 7 was 92. 4% reliable, 125 IT 3 resin uptake rate 91. 6% reliable, 131 I thyroid uptake rate in 24 hrs. 89. 4% reliable, serum T 4 level 85. 9% reliable and BMR 75. 5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthymidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was

  17. A Study on the Clinical Diagnosis of Hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ku, In Soo; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1973-03-15

    To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: l. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7. 6% of the patients were male and 92. 4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91. 3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight low, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyapnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid function tests was as follows: T{sub 7} was 92. 4% reliable, {sup 125}IT{sub 3} resin uptake rate 91. 6% reliable, {sup 131}I thyroid uptake rate in 24 hrs. 89. 4% reliable, serum T{sub 4} level 85. 9% reliable and BMR 75. 5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthymidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical

  18. Hyperthyroidism (Overactive Thyroid)

    Science.gov (United States)

    ... gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism significantly, causing sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness ...

  19. Association of transient hyperthyroidism and severity of hyperemesis gravidarum.

    Science.gov (United States)

    Malek, Nor Zila Hassan; Kalok, Aida; Hanafiah, Zainal Abidin; Shah, Shamsul Azhar; Ismail, Nor Azlin Mohamed

    2017-03-23

    Background Transient non-immune hyperthyroidism in early pregnancy is hyperthyroidism diagnosed for the first time in early pregnancy, without evidence of thyroid autoimmunity or clinical findings of Grave's disease and resolved spontaneously as the pregnancy progressed. Hyperemesis gravidarum (HG) is the commonest cause with 66%-73% of women with severe HG were found to have elevated thyroid function. Materials and methods We conducted a cross sectional study to determine the prevalence of transient hyperthyroidism in patients with hyperemesis gravidarum and its relation to the severity of nausea and vomiting. Severity of nausea and vomiting in pregnancy was assessed using the modified pregnancy-unique quantification of emesis (PUQE) scoring system. Each patient had urine and blood investigations which also included a full blood count and thyroid and renal function tests. Patients with abnormal thyroid function were retested at 20 weeks of gestation. The patients' demographic data, electrolyte levels, thyroid function and their respective PUQE score were analyzed. Results The prevalence of transient hyperthyroidism in women with hyperemesis gravidarum was 4.8%. Although there was a significant association between the severity of the PUQE score and hypokalemia (p = 0.001), there was no significant association with transient hyperthyroidism in early pregnancy (p = 0.072). Free T4 and TSH values of all women with transient hyperthyroidism were normalized by 20 weeks of gestation. Conclusion Transient hyperthyroidism in pregnancy is not significantly associated with the severity of the PUQE score. Women with transient hyperthyroidism in pregnancy are normally clinically euthyroid, hence a routine thyroid function test is unnecessary unless they exhibit clinical signs or symptoms of hyperthyroidism.

  20. Thyroid artery embolization with microspheres for hyperthyroidism

    International Nuclear Information System (INIS)

    Du Yahui; Zhong Chenfu; Chen Weijun; Zhang Ying; Luo Jun; Li Xiaoguang; Cao Junjie; Gan Changli; Cao Junjie; Gan Changli

    2006-01-01

    Objective: To evaluate the method and efficacy of thyroid artery embolization as a new therapy for hyperthyroidism. Methods: Thirteen patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 25 thyroid arteries were embolized with microspheres. The indications for this therapy were as followings: 1) To give hyperthyroid patients having an alternative for surgical and 131 I treatment, and 2) To provide a new method for those clinically being difficult to get control with medicine. Results: Serum level of thyroid hormones dropped significantly[T3 from 2.84-9.0 ng/ml to 0.8-2.2 ng/ml, T4 from 162.9-277.2 ng/ml to 50-126 ng/ml] and symptoms of hyperthyroidism were under control in 12 patients within 1 month after the embolization. One patient remained no change 1 month later and refused to be embolized again. The symptoms of twelve patients were effectively controlled through low dose antithyroid medication for more than 6 months follow up with no serious complications. Conclusion: Thyroid artery embolization with microspheres is an effective alternative for surgical and 131 I treatment of hyperthyroidism. (authors)

  1. Interventional embolization for refractory hyperthyroidism

    International Nuclear Information System (INIS)

    Jiang Guomin; Zhang Yunping; Chen Yaxian; Zhao Jinwei; Yang Weihuai; Chen Jinluo

    2001-01-01

    Objective: To evaluate the clinical effects of the thyroid artery embolization for refractory hyperthyroidism. Methods: Super selective catheterization and interventional embolization of thyroid superior and inferior arteries were performed with PVA microspheres and Gelfoam particles. Changes of function and size of thyroid were investigated after embolization. Results: The procedures were succeeded in all 21 patients. Followed up by 3-12 months, serum level of thyroid hormones dropped significantly (median FT 3 from 17.1 pmol/L to 7.44 pmol/L, median FT 4 from 51.1 pmol/L to 23.3 pmol/L, P< 0.01). The size of thyroid glands decreased remarkably. Symptoms of hyperthyroidism were controlled in 4 patients and were effectively controlled through low dose antithyroid medication in 17 patients. No serious complications occurred. Conclusions: Thyroid artery embolization is a new safe and effective method for refractory hyperthyroidism

  2. Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

    Science.gov (United States)

    Kurtoğlu, Selim; Özdemir, Ahmet

    2017-01-01

    Fetal and neonatal hyperthyroidism may occur in mothers with Graves’ disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th–20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7–17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism. PMID:28439194

  3. Pulmonary function and V/Q distribution in hyperthyroidism

    International Nuclear Information System (INIS)

    Mori, Yutaka; Mashima, Yasuoki; Shimada, Takao; Kawakami, Kenji; Tominaga, Shigeru.

    1987-01-01

    Pulmonary functions of the hyperthyroidisms were evaluated before and after therapy. Kr-81m continuous inhalation and Tc-99m MAA (Macro Agguregated Albumin) perfusion study, spirography (VC, RV, FRC, TLC, CV), Diffusion capacity, and flow volume (V25, V50) study were done before and after therapy of 32 hyperthyroidisms. As a result VC% increased and RV% decreased significantly after the therapy, due to improvement of weakness of respiratory muscle. No significant changes were recognized on FRC, TLC, CV, DLco, V25, V50 after the therapy. Perfusion shifted to the upper lung fields in 21 (91 %) out of 23 hyperthyroidism patients. There was no significant change of ventilatory distribution after the therapy. V/Q ratio in upper lung fields therefore decreased in hyperthyroid state. After the therapy, perfusion in upper lung fields recovered to normal pattern, corresponding to normalization of T4 value. Shift of perfusion to upper lung fields was considered to be one of pathophysiological changes of hemodynamics in the hyperthyroidisms. (author)

  4. DNA-synthesis of lymphocytes in hyperthyroid and enthyroid subjects. Effect of 131I therapy on hyperthyroidism

    International Nuclear Information System (INIS)

    Lundell, G.; Wasserman, J.; Einhorn, N.; Granberg, P.-O.

    1976-01-01

    The DNA-synthesis of human lymphoid cells as estimated by the measurement of thymidine incorporation in vitro was investigated in healthy controls and in patients with various thyroid disorders before and after therapy. Hyperthyroid patients treated with 131 I and surgery (euthyroid at initial blood sampling before surgery), patients with atoxic nodular goitre treated by surgery and healthy untreated control individuals comprised the material. The synthesis of DNA in lymphocytes was higher in hyperthyroid patients in comparison with euthyroid individuals, and decreased subsequent to 131 I therapy in the hyperthyroid patients. No decrease was recorded in the other groups of patients. No evidence suggesting a change in the lymphocyte reactivity to thyroglobulin was found in any of the patient groups. (author)

  5. 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.

  6. Differential diagnosis of hyperthyroidism

    International Nuclear Information System (INIS)

    Emrich, D.

    1984-01-01

    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. (orig.) [de

  7. Bone mineral content in hyperthyroid patients after combined medical and surgical treatment

    International Nuclear Information System (INIS)

    Nielsen, H.E.; Mosekilde, L.; Charles, P.

    1979-01-01

    Bone mineral content (BMC) and bone mineral concentration (BMC') of the forearm were determined by photon absorptiometry in 20 untreated hyperthyroid patients and in 33 patients previously treated for hyperthyroidism. In untreated hyperthyroidism a significant decrease was found in both BMC and BMC'. In treated hyperthyroidism BMC and BMC' were normalized. The findings suggest that a previous hyperthyroid state is not a risk factor for development of spontaneous fractures providing the hyperthyroid state is effectively treated. (Auth.)

  8. Metabolic and Clinical Consequences of Hyperthyroidism on Bone Density

    Science.gov (United States)

    Gorka, Jagoda; Taylor-Gjevre, Regina M.

    2013-01-01

    In 1891, Von Recklinghausen first established the association between the development of osteoporosis in the presence of overt hyperthyroidism. Subsequent reports have demonstrated that BMD loss is common in frank hyperthyroidism, and, to a lesser extent, in subclinical presentations. With the introduction of antithyroid medication in the 1940s to control biochemical hyperthyroidism, the accompanying bone disease became less clinically apparent as hyperthyroidism was more successfully treated medically. Consequently, the impact of the above normal thyroid hormones in the pathogenesis of osteoporosis may be presently underrecognized due to the widespread effective treatments. This review aims to present the current knowledge of the consequences of hyperthyroidism on bone metabolism. The vast number of recent papers touching on this topic highlights the recognized impact of this common medical condition on bone health. Our focus in this review was to search for answers to the following questions. What is the mechanisms of action of thyroid hormones on bone metabolism? What are the clinical consequences of hyperthyroidism on BMD and fracture risk? What differences are there between men and women with thyroid disease and how does menopause change the clinical outcomes? Lastly, we report how different treatments for hyperthyroidism benefit thyroid hormone-induced osteoporosis. PMID:23970897

  9. Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction.

    Science.gov (United States)

    Freitas, Felipe; Estato, Vanessa; Carvalho, Vinícius Frias; Torres, Rafael Carvalho; Lessa, Marcos Adriano; Tibiriçá, Eduardo

    2013-10-01

    The pathophysiology underlying hyperthyroidism-induced left ventricle (LV) dysfunction and hypertrophy directly involves the heart and indirectly involves the neuroendocrine systems. The effects of hyperthyroidism on the microcirculation are still controversial in experimental models. We investigated the effects of hyperthyroidism on the cardiac function and microcirculation of an experimental rat model. Male Wistar rats (170-250 g) were divided into two groups: the euthyroid group (n = 10), which was treated with 0.9% saline solution, and the hyperthyroid group (n = 10), which was treated with l-thyroxine (600 μg/kg/day, i.p.) during 14 days. An echocardiographic study was performed to evaluate the alterations in cardiac function, structure and geometry. The structural capillary density and the expression of angiotensin II AT1 receptor in the LV were analyzed using histochemistry and immunohistochemistry, respectively. Hyperthyroidism was found to induce profound cardiovascular alterations, such as systolic hypertension, tachycardia, LV dysfunction, cardiac hypertrophy, and myocardial fibrosis. This study demonstrates the existence of structural capillary rarefaction and the down-regulation of the cardiac angiotensin II AT1 receptor in the myocardium of hyperthyroid rats in comparison with euthyroid rats. Microvascular rarefaction may be involved in the pathophysiology of hyperthyroidism-induced cardiovascular alterations. © 2013 John Wiley & Sons Ltd.

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

    OpenAIRE

    Soylu, Aliye; Taskale, Mustafa Gurkan; Ciltas, Aydin; Kalayci, Mustafa; Kumbasar, A Baki

    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...

  11. Interventions for preventing and treating hyperthyroidism in pregnancy

    Science.gov (United States)

    Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

    2014-01-01

    Background Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. Objectives To assess the effects of interventions for preventing or treating hyperthyroidism in pregnant women. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (28 July 2010). Selection criteria We intended to include randomised controlled trials comparing antithyroid treatments in pregnant women with hyperthyroidism. Data collection and analysis Two review authors would have assessed trial eligibility and risk of bias, and extracted data. Main results No trials were located. Authors’ conclusions As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid drugs for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil. PMID:20824882

  12. Study on the application of hepatofibrosis index in hyperthyroidism

    International Nuclear Information System (INIS)

    Zhu Chengyi; Fu Hongye; Shi Genming; Wu Jianyuan

    2004-01-01

    To explore the changes of hepatofibrosis index in hyperthyroidism, the index of thyroid function and hepatofibrosis were assayed by RIA in 173 patients with hyperthyroidism and 55 normal persons. The results showed that the levels of PC III, IV·C and HA were significantly higher than that of normal control. Furthermore, these serum levels of hepatofibrosis were concordance with that of TT 3 , TT 4 , FT 3 and FT 4 in hyperthyroidism. The serum levels of PC III, IV·C were positive correlated with that of goiter. The positive rate of PC III and IV·C in hyperthyroidism is conformed with that of the index of thyroid function. The study suggested that PC III and IV·C may be a new supplementary index of the diagnosis and observation of curative effect in hyperthyroidism. (authors)

  13. Hyperthyroidism: a review of the treatment options

    International Nuclear Information System (INIS)

    Chen Danyun; Jing Jin

    2007-01-01

    Hyperthyroidism is commonly treated with anti-thyroid medications, radioactive iodine, or surgery. Three kinds of treatments have their own advantages and disadvantages. Therefore, the treatment of hyperthyroidism is still controversial. With regard to the first choice, strategies vary among different countries. (authors)

  14. Laboratory testing in hyperthyroidism.

    Science.gov (United States)

    Grebe, Stefan K G; Kahaly, George J

    2012-09-01

    The clinical diagnosis of hypo- or hyperthyroidism is difficult (full text available online: http://education.amjmed.com/pp1/272). Clinical symptoms and signs are often non-specific, and there is incomplete correlation between structural and functional thyroid gland changes. Laboratory testing is therefore indispensible in establishing the diagnosis of thyrotoxicosis. Similar considerations apply to treatment monitoring. Laboratory testing also plays a crucial role in establishing the most likely cause for a patient's hyperthyroidism. Finally, during pregnancy, when isotopic scanning is relatively contraindicated and ultrasound is more difficult to interpret, laboratory testing becomes even more important. Copyright © 2012. Published by Elsevier Inc.

  15. 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....

  16. The treatment of hyperthyroidism in adolescents and children with 131I

    International Nuclear Information System (INIS)

    Feng Fei; Zhao Deshan

    2009-01-01

    Hyperthyroidism in adolescents and children is a common endocrinium disorder, which disturbs the development of diverse body systems, especially of skeletal and central nervous systems. The patients with hyperthyroidism have a lower long-term, spontaneous remission of the disease. The majority of adolescents and children patients with hyperthyroidism have to receive an effective, safe therapy. Currently, there are three methods for treating hyperthyroidism. They include in antithyroid drugs (ATD), surgery and radioactive iodine ( 131 I) therapy. ATD always is the first line way to these patients with hyperthyroidism for endocrinologist yet. But the remission rate of hyperthyroidism for ATD is lower, the remission of hyperthyroidism also need spend longer time, and side effects of ATD are more common in adolescents and children than in adult. The success ratio and complications of surgery are mainly depended on the technic of surgeons, 131 I has been used as the treatment of hyperthyroidism for more than six decades. So far, there are still no enough evidences to show that the incidence of thyroid cancer and other malignant diseases, the patients fertility rate, rate of abortion and malformation of descendants in hyperthyroidism patients following 131 I were marked difference with that in other people. The remission rate of hyperthyroidism following 131 I was higher and its side effects were less. 131 I therapy can be the first choice to adolescents and children with hyperthyroidism who are no suitable to ATD therapy. Hypothyroidism is most often one outcome of pediatric patients with hyperthyroidism after 131 I therapy. Hence, the patients with hypothyroidism have to receive the replacement treatment of thyroxine. Since the development of adolescents and children are more dependent on thyroxine and adolescents and children are more sensitive to the radioactive rays than adults, it is more suitable to get ideal control with a relative lower dosage of mi to

  17. 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.

  18. Surgical Intervention for Medically Refractory Hyperthyroidism.

    Science.gov (United States)

    Knollman, Philip D; Giese, Ann; Bhayani, Mihir K

    2016-05-01

    Pediatric hyperthyroidism can be multifactorial, with Graves' disease (GD) being the most common etiology. Treatment focuses on identification of the cause of the hyperthyroidism and achieving a biochemical cure with symptom resolution. This article highlights the clinical presentation, diagnosis, and treatment of a pediatric patient with GD. [Pediatr Ann. 2016;45(5):e171-e175.]. Copyright 2016, SLACK Incorporated.

  19. Rational diagnostic studies of hyperthyroidism - can they be rationalized

    International Nuclear Information System (INIS)

    Schuemichen, C.; Bernhard, G.; Aurnhammer, R.

    1983-01-01

    The value of various diagnostic tests for recognizing hyperthyroidism was assessed in 285 patients. The prevalence of hyperthyroidism was 33% altogether: 21.8% diffuse hyperthyroidism (Graves' disease and disseminated autonomy) and 11.2% autonomous adenoma. A negative TRH-test was found in 29.5% of the euthyroid patients, 11.4% in patients younger and 40.7% in patients older than 50 years. In one patient with thyrotoxicosis the TRH-test was positive in the beginning. In 29% of the patients with diffuse hyperthyroidism and in 50% of the patients with hyperthyroid autonomous adenoma only one hormone level was elevated (T 3 , T 4 or FT 4 ). The radioioine test contributed primarily to the final diagnosis in 1.6% of diffuse hyperthyroidism and in 6.2% of hyperthyroid autonomous adenoma. Because of its high sensitivity the TRH-test remains the basic test in the diagnosis of thyrotoxicosis. The diagnostic value of T 3 and FT 4 is equivalent with slight advantages of FT 4 . In order to lower costs, the total T 4 measurements can, and the radioiodine test has to be, omitted. However, it ought to be kept in mind that if only the TRH test and T 3 and FT 4 are included in the diagnostic study, the final diagnosis is not substantiated adequately in one third of the patients with thyrotoxicosis. (orig.) [de

  20. Clinical and biochemical efficacy of diltiazem in hyperthyroidism

    International Nuclear Information System (INIS)

    Marwat, M.A.

    2008-01-01

    To evaluate the effect of diltiazem on the adrenergic manifestations of hyperthyroidism and thyroid function tests. This prospective, interventional study included 19 newly diagnosed patients (16 females, 3 males with mean age of 35.31+-0.36 years) of hyperthyroidism attending the out patient department of Institute of Radiotherapy and Nuclear Medicine, Peshawar. All patients took diltiazem 30 mg three times a day for 6 weeks. Clinical assessment was done before starting therapy and then serially after 1, 2, 4 and 6 weeks (+-3 days) using Standardized and modified hyperthyroid symptom score. Serum free T/sub 4/ measurements were done before starting diltiazem and then serially after 2, 4 and 6 weeks (+-3 days) of therapy. Following therapy with diltiazem the hyperthyroid systems core decreased significantly at 1, 2, 4 and 6 weeks of therapy. With individual values dropping from 14.42 to 12.89 pmol/L after 1 week (P 0.05). Diltiazem effectively controls the clinical manifestation of hyperthyroidism. It also causes some decline in free thyroxine levels. (author)

  1. Power spectral analysis of heart rate in hyperthyroidism.

    Science.gov (United States)

    Cacciatori, V; Bellavere, F; Pezzarossa, A; Dellera, A; Gemma, M L; Thomaseth, K; Castello, R; Moghetti, P; Muggeo, M

    1996-08-01

    The aim of the present study was to evaluate the impact of hyperthyroidism on the cardiovascular system by separately analyzing the sympathetic and parasympathetic influences on heart rate. Heart rate variability was evaluated by autoregressive power spectral analysis. This method allows a reliable quantification of the low frequency (LF) and high frequency (HF) components of the heart rate power spectral density; these are considered to be under mainly sympathetic and pure parasympathetic control, respectively. In 10 newly diagnosed untreated hyperthyroid patients with Graves' disease, we analyzed power spectral density of heart rate cyclic variations at rest, while lying, and while standing. In addition, heart rate variations during deep breathing, lying and standing, and Valsalva's maneuver were analyzed. The results were compared to those obtained from 10 age-, sex-, and body mass index-matched control subjects. In 8 hyperthyroid patients, the same evaluation was repeated after the induction of stable euthyroidism by methimazole. Heart rate power spectral analysis showed a sharp reduction of HF components in hyperthyroid subjects compared to controls [lying, 13.3 +/- 4.1 vs. 32.0 +/- 5.6 normalized units (NU; P hyperthyroid subjects while both lying (11.3 +/- 4.5 vs. 3.5 +/- 1.1; P hyperthyroid patients than in controls (1.12 +/- 0.03 vs. 1.31 +/- 0.04; P activity and, thus, a relative hypersympathetic tone.

  2. 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.

  3. Coexistence of hyperthyroidism and thyroid cancer

    Directory of Open Access Journals (Sweden)

    Fatih Taşkesen

    2014-06-01

    Full Text Available Objective: Thyroid cancer can be associated with thyrotoxicosis caused by Graves' disease, toxic multinodular goiter, or toxic nodular goiter. The aim of this study was considered to be endemic in our region have received the diagnosis of hyperthyroidism, thyroid cancer is detected thyroidectomy performed and patients were retrospectively evaluate. Methods: We retrospectively studied 69 patients assessed for hyperthyroidism between 2006 and 2012. Clinical hyperthyroidism was diagnosed by elevated tri-iodothyronine/thyroxine (T3/T4 ratios and low thyroid-stimulating hormone (TSH levels, with clinical signs and symptoms. The criteria for surgery were cytological evidence of malignancy, a goiter causing symptoms of tracheal or esophageal compression, side effects of antithyroid drug therapy, or Graves’ disease with multiple relapses after therapy withdrawal or responsiveness to antithyroid drugs. Results: Totally 69 patients were included. In 20 (28.9% patients there was toxic multinodular goiter, in 28 (40.6% Graves’s disease, and in 21 (30.5% patients there was toxic nodular goiter. Of these patients, 12 (17.4% had thyroid cancer. Conclusions: As a result; low likelihood of malignancy in patients with hyperthyroidism, though suspicious lesions detected in the lymph nodes and neck adenopathies be examined in detail.

  4. Pregnancy with hyperthyroidism

    International Nuclear Information System (INIS)

    Shahid, R.

    2003-01-01

    Objective: The purpose of the study was (i) to diagnose the pregnant women suffering from hyperthyroidism by differentiating their symptoms from normal pregnancy and confirming this disease biochemically and (ii) to treat such patients medically to achieve euthyroid state of the mother while monitoring the developing fetus for better obstetrical outcome. Subjects and Methods: A total of 30 patients in reproductive age group, suffering from hyperthyroidism with pregnancy, were studied. Patients were recruited in the study in their first trimester having no associated medical problems. The patients were divided into two groups. Group I patients were diagnosed by hyperthyroidism for the first time during pregnancy by biochemical methods. These patients were treated medically methods. These patients were treated medically. After treatment effects on their previous obstetrical complications, general health and fetal well-being were monitored. The group II patients were already under medical treatment and served as control. Their thyroid status in all trimesters, types of medicine, dose adjustment and maternal and fetal well-being were compared with the patients of group I. The patients of both the groups were treated medically with beta blockers and anti-thyroids drugs mainly carbimazole. For fetal monitoring, ultrasonography (USG) and cardiotocography (CTG) were carried out. Results: The most common type of hyperthyroidism, in patients of both the groups was toxic nodular goiter that affected 70% of the patients. The most common previous obstetrical complication in patients of both the groups was abortion (85.7%), followed by premature labour (7%). Carbimazole was the drug of choice given to 70% and 60% patients of group I and group II respectively. Having achieved euthyroid state, dose reduction was possible in 65% patients of group I and 83% patients of group II. Conclusion: Euthyroid state in mothers, by the time of deliver, can be easily achieved with antithyroid

  5. Beta-adrenergic blockade for the treatment of hyperthyroidism.

    Science.gov (United States)

    Geffner, D L; Hershman, J M

    1992-07-01

    To review the clinical and biochemical effects of beta-adrenergic blocking drugs on hyperthyroidism. Studies published since 1972 were identified through a computerized search of MEDLINE and extensive searching of the bibliographies of the articles identified. Based on an understanding of the differences in beta-blocker metabolism in euthyroid and hyperthyroid patients, we reviewed the differences in pharmacokinetics and metabolic and clinical outcomes during their use in hyperthyroidism, as reported in the articles reviewed. beta Blockers have been used to modify the severity of the hyperadrenergic symptoms of hyperthyroidism for the past 20 years. The clinical efficacy of these agents is affected by hyperthyroid-induced alterations in their gastrointestinal absorption, hepatic metabolism, and renal excretion. The mechanisms whereby these clinical changes are effected is unknown. The agents differ in their beta 1 cardioselectivity, membrane-stabilizing activity, intrinsic sympathomimetic activity, and lipid solubility. They do not appear to alter synthesis or secretion of thyroid hormone by the thyroid gland. Their effects on thyroxine metabolism are contradictory. Decreased thyroxine to triiodothyronine conversion is caused by some, but not all, beta blockers, and this appears to correlate with membrane-stabilizing activity. There does not appear to be any alteration in catecholamine sensitivity during beta-adrenergic blockade. The principal mechanism of action of beta blockers in hyperthyroidism is to antagonize beta-receptor-mediated effects of catecholamines. beta Blockers are effective in treating hypermetabolic symptoms in a variety of hyperthyroid states. Used alone, they offer significant symptomatic relief. They are also useful adjuvants to antithyroid medications, surgery, and radioactive iodide treatment in patients with Graves' disease and toxic nodular goiters.

  6. 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.

  7. 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.

  8. Subclinical Hyperthyroidism: When to Consider Treatment.

    Science.gov (United States)

    Donangelo, Ines; Suh, Se Young

    2017-06-01

    Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular goiter, or transient thyroiditis), by administration of thyroid hormone to treat malignant thyroid disease, or by unintentional excessive replacement therapy. The prevalence of subclinical hyperthyroidism in the general population is about 1% to 2%; however, it may be higher in iodinedeficient areas. The rate of progression to overt hyperthyroidism is higher in persons with thyroid-stimulating hormone levels less than 0.1 mIU per L than in persons with low but detectable thyroid-stimulating hormone levels. Subclinical hyperthyroidism is associated with an increased risk of atrial fibrillation and heart failure in older adults, increased cardiovascular and all-cause mortality, and decreased bone mineral density and increased bone fracture risk in postmenopausal women. However, the effectiveness of treatment in preventing these conditions is unclear. A possible association between subclinical hyperthyroidism and quality-of-life parameters and cognition is controversial. The U.S. Preventive Services Task Force found insufficient evidence to assess the balance of benefits and harms of screening for thyroid dysfunction in asymptomatic persons. The American Thyroid Association and the American Association of Clinical Endocrinologists recommend treating patients with thyroid-stimulating hormone levels less than 0.1 mIU per L if they are older than 65 years or have comorbidities such as heart disease or osteoporosis.

  9. [Hyperthyroidism in older patients].

    Science.gov (United States)

    Brun, R; Jenny, M; Junod, J P

    1978-09-30

    This study comprises 81 thyrotoxic patients with onset after the age of 60. In elderly persons, toxic multinodular goiter is the most common cause (68%) of hyperthyroidism, followed by solitary thyroid nodules (16%) and Graves' disease (16%). Cardiovascular disorders (cardiac failure, arrythmias etc.) constitute the first and often the only symptom in 62% of the cases. The other forms of appearance are both various and deceptive: depression, slight fever, asthenia or nausea. Separate analysis of the three forms of hyperthyroidism did not reveal clinical, biological or therapeutic differences between them, except an inferior rate of captation for the toxic nodules. Isolated measurement of T3 or T4 is often insufficient to confirm the diagnosis because either of these hormones may appear at a normal rate. In three cases only the free thyroxin index was pathological on first determination. The authors have established that the autonomous nodules are larger and more active after, rather than before, 60 years of age, and have attempted to define their morphological identity. The results of the treatment are analyzed and preference is expressed for radioactive iodine in every form of hyperthyroidism.

  10. Is hyperthyroidism underestimated in pregnancy and misdiagnosed as hyperemesis gravidarum?

    Science.gov (United States)

    Luetic, Ana Tikvica; Miskovic, Berivoj

    2010-10-01

    Thyroid changes are considered to be normal events that happen as a large maternal multiorganic adjustment to pregnancy. However, hyperthyroidism occurs in pregnancy with clinical presentation similar to hyperemesis gravidarum (HG) and pregnancy itself. Moreover, 10% of women with HG will continue to have symptoms throughout the pregnancy suggesting that the underlying cause might not be elevation of human chorionic gonadotropin in the first trimester. Variable frequency of both hyperthyroidism and HG worldwide might suggest the puzzlement of inclusion criteria for both diagnoses enhanced by the alternation of thyroid hormone levels assessed in normal pregnancy. Increased number of hyperthyroidism among women population without the expected rise in gestational hyperthyroidism encouraged us for creating the hypotheses that hyperthyroidism could be underestimated in normal pregnancy and even misdiagnosed as HG. This hypothesis, if confirmed, might have beneficial clinical implications, such as better detection of hyperthyroidism in pregnancies, application of therapy when needed with the reduction of maternal or fetal consequences. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. 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....

  12. Cause of impaired carbohydrate metabolism in hyperthyroidism

    International Nuclear Information System (INIS)

    Foeldes, J.; Megyesi, K.; Koranyi, L.

    1984-01-01

    Hyperthyroidism (HT) affects glucose metabolism in various ways. The role of insulin, glucagon and growth-hormone (GH) was determined. After glucose loading the insulin response is weaker in HT than in euthyroid subjects. Enhanced degradation of insulin has been reported. It is suggested that in HT the serum insulin concentration declines at a slightly accelerated rate. In HT the deranged carbohydrate metabolism might be a consequence of altered tissue sensitivity to insulin. To elucidate this problem insulin receptors on erythrocytes obtained from hyperthyroid women were investigated. The maximal specific binding of 125 I-insulin to RBC of hyperthyroid patients was decreased and the analysis refers to a decreased receptor concentration in RBC. The nature of glucagon secretion and its influence on glucose metabolism in HT was investigated. The basal plasma glucagon is elevated in hyperthyroid patients. The suppression of glucagon secretion induced by an oral glucose loading was of significantly lesser degree in hyperthyroid patients than in controls. Applying the erythrocyte receptor assay a decreased specific binding of 125 I-glucagon to RBC of hyperthyroid patients has been found and data indicate a significantly less glucagon receptor concentration in thyrotoxicosis. Physiological elevations of serum GH levels led to a significant impairment of glucose metabolism. Beside the GH-RH and somatostatin, the dopaminergic neurotransmitter system participates in the regulation of GH secretion too. It has been demonstrated that after administration of the dopamine agonist l-dopa the GH response was weaker in HT than in controls. This indicates that in thyrotoxicosis the GH secretion can not be stimulated in such a degree as in euthyroidism. (author)

  13. Cause of impaired carbohydrate metabolism in hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Foeldes, J.; Megyesi, K.; Koranyi, L. (Semmelweis Orvostudomanyi Egyetem, Budapest (Hungary))

    1984-01-01

    Hyperthyroidism (HT) affects glucose metabolism in various ways. The role of insulin, glucagon and growth-hormone (GH) was determined. After glucose loading the insulin response is weaker in HT than in euthyroid subjects. Enhanced degradation of insulin has been reported. It is suggested that in HT the serum insulin concentration declines at a slightly accelerated rate. In HT the deranged carbohydrate metabolism might be a consequence of altered tissue sensitivity to insulin. To elucidate this problem insulin receptors on erythrocytes obtained from hyperthyroid women were investigated. The maximal specific binding of /sup 125/I-insulin to RBC of hyperthyroid patients was decreased and the analysis refers to a decreased receptor concentration in RBC. The nature of glucagon secretion and its influence on glucose metabolism in HT was investigated. The basal plasma glucagon is elevated in hyperthyroid patients. The suppression of glucagon secretion induced by an oral glucose loading was of significantly lesser degree in hyperthyroid patients than in controls. Applying the erythrocyte receptor assay a decreased specific binding of /sup 125/I-glucagon to RBC of hyperthyroid patients has been found and data indicate a significantly less glucagon receptor concentration in thyrotoxicosis. Physiological elevations of serum GH levels led to a significant impairment of glucose metabolism. Beside the GH-RH and somatostatin, the dopaminergic neurotransmitter system participates in the regulation of GH secretion too. It has been demonstrated that after administration of the dopamine agonist l-dopa the GH response was weaker in HT than in controls. This indicates that in thyrotoxicosis the GH secretion can not be stimulated in such a degree as in euthyroidism.

  14. The development and current status of 131I treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Wang Chunmei; Wang Xuemei

    2010-01-01

    Hyperthyroidism is an autoimmune diseasein which excessive amounts of thyroid hormones circulate in the blood. The treatments for hyperthyroidism mainly include antithyroid drugs, 131 I treatment, and surgery. 131 I had been verified as an effective, safe, simple method to treat adult and children hyperthyroidism. Current research trends of 131 I treatment mainly are problems of 131 I treatment of hyperthyroidism and its long-term security. (authors)

  15. Antithyroid antibodies in hyperthyroidism - personal experience

    International Nuclear Information System (INIS)

    Dedoussis, H.

    2003-01-01

    Thyroid diseases of autoimmune type may be expressed by symptoms and signs of either hyperthyroidism or euthyroidism or even hypothyroidism. Common factor in these diseases is the presence in the serum of these patients of antithyroid or anti-TSN autoantibodies in various percentages. Since there is not always a positive correlation between the levels of these antibodies and the severity of thyroid disease we have studied in cases of Graves disease (GD), Multinodular toxic goiter (MTG) and Toxic adenoma (TA), the anti-microsomal antibody (antithyroid peroxidase-ATPO-Ab), the antithyroglobulin antibody (Tg-Ab) and the anti-TSH receptor antibody (TSH-Ab) in 260 patients with the three above forms of hyperthyroidism. In Group A, GD, 23 men and 44 women, in Group B MTG, 24 men and 71 women in Group C TA, 8 men and 25 women and in Group C patients with clinical hyperthyroidism without detectable goiter, 19 men and 46 women. thyroid status was assessed clinically by the so called thyroid index of hyperthyroidism, modified by the authors and by the laboratory tests of free thyroxine (FT4), free triiodothyronine (FT3), TSH and the I-131 uptake by the thyroid gland. Results showed that TPO-Ab were in the 4 Groups:75%, 36%,6%, and 66%. The Tg-Ab were:48%, 25%, 0% and 28%. The TSH-Ab were: 49%, 27%, 12% and 23% respectively. Results show that: a) the percentage of TPO-Ab an GD is high and is related to the duration and or the size of the goiter, since in Group D there was a lower percentage of positive TPO-Ab. b) TSH-Ab and Tg-Ab are of minor importance in differentiating different types of hyperthyroidism and may as well be omitted. c) in patients with GD the high levels of TPO-Ab are not synchronous but are related to the severity and/or the relapse of the disease. d) Tg-Ab although not expected are sometimes increased in hypothyroidism as well as in normal people. e) in order to realize the importance of TSH-Ab we should be able to test the number and the sensitivity of

  16. Effect of experimental hyperthyroidism on protein turnover in skeletal and cardiac muscle.

    Science.gov (United States)

    Carter, W J; Van Der Weijden Benjamin, W S; Faas, F H

    1980-10-01

    Since experimental hyperthyroidism reduces skeletal muscle mass while simultaneously increasing cardiac muscle mass, the effect of hyperthyroidism on muscle protein degradation was compared in skeletal and cardiac muscle. Pulse-labeling studies using (3H) leucine and (14C) carboxyl labeled aspartate and glutamate were carried out. Hyperthyroidism caused a 25%-29% increase in protein breakdown in both sarcoplasmic and myofibrillar fractions of skeletal muscle. Increased muscle protein degradation may be a major factor in the development of skeletal muscle wasting and weakness in hyperthyroidism. In contrast, protein breakdown appeared to be reduced 22% in the sarcoplasmic fraction of hyperthyroid heart muscle and was unchanged in the myofibrillar fraction. Possible reasons for the contrasting effects of hyperthyroidism on skeletal and cardiac muscle include increased sensitivity of the hyperthyroid heart to catecholamines, increased cardiac work caused by the hemodynamic effects of hyperthyroidism, and a different direct effect of thyroid hormone at the nuclear level in cardiac as opposed to skeletal muscle.

  17. Unstable angina with normal coronary angiography in hyperthyroidism: a case report.

    Science.gov (United States)

    Lin, Tsung-Hsien; Su, Ho-Ming; Voon, Wen-Chol; Lai, Wen-Ter; Sheu, Sheng-Hsiung

    2005-01-01

    Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58-year-old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laboratory data showed that the patient suffered from hyperthyroidism, for which he was successfully treated with anti-thyroid agents. We are reminded that typical chest pain might be the first symptom of hyperthyroidism.

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

    Science.gov (United States)

    Chung, Shiu-Dong; Liu, Shih-Ping; Lin, Ching-Chun; Li, Hsien-Chang; Lin, Herng-Ching

    2013-01-01

    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. 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. 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%, phyperthyroidism 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. 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.

  19. Subclinical hyperthyroidism: clinical features and treatment options.

    Science.gov (United States)

    Biondi, Bernadette; Palmieri, Emiliano Antonio; Klain, Michele; Schlumberger, Martin; Filetti, Sebastiano; Lombardi, Gaetano

    2005-01-01

    Subclinical hyperthyroidism appears to be a common disorder. It may be caused by exogenous or endogenous factors: excessive TSH suppressive therapy with L-thyroxine (L-T4) for benign thyroid nodular disease, differentiated thyroid cancer, or hormone over-replacement in patients with hypothyroidism are the most frequent causes. Consistent evidence indicates that 'subclinical' hyperthyroidism reduces the quality of life, affecting both the psycho and somatic components of well-being, and produces relevant signs and symptoms of excessive thyroid hormone action, often mimicking adrenergic overactivity. Subclinical hyperthyroidism exerts many significant effects on the cardiovascular system; it is usually associated with a higher heart rate and a higher risk of supraventricular arrhythmias, and with an increased left ventricular mass, often accompanied by an impaired diastolic function and sometimes by a reduced systolic performance on effort and decreased exercise tolerance. It is well known that these abnormalities usually precede the onset of a more severe cardiovascular disease, thus potentially contributing to the increased cardiovascular morbidity and mortality observed in these patients. In addition, it is becoming increasingly apparent that subclinical hyperthyroidism may accelerate the development of osteoporosis and hence increased bone vulnerability to trauma, particularly in postmenopausal women with a pre-existing predisposition. Subclinical hyperthyroidism and its related clinical manifestations are reversible and may be prevented by timely treatment.

  20. Outcome of hyperthyroidism treated by radioactive iodine

    International Nuclear Information System (INIS)

    Al-Shaikh, A.A.

    2009-01-01

    To study the outcome of Radioactive Iodine (RAI) in treatment of hyperthyroidism. It is a retrospective study of all patients of hyperthyroidism treated by Radioactive Iodine (RAI) seen in endocrinology clinic at King Abdulaziz University Hospital and Dr. Soliman Fageeh Hospital in Jeddah, Saudia Arabia. Two hundred and sixteen (216) patients were treated by RAI. They proved to have hyperthyroidism by thyroid function test (TSH, FT4 and T3) and isotopes scanning of the thyroid gland. All received 10 mci of RAI and were then followed up after one month and every two months thereafter for at least one year. The efficacy of the therapy was assessed by the improvement of the clinical features and by the thyroid function tests. A total of 216 patients were seen, the mean age was 36.5+- 10.64 years. One hundred fifty three were female and sixty three were male. Graves disease was the underlying cause in 163 patients [65.55%], toxic multi nodular goiter in 37 patients [25.1%] and toxic adenoma in 16 patients [9.3%]. The symptoms improved after one month only in 11 patients but others required antithyroid treatment for two months. Only 17 patients remained hyperthyroid after six months of treatment. Radioactive iodine is very effective in treatment of hyperthyroidism with minor side effects such as weight gain, fatigability and hypothyroidism. (author)

  1. Interventions for hyperthyroidism pre-pregnancy and during pregnancy.

    Science.gov (United States)

    Earl, Rachel; Crowther, Caroline A; Middleton, Philippa

    2013-11-19

    Women with hyperthyroidism in pregnancy have increased risks of miscarriage, stillbirth, preterm birth, and intrauterine growth restriction; and they can develop severe pre-eclampsia or placental abruption. To identify interventions used in the management of hyperthyroidism pre-pregnancy or during pregnancy and to ascertain the impact of these interventions on important maternal, fetal, neonatal and childhood outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013). We planned to include randomised controlled trials, quasi-randomised controlled trials, and cluster-randomised trials comparing antithyroid interventions for hyperthyroidism pre-pregnancy or during pregnancy with another intervention or no intervention (placebo or no treatment). Two review authors assessed trial eligibility and planned to assess trial quality and extract the data independently. No trials were included in the review. As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid interventions for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs used have potential for harm, one for the mother and the other for the child. More observational research is required about the potential harms of methimazole in early pregnancy and about the potential liver damage from propylthiouracil.

  2. Hyperthyroidism and risk for bipolar disorders: a nationwide population-based study.

    Science.gov (United States)

    Hu, Li-Yu; Shen, Cheng-Che; Hu, Yu-Wen; Chen, Mu-Hong; Tsai, Chia-Fen; Chiang, Huey-Ling; Yeh, Chiu-Mei; Wang, Wei-Shu; Chen, Pan-Ming; Hu, Tsung-Ming; Chen, Tzeng-Ji; Su, Tung-Ping; Liu, Chia-Jen

    2013-01-01

    Thyroid disorders have long been associated with psychiatric illness, often with symptoms suggestive of mood disorders. The most common clinical features associated with hyperthyroidism are anxiety and depression. The risk of bipolar disorders, especially bipolar mania, among patients with thyroid disorders has not been well characterized. We explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders, and examined the risk factors for bipolar disorders in patients with hyperthyroidism. We identified patients who were diagnosed with hyperthyroidism between 2000 and 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort without hyperthyroidism was matched based on age, sex, and comorbidities. The occurrence of bipolar disorders was evaluated in both cohorts based on diagnosis and the use of mood stabilizer drugs. The hyperthyroidism cohort consisted of 21, 574 patients, and the comparison cohort consisted of 21, 574 matched control patients without hyperthyroidism. The incidence of bipolar disorders (incidence rate ratio [IRR], 2.31, 95% CI 1.80-2.99, Phyperthyroidism patients than the control patients. Multivariate, matched regression models showed that women (HR 2.02, 95% CI 1.34-3.05, P = .001), patients with alcohol use disorders (HR 3.03, 95% CI 1.58-5.79, P = .001), and those with asthma (HR 1.70, 95% CI 1.18-2.43, P = .004) were independent risk factors for the development of bipolar disorders in hyperthyroidism patients. Although a possibility that the diagnosis of bipolar disorders in this study actually includes "bipolar disorders due to hyperthyroidism" cannot be excluded, this study suggests that hyperthyroidism may increase the risk of developing bipolar disorders.

  3. Hyperthyroidism and Risk for Bipolar Disorders: A Nationwide Population-Based Study

    Science.gov (United States)

    Hu, Yu-Wen; Chen, Mu-Hong; Tsai, Chia-Fen; Chiang, Huey-Ling; Yeh, Chiu-Mei; Wang, Wei-Shu; Chen, Pan-Ming; Hu, Tsung-Ming; Chen, Tzeng-Ji; Su, Tung-Ping; Liu, Chia-Jen

    2013-01-01

    Background Thyroid disorders have long been associated with psychiatric illness, often with symptoms suggestive of mood disorders. The most common clinical features associated with hyperthyroidism are anxiety and depression. The risk of bipolar disorders, especially bipolar mania, among patients with thyroid disorders has not been well characterized. Objective We explored the relationship of hyperthyroidism and the subsequent development of bipolar disorders, and examined the risk factors for bipolar disorders in patients with hyperthyroidism. Methods We identified patients who were diagnosed with hyperthyroidism between 2000 and 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort without hyperthyroidism was matched based on age, sex, and comorbidities. The occurrence of bipolar disorders was evaluated in both cohorts based on diagnosis and the use of mood stabilizer drugs. Results The hyperthyroidism cohort consisted of 21, 574 patients, and the comparison cohort consisted of 21, 574 matched control patients without hyperthyroidism. The incidence of bipolar disorders (incidence rate ratio [IRR], 2.31, 95% CI 1.80–2.99, Phyperthyroidism patients than the control patients. Multivariate, matched regression models showed that women (HR 2.02, 95% CI 1.34–3.05, P = .001), patients with alcohol use disorders (HR 3.03, 95% CI 1.58–5.79, P = .001), and those with asthma (HR 1.70, 95% CI 1.18–2.43, P = .004) were independent risk factors for the development of bipolar disorders in hyperthyroidism patients. Conclusions Although a possibility that the diagnosis of bipolar disorders in this study actually includes "bipolar disorders due to hyperthyroidism" cannot be excluded, this study suggests that hyperthyroidism may increase the risk of developing bipolar disorders. PMID:24023669

  4. Analiza poziomu zgodności ocen dwóch terapeutów manualnych (MT w diagnozie skręcenia miednicy na podstawie wybranych testów manualnych.

    Directory of Open Access Journals (Sweden)

    Michał Cichosz

    2015-06-01

      Streszczenie Wstęp Skręcenie (torsja miednicy jest w fizjoterapii oraz medycynie manualnej często stawianym rozpoznaniem opartym głównie na podstawie badania fizykalnego oraz danych z wywiadu pacjenta. Coraz częściej łączy się je i opisuje wspólnie z dysfunkcją stawów krzyżowo- biodrowych (SIJD, której nie towarzyszy ból, jedynie zmiany w przestrzennym funkcjonowaniu kompleksu miedniczego. Cel pracy: Celem niniejszej pracy jest ocena poziomu zgodności ocen dwóch terapeutów manualnych (MT dla wybranych testów diagnostycznych stawów krzyżowo- biodrowych. Materiał badawczy: Badania przeprowadzono na 180 osobowej grupie studentów w wieku między 20 a 30 lat. Wyniki: Największą zgodność szacunków, określaną jako znaczną odnotowano jedynie w przypadku testu ASLR, przy wartości k= 0,62. Pozostałe testy charakteryzowały się niższymi wartościami zgodności. Wnioski: Większość analizowanych testów charakteryzuje się umiarkowana oraz niższą wartością zgodności wyników. Na poziom zgodności ocen ma wpływ typu budowy ciała badanego.   Summary Introduction: The twist (torsion of the pelvis is in physiotherapy and manual medicine based diagnosis is often posed mainly based on physical examination, and data the patient's history. More often they combine them and describes, together with dysfunction of the sacroiliac joints (SIJD, which is not accompanied by pain, only changes in the spatial functioning of pelvic complex. Aim: The  purpose  of  this  study  is  to  assess  the level  of  compliance  reviews  two manual  therapists (MT for  selected  diagnostic  tests  the  sacroiliac  joints. Research material: The research was conducted on 180 members of a group of students aged between 20 and 30 years. Results: The biggest compliance estimates, defined as significant was noted only in the ASLR test, with values of k = 0,62. Other tests were characterized by lower values of conformity. Conclusions: Most of

  5. Graves disease hyperthyroidism and glycometabolism

    International Nuclear Information System (INIS)

    Sun Qiting; Zhao Deshan

    2010-01-01

    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 131 I 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. (authors)

  6. Hyperthyroidism in adults: variable clinical presentations and approaches to diagnosis.

    Science.gov (United States)

    Knudson, P B

    1995-01-01

    Hyperthyroidism is a disease that has various symptoms and can present in many ways. In the elderly patient hyperthyroidism often is not expressed in the classical manner. A case report of a middle-aged man who had hyperthyroidism with only one symptom is detailed. A literature review utilizing MEDLINE files from 1988 to the present, as well as current textbooks of medicine and endocrinology, was used to prepare this report. Keywords for the search were "hyperthyroidism," "symptoms," "unintentional weight loss," and "differential diagnosis." The clinical presentation of hyperthyroidism can vary from almost asymptomatic to apathetic in appearance to a marked hyperdynamic physiologic response. Family physicians must be well informed of this variation in disease expression. Overlooking the diagnosis of this relatively easily treated condition can be detrimental to patient care and expensive.

  7. Clinical analysis of 503 cases of hyperthyroidism related hepatic damage

    International Nuclear Information System (INIS)

    Zhang Xiaoxia

    2004-01-01

    The clinical characteristics and the therapeutic method of 503 hyperthyroidism related hepatic damage in the paper was discussed. The incidence of the disease of hyperthyroidism related hepatic damage was 39.7%, the rate increases with the increase in age of the patients and the increase of the course of hyperthy-roidism (P 3 and FT 4 . The state of the illness may be get better with the treatment, and ALT and AST were all resumed; The hyperthyroidism was easy to lead to hepatic damage. Treatment was given priority to controlling of hyperthyroidism and put the protection of liver to the second place: the degree of hepatic damage was closely related to age, the course of disease and the state of illness. A timely diagnoses and proper therapy may be lead to desirable result. (author)

  8. Unstable Angina with Normal Coronary Angiography in Hyperthyroidism: A Case Report

    Directory of Open Access Journals (Sweden)

    Tsung-Hsien Lin

    2005-01-01

    Full Text Available Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58-year-old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laboratory data showed that the patient suffered from hyperthyroidism, for which he was successfully treated with anti-thyroid agents. We are reminded that typical chest pain might be the first symptom of hyperthyroidism.

  9. Contact system activation and high thrombin generation in hyperthyroidism.

    Science.gov (United States)

    Kim, Namhee; Gu, Ja-Yoon; Yoo, Hyun Ju; Han, Se Eun; Kim, Young Il; Nam-Goong, Il Sung; Kim, Eun Sook; Kim, Hyun Kyung

    2017-05-01

    Hyperthyroidism is associated with increased thrombotic risk. As contact system activation through formation of neutrophil extracellular traps (NET) has emerged as an important trigger of thrombosis, we hypothesized that the contact system is activated along with active NET formation in hyperthyroidism and that their markers correlate with disease severity. In 61 patients with hyperthyroidism and 40 normal controls, the levels of coagulation factors (fibrinogen, and factor VII, VIII, IX, XI and XII), D-dimer, thrombin generation assay (TGA) markers, NET formation markers (histone-DNA complex, double-stranded DNA and neutrophil elastase) and contact system markers (activated factor XII (XIIa), high-molecular-weight kininogen (HMWK), prekallikrein and bradykinin) were measured. Patients with hyperthyroidism showed higher levels of fibrinogen (median (interquartile range), 315 (280-344) vs 262 (223-300), P  = 0.001), D-dimer (103.8 (64.8-151.5) vs 50.7 (37.4-76.0), P  hyperthyroidism's contribution to coagulation and contact system activation. Free T4 was significantly correlated with factors VIII and IX, D-dimer, double-stranded DNA and bradykinin. This study demonstrated that contact system activation and abundant NET formation occurred in the high thrombin generation state in hyperthyroidism and were correlated with free T4 level. © 2017 European Society of Endocrinology.

  10. Luteal activity of pregnant rats with hypo-and hyperthyroidism.

    Science.gov (United States)

    Silva, Juneo Freitas; Ocarino, Natália Melo; Serakides, Rogéria

    2014-07-12

    Luteal activity is dependent on the interaction of various growth factors, cytokines and hormones, including the thyroid hormones, being that hypo- and hyperthyroidism alter the gestational period and are also a cause of miscarriage and stillbirth. Because of that, we evaluated the proliferation, apoptosis and expression of angiogenic factors and COX-2 in the corpus luteum of hypo- and hyperthyroid pregnant rats. Seventy-two adult female rats were equally distributed into three groups: hypothyroid, hyperthyroid and control. Hypo- and hyperthyroidism were induced by the daily administration of propylthiouracil and L-thyroxine, respectively. The administration began five days before becoming pregnant and the animals were sacrificed at days 10, 14, and 19 of gestation. We performed an immunohistochemical analysis to evaluate the expression of CDC-47, VEGF, Flk-1 (VEGF receptor) and COX-2. Apoptosis was evaluated by the TUNEL assay. We assessed the gene expression of VEGF, Flk-1, caspase 3, COX-2 and PGF2α receptor using real time RT-PCR. The data were analyzed by SNK test. Hypothyroidism reduced COX-2 expression on day 10 and 19 (P Hyperthyroidism increased the expression of COX-2 on day 19 (P hyperthyroid animals, being this effect dependent of the gestational period.

  11. Hyperthyroidism in patients with thyroid cancer.

    Science.gov (United States)

    Sharma, Sunil Dutt; Kumar, Gaurav; Guner, Karen; Kaddour, Hesham

    2016-06-01

    We present a retrospective case series of patients with hyperthyroidism and thyroid cancer. Our goal was to look at their clinical characteristics and outcomes to determine which patients would require further investigation. We reviewed the case notes of all patients with a histopathologic diagnosis of thyroid cancer and biochemical evidence of hyperthyroidism who had been treated at a thyroid cancer center from January 2006 through October 2013. During that time, 66 patients had been diagnosed with thyroid cancer. Of these, 8 patients (12%)-all women, aged 29 to 87 years (mean: 55.6; median: 50.5)-had biochemical evidence of hyperthyroidism. Among these 8 patients, 4 had an autonomously functioning toxic nodule (AFTN), 3 were diagnosed with Graves disease, and 1 had a toxic multinodular goiter. Five patients had suspicious features on preoperative ultrasonography. All 8 patients were diagnosed with the papillary type of thyroid carcinoma. The mean size of the tumor in the 4 patients with AFTN was significantly larger than it was in those with Graves disease (42.3 ± 23.8 mm vs. 3.8 ± 1.6; p = 0.04). The 3 patients with Graves disease all had incidentally found papillary microcarcinoma. Between these two groups, the patients with AFTN had a poorer prognosis; 2 of them had extracapsular invasion and lymph node metastasis, and another died of her disease. We found that the incidence of hyperthyroidism in thyroid cancer patients was relatively high (12%). In contrast to what has previously been reported in the literature, patients with AFTN seem to have more aggressive disease and poorer outcomes than do patients with Graves disease. Any suspicious nodule associated with hyperthyroidism should be evaluated carefully.

  12. Dietary-induced hyperthyroidism marginally affects neonatal testicular development

    NARCIS (Netherlands)

    Rijntjes, Eddy; Wientjes, Anna T.; Swarts, Hans J. M.; de Rooij, Dirk G.; Teerds, Katja 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

  13. Both hypothyroidism and hyperthyroidism increase plasma irisin levels in rats.

    Science.gov (United States)

    Atici, Emine; Mogulkoc, Rasim; Baltaci, Abdulkerim Kasim; Menevse, Esma

    2017-11-28

    Background A recently discovered hormone, irisin is accepted to be significantly involved in the regulation of body weight. Thyroid functions may be, directly or indirectly, associated with irisin. Aim The aim of the present study is to determine the effect of experimental thyroid dysfunction on irisin levels in rats. Methods The study registered 40 adult male Sprague-Dawley rats, which were allocated to groups as follows: 1. Control; 2. Hypothyroidism induced by injection of 10 mg/kg/day intraperitoneal propylthiouracil (PTU) for 3 weeks; 3. Hypothyroidism (PTU 2 weeks) + L-thyroxin (1.5 mg/kg/day for 1 week); 4. Hyperthyroidism induced in rats by 3-week thyroxin (0.3 mg/kg/day); 5. Hyperthyroidism + PTU. At the end of the study, blood samples were collected to quantify free triiodothyronine (FT3), free triiodothyronine (FT4) and irisin levels. Results FT3 and FT4 levels were reduced in hypothyroidism and were significantly elevated in hyperthyroidism (p hyperthyroidism groups (p hyperthyroidism, and that when hypothyroidism is corrected by thyroxin administration and hyperthyroidism by PTU injection, plasma irisin values go back to normal.

  14. Symptom rating scale for assessing hyperthyroidism.

    Science.gov (United States)

    Klein, I; Trzepacz, P T; Roberts, M; Levey, G S

    1988-02-01

    A hyperthyroid symptom scale (HSS) was designed and administered to ten subjects with untreated Graves' disease. All subjects had clinical and chemical evidence of hyperthyroidism and reproducible HSS scores of 20 or more points. During sequential treatments with propranolol hydrochloride (phase 2) followed by propylthiouracil (phase 3) there was a significant decline in the HSS scores at each phase. Accompanying the decrease in HSS scores was a decrease in heart rate, but there was no change in thyroid function test results at phase 2 and a decrease in heart rate, thyroid function test results, and goiter size at phase 3. This new scale includes ten categories of symptoms, it is sensitive to changes in both the adrenergic and metabolic components of hyperthyroidism, and it is useful in the clinical assessment and management of patients with thyrotoxicosis.

  15. Effects of feline hyperthyroidism on kidney function: a review.

    Science.gov (United States)

    Vaske, Heather H; Schermerhorn, Thomas; Grauer, Gregory F

    2016-02-01

    Chronic kidney disease and hyperthyroidism are two commonly diagnosed conditions in the geriatric feline population, and are often seen concurrently. Management of both diseases is recommended; however, the physiologic implications of both diseases must be understood to ensure the most favorable outcome for each patient. This report reviews the complex interplay between hyperthyroidism and kidney function, as well as the effects of hyperthyroid therapy on kidney function. © ISFM and AAFP 2015.

  16. Hyperthyroidism and Graves? disease: Is an ultrasound examination needed?

    OpenAIRE

    Varadhan, Lakshminarayanan; Varughese, George Iype; Sankaranarayanan, Sailesh

    2016-01-01

    Aim: The aim of our study was to assess the limitation of clinical examination in determining the morphology of thyroid gland in patients with hyperthyroidism and its implications. Methods: A retrospective analysis of consecutive patients with hyperthyroidism seen in a tertiary endocrine clinic were analyzed. Sub-analysis was performed on patients with proven Graves' disease. Results: Of the 133 patients included in this study with hyperthyroidism, 60 (45%) patients had significant nodularity...

  17. Bladder Pain Syndrome/Interstitial Cystitis Is Associated with Hyperthyroidism

    Science.gov (United States)

    Liu, Shih-Ping; Lin, Ching-Chun; Lin, Herng-Ching

    2013-01-01

    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%, phyperthyroidism 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. PMID:23991081

  18. 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

  19. Hyperthyroidism and female urinary incontinence: a population-based cohort study.

    Science.gov (United States)

    Chung, Shiu-Dong; Chen, Yi-Kuang; Chen, Yi-Hua; Lin, Herng-Ching

    2011-11-01

    The imbalanced autonomic nervous system present in hyperthyroidism may cause lower urinary tract symptoms. Urinary incontinence (UI) is the most bothersome lower urinary tract symptom; however, in the literature, reports regarding urinary dysfunction and/or incontinence among hyperthyroid patients are scarce. This population-based cohort study aimed to examine the relationship between hyperthyroidism in women and the risk of developing UI in Taiwan. This study used data from the Longitudinal Health Insurance Database. For this study, 10,817 female patients diagnosed with hyperthyroidism from 2001 to 2005 were recruited together with a comparison cohort of 54,085 matched enrollees who did not have a history of hyperthyroidism. All patients were tracked for a 3-year period from their index date to identify those who had a subsequent UI. The stratified Cox proportional hazards models were used to compute the risk of UI between study and comparison cohorts. During the follow-up period, of 64,169 patients, 173 (1·60%) from the hyperthyroidism group and 560 (1·04%) from the comparison group, had a diagnosis of UI. The regression analysis showed that, after adjusting for monthly income, geographic region, urbanization level of the community in which the patient resided, obesity and hysterectomy, patients with hyperthyroidism were more likely to have UI during the 3-year follow-up period than the comparison patients (hazard ratio = 1·54; 95% CI = 1·30-1·83; P hyperthyroidism at the 3-year follow-up. © 2011 Blackwell Publishing Ltd.

  20. Metabolic clearance and blood production rates of estradiol in hyperthyroidism.

    Science.gov (United States)

    Ridgway, E C; Longcope, C; Maloof, F

    1975-09-01

    The metabolic clearance rate of 17beta-estradiol (MCR2), the plasma levels of 17beta-estradiol (E2)1, sex-steroid binding globulin (SSBG), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured in 10 hyperthyroid subjects (7 men and 3 women). The blood production rate of 17beta-estradiol (PB2) was calculated for all subjects. Nine of the 10 hyperthyroid subjects had a decreased MCR2 which returned towards normal in 5 of the 6 subjects restudied following therapy. In all 10 subjects the levels of SSBG were increased when they were hyperthyroid and returned toward normal with therapy. It is concluded that the decrease in MCR2 is largely due to the increased binding of 17beta-estradiol to SSBG. In 7 of the 10 hyperthyroid the plasma E2 concentrations were normal whereas 3 had slightly elevated levels. In 8 of the 10 hyperthyroid the PB2 was within the normal range. Only 2 hyperthyroid subjects had slightly elevated PB2. In the 6 subjects who were restudied after therapy, there was no consistent change in PB2 which remained in the normal range in all cases. It is concluded that the MCR2 is decreased in most subjects with hyperthyroidism in association with an increase of SSBG. Despite this change in MCR2 there is no significant change in PB2. The increase in SSBG levels in hyperthyroidism appears to be a direct effect of the elevation of thyroid hormone activity and is not mediated through estrogen.

  1. Iatrogenic hyperthyroidism secondary to dextrothyroxine administration

    Energy Technology Data Exchange (ETDEWEB)

    Hankins, J.H.; Heise, C.M.; Cowan, R.J.

    1984-01-01

    Two patients are reported who presented with clinical hyperthyroidism, increased serum thyroid function studies, and depressed radioactive iodine uptake, secondary to chronic ingestion of D-T4. Symptoms abated, and function studies returned to normal, following discontinuation of D-T4. This uncommon effect of D-T4 may be more prevalent than is generally realized and must be recognized as another potential cause of low radioiodine uptake in patients with clinical hyperthyroidism.

  2. Iatrogenic hyperthyroidism secondary to dextrothyroxine administration

    International Nuclear Information System (INIS)

    Hankins, J.H.; Heise, C.M.; Cowan, R.J.

    1984-01-01

    Two patients are reported who presented with clinical hyperthyroidism, increased serum thyroid function studies, and depressed radioactive iodine uptake, secondary to chronic ingestion of D-T4. Symptoms abated, and function studies returned to normal, following discontinuation of D-T4. This uncommon effect of D-T4 may be more prevalent than is generally realized and must be recognized as another potential cause of low radioiodine uptake in patients with clinical hyperthyroidism

  3. Effect of hyperthyroidism on clearance and secretion of glucagon in man.

    Science.gov (United States)

    Dimitriadis, G; Hatziagelaki, E; Mitrou, P; Lambadiari, V; Maratou, E; Raptis, A E; Gerich, J E; Raptis, S A

    2011-04-01

    Glucagon has been proposed to contribute to the increased glucose production found in hyperthyroidism. However, fasting plasma glucagon levels are not increased in hyperthyroidism suggesting that the activity of the α-cell is normal. Nevertheless, an increase in the clearance rate of glucagon may mask increased glucagon secretion. This study was designed to examine the effects of hyperthyroidism on the kinetics of glucagon. A primed-continuous infusion of glucagon was administered to 9 euthyroid and 9 hyperthyroid subjects at 3 sequential rates (1,200, 3,000 and 6,000 pg/kg/min, each given for 2 h). Arterialized blood was drawn at 15-30 min intervals for determination of glucagon. Fasting plasma glucagon levels were comparable in euthyroids (195±8 pg/ml) and hyperthyroids (231±16 pg/ml). During infusions (1,200, 3,000 and 6,000 pg/kg/min), plasma glucagon increased to 387±19, 624±44 and 977±51 pg/ml in euthyroids and to 348±23, 597±42 and 938±56 pg/ml in hyperthyroids respectively. At these infusion rates, metabolic clearance of glucagon (ml/kg/min) was 6.6±0.5, 7.4±0.6 and 7.9±0.5 in euthyroids and 12.6±2, 8.9±1 and 8.8±0.6 in hyperthyroids, respectively. Metabolic clearance of glucagon differed between hyperthyroids and euthyroids at 1 200 pg/kg/min infusion rate (p=0.001). The basal delivery rate of glucagon (ng/kg/min) was 1.3±0.1 in euthyroids and 2.9±0.6 in hyperthyroids (p=0.0005). In hyperthyroidism, the secretion and metabolic clearance rates of glucagon are increased. These effects may explain the changes in plasma glucagon levels observed in hyperthyroidism and support the important role of glucagon in increasing endogenous glucose production in this condition. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  4. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study.

    Science.gov (United States)

    Brandt, Frans; Thvilum, Marianne; Almind, Dorthe; Christensen, Kaare; Green, Anders; Hegedüs, Laszlo; Brix, Thomas Heiberg

    2014-02-01

    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. In this study, we aimed to investigate the association and temporal relationship between hyperthyroidism and psychiatric morbidity. Register-based nationwide cohort study. Data on hyperthyroidism and psychiatric morbidity were obtained by record linkage of the Danish National Patient Registry and the Danish National Prescription Registry. A total of 2631 hyperthyroid individuals were identified and matched 1:4 with non-hyperthyroid controls and followed for a mean duration of 6 years (range 0-13). Logistic and Cox regression models were used to assess the risk of psychiatric morbidity before and after the diagnosis of hyperthyroidism respectively. BEFORE THE DIAGNOSIS OF HYPERTHYROIDISM, SUCH INDIVIDUALS HAD AN INCREASED RISK OF BEING HOSPITALIZED WITH PSYCHIATRIC DIAGNOSES (ODDS RATIO (OR): 1.33; 95% CI: 0.98-1.80) and an increased risk of being treated with antipsychotics (OR: 1.17; 95% CI: 1.00-1.38), antidepressants (OR: 1.13; 95% CI: 1.01-1.27), or anxiolytics (OR: 1.28; 95% CI: 1.16-1.42). After the diagnosis of hyperthyroidism, there was a higher risk of being hospitalized with psychiatric diagnoses (hazard ratio (HR): 1.51; 95% CI: 1.11-2.05) and an increased risk of being treated with antipsychotics (HR: 1.46; 95% CI: 1.20-1.79), antidepressants (HR: 1.54; 95% CI: 1.36-1.74), or anxiolytics (HR: 1.47; 95% CI: 1.27-1.69). Hyperthyroid individuals have an increased risk of being hospitalized with psychiatric diagnoses and being treated with antipsychotics, antidepressants, and anxiolytics, both before and after the diagnosis of hyperthyroidism.

  5. 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

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

    Science.gov (United States)

    Dai, W X; Meng, X W

    2000-05-01

    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.

  7. Both hypothyroidism and hyperthyroidism increase atrial fibrillation inducibility in rats.

    Science.gov (United States)

    Zhang, Youhua; Dedkov, Eduard I; Teplitsky, Diana; Weltman, Nathan Y; Pol, Christine J; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A Martin

    2013-10-01

    Evidence indicates that cardiac hypothyroidism may contribute to heart failure progression. It is also known that heart failure is associated with an increased risk of atrial fibrillation (AF). Although it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Thyroidectomized rats with serum-confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (N=9), euthyroid (N=9), and hyperthyroid (N=9) groups. Rats received placebo, 3.3-mg l-thyroxine (T4), or 20-mg T4 pellets (60-day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid, and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic functions, whereas hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all Phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and to prevent cardiac arrhythmias and AF.

  8. 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.

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

    Science.gov (United States)

    Datt, Vishnu; Tempe, Deepak K; Singh, Baljit; Tomar, Akhlesh S; Banerjee, Amit; Dutta, Devesh; Bhandari, Hricha

    2010-01-01

    The relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently or after 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.

  10. Ischaemic stroke in hyperthyroidism without cardiac arrhythmia - A ...

    African Journals Online (AJOL)

    BACKGROUND: The relationship between hyperthyroidism and stroke is well established in the setting of atrial fibrillation. However there is limited literature for ischaemic stroke occurring in hyperthyroidism without cardiac arrhythmia. No such case had been described in South East Nigeria. METHOD: This report highlights ...

  11. 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.

  12. Hyperthyroid dementia: clinicoradiological findings and response to treatment.

    Science.gov (United States)

    Fukui, T; Hasegawa, Y; Takenaka, H

    2001-02-15

    Dementia associated with hyperthyroidism is less well documented than is hypothyroid dementia. Therapeutic response of hyperthyroid dementia and associated cerebral circulatory and/or metabolic abnormalities has not been elucidated. We described a patient with hyperthyroid dementia and clinicoradiological response to treatment. Single photon emission computed tomographic (SPECT) study was repeated and analyzed semiquantitatively. A 67-year-old man experienced progressive impairments of attention, memory, constructive skills and behavior as well as hand tremor and weight loss of two-year duration. Laboratory findings were compatible with Graves' disease. The initial SPECT showed diffuse tracer uptake defect with an accentuation in the bilateral temporoparietal regions. Clinical and SPECT findings both suggested concurrent "possible" Alzheimer's disease. However, initial treatment with a beta-blocker improved behavior and attention-related cognitive functions as well as tracer uptake in the frontal lobes. Subsequent treatment with additional methimazole then improved memory and constructive abilities when a euthyroid state was established. Uptake defect in the temporoparietal regions also responded gradually to the medication. We suggest that the present patient represent hyperthyroid dementia, which responds favorably to treatment with regard to clinical symptoms and SPECT findings. We also suggest that thyroid function be measured in patients with "possible" Alzheimer's disease because treatable hyperthyroid dementia may not be identified.

  13. Atypical features of hyperthyroidism in Blacks

    International Nuclear Information System (INIS)

    Kalk, W.J.

    1980-01-01

    Hyperthyroidism is reportedly uncommon in the indigenous populations of Africa. The presenting symptoms volunteered, the symptoms elicited by direct questioning, and the results of physical examination were therefore prospectively compared in 60 Black and 56 White patients with thyrotoxicosis attending a single thyroid clinic. Fewer Blacks than Whites volunteered information about weight loss, while more Blacks complained only of the presence of a goitre. A 'chance' diagnosis of hyperthyroidism was made more frequently in Blacks. Symptomatology elicited by direct questioning and findings on physical examination were generally similar in each group, except that Blacks presented more frequently with complicated disease (cardiac failure and overt myopathy) and infiltrative ophthalmopathy. The frequency with which hyperthyroidism presents 'atypically' in Black compared with White patients may reflect educational, socio-economic and cultural differences in the Black and White populations, and may partly explain the infrequency with which this disease is diagnosed in Blacks

  14. Weight gain following treatment of hyperthyroidism.

    Science.gov (United States)

    Dale, J; Daykin, J; Holder, R; Sheppard, M C; Franklyn, J A

    2001-08-01

    Patients frequently express concern that treating hyperthyroidism will lead to excessive weight gain. This study aimed to determine the extent of, and risk factors for, weight gain in an unselected group of hyperthyroid patients. We investigated 162 consecutive hyperthyroid patients followed for at least 6 months. Height, weight, clinical features, biochemistry and management were recorded at each clinic visit. Documented weight gain was 5.42 +/- 0.46 kg (mean +/- SE) and increase in BMI was 8.49 +/- 0.71%, over a mean 24.2 +/- 1.6 months. Pre-existing obesity, Graves' disease causing hyperthyroidism, weight loss before presentation and length of follow-up each independently predicted weight gain. Patients treated with thionamides or radioiodine gained a similar amount of weight (thionamides, n = 87, 5.16 +/- 0.63 kg vs. radioiodine, n = 62, 4.75 +/- 0.57 kg, P = 0.645), but patients who underwent thyroidectomy (n = 13) gained more weight (10.27 +/- 2.56 kg vs. others, P = 0.007). Development of hypothyroidism (even transiently) was associated with weight gain (never hypothyroid, n = 102, 4.57 +/- 0.52 kg, transiently hypothyroid, n = 29, 5.37 +/- 0.85 kg, on T4, n = 31, 8.06 +/- 1.42 kg, P = 0.014). This difference remained after correcting for length of follow-up. In the whole cohort, weight increased by 3.95 +/- 0.40 kg at 1 year (n = 144) to 9.91 +/- 1.62 kg after 4 years (n = 27) (P = 0.008), representing a mean weight gain of 3.66 +/- 0.44 kg/year. We have demonstrated marked weight gain after treatment of hyperthyroidism. Pre-existing obesity, a diagnosis of Graves' disease and prior weight loss independently predicted weight gain and weight continued to rise with time. Patients who became hypothyroid, despite T4 replacement, gained most weight.

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

    International Nuclear Information System (INIS)

    Edmondson, E.A.; Bonnet, K.A.; Friedhoff, A.J.

    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 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

  16. 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.

  17. Lower urinary tract symptoms and urinary flow rates in female patients with hyperthyroidism.

    Science.gov (United States)

    Ho, Chen-Hsun; Chang, Tien-Chun; Guo, Ya-Jun; Chen, Shyh-Chyan; Yu, Hong-Jeng; Huang, Kuo-How

    2011-01-01

    To investigate lower urinary tract symptoms (LUTS) and voiding function in a cohort of hyperthyroid women. The autonomic nervous system (ANS) imbalance has been thought to cause LUTS in hyperthyroidism. Between January 2008 and December 2008, 65 newly diagnosed, untreated female hyperthyroid patients were enrolled in this study. Another 62 age-matched healthy women were enrolled as a control group. Demographics, LUTS, urinary flow rates, hyperthyroid symptoms, and serum levels of thyroid hormones were recorded before and after the medical treatment for hyperthyroidism. Compared with the control group, the hyperthyroid patients had a higher mean symptom score of frequency (1.15 ± 1.75 vs 0.31 ± 1.05, P = .01), incomplete emptying (0.91 ± 1.47 vs 0.29 ± 1.12, P = .02), straining (1.05 ± 0.85 vs 0.27 ± 0.51, P Hyperthyroid women demonstrated a lower mean peak flow rate (25.0 ± 5.3 vs 28.6 ± 6.1 mL/s, P = .02). After treatment, both LUTS and flow rates improved significantly. The severity of LUTS was associated with neither serum levels of thyroid hormone nor other hyperthyroid symptoms. Hyperthyroid women have worse LUTS and lower peak flow rates than healthy controls. However, the severity of LUTS is only mild (IPSS hyperthyroidism. The exact mechanisms of LUTS and/or lower urinary tract dysfunction in hyperthyroidism require further investigation. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Reversible Pulmonary Hypertension and Isolated Right-sided Heart Failure Associated with Hyperthyroidism

    OpenAIRE

    Ismail, Hassan M.

    2007-01-01

    Hyperthyroidism may present with signs and symptoms related to dysfunction of a variety of organs. Cardiovascular pathology in hyperthyroidism is common. A few case reports describe isolated right heart failure, tricuspid regurgitation, and pulmonary hypertension as the prominent cardiovascular manifestations of hyperthyroidism. Although most textbooks do not mention hyperthyroidism as a cause of pulmonary hypertension and isolated right heart failure, the literature suggests that some hypert...

  19. The Relative Frequency of Persistent Hyperthyroidism After I131Therapy

    International Nuclear Information System (INIS)

    Al-EID, M.A.

    1998-01-01

    517 patients with different types of hyperthyroidism who had treated by I 131 therapy were studied. The study demonstrated that diffuse toxic goiter was the most common type of hyperthyroidism. The relative frequency of persistent hyperthyroidism in all types after the first dose of I 131 utilizing our empirical regimen in estimation of therapy doses was low (9.5%). While high frequency of persistent hyperthyroidism among diffuse toxic goiter patients (14%), probably was due to many factors discussed in this paper. Some of these factors are impossible to be estimated precisely and therefore, can not be avoided. But careful dose estimation for each case with diffuse toxic goiter may reduce the rate of retreatment by I 131 . Antithyroid medication prior to I 131 therapy might be another factor resulted in increasing of retreatment of retreatment rate diffuse toxic goiter cases. Longer time interval (more than 5 days) of ceasing antithyroid medication prior therapy is suggested to avoid the effects of these drugs. Patients with other types of hyperthyroidism were not frequently required more than one dose and the frequency of persistent hyperthyroidism was almost negligible

  20. 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 effects of SHy on all-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.

  1. 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

    nodular goitre (TNG) HR was 2.10 (95% CI: 1.02-4.36). With respect to labour market income, the income of hyperthyroid individuals increased on average 1189 € less than their controls (Psimilar results...... market income. Similar results in monozygotic twins discordant for hyperthyroidism suggest that genetic confounding is unlikely.......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...

  2. Various Manifestations of Hyperthyroidism in an Ambulatory Clinic: Case Studies

    Science.gov (United States)

    Tripp, Warren; Rao, Vijaya; Creary, Ludlow B.

    1987-01-01

    This study reviews five cases of women with hyperthyroidism, three black women and two Hispanic women. Initially, two patients presented with voice changes, weight loss, and increased appetite. Only two patients presented with classical symptoms of hyperthyroidism. Examination showed all patients had diffusely enlarged thyroids and exaggerated reflexes. Two patients showed Graves' opthalmopathy. These cases document the variety of presentations of hyperthyroidism. Hence, a high index of suspicion must exist for this disease, even in the absence of a number of the classical manifestations of hyperthyroidism. When patients present to primary care centers with a constellation of symptoms, an examination of the thyroid gland is essential. PMID:3694696

  3. Observation of curative effect of 131I in treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Huang Kebin; Xu Fan; Zhang Yaping; Wang Jingchang; Zhao Mingli; Ye Ming

    2012-01-01

    Objective: To explore the curative effect of 131 I in the treatment of hyperthyroidism. Method: 126 patients with hyperthyroidism were treated with 131 I and the curative effect was analyzed. Result: The results showed that among 126 cases of hyperthyroidism treated with 131 I, 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 131 I is safe and effective method. (authors)

  4. 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

    Background: Hospital-based studies may be hampered by referral bias. We investigated how the phenomenon may influence studies of hyperthyroid patients. Methods: By means of a computer-based linkage to the laboratory database and subsequent detailed evaluation of subjects with abnormal test results......, we prospectively identified all 1,148 patients diagnosed with overt hyperthyroidism in a four-year period in and around Aalborg City, Denmark. Each patient was classified according to nosological type of hyperthyroidism. We studied the referral pattern of patients to local hospital units......, 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...

  5. [Hyperthyroidism in family medecine].

    Science.gov (United States)

    Bernier, M; Varlet, E

    2017-01-01

    Hyperthyroidism and sub-hyperthyroidism are common illnesses. Their diagnosis and their treatment are accessible to the general practitioner in the any great majority of the cases. A careful clinical examination already allows to direct the diagnosis. The development is simple and consists of a blood dosage, an ultrasound and sometimes a scintigraphy. Rare cases and severe forms are to be recognized and to refer to specialized centre. The treatment of first intention are betablockers. The comorbidities are cardiovascular (atrial fibrillation mostly) and skeletal (osteoporosis). Considering the increase of cardiovascular risks and the fracture risk in this pathology, the screening is especially indicated for women above 65 years. This screening is simple and little invasive, it consists of the annual dosage of the TSH.

  6. Smoking and other lifestyle factors and the risk of Graves' hyperthyroidism.

    Science.gov (United States)

    Holm, Ingrid A; Manson, Joann E; Michels, Karin B; Alexander, Erik K; Willett, Walter C; Utiger, Robert D

    2005-07-25

    Hyperthyroidism caused by Graves' disease is common in women, yet little is known about risk factors for the disease. We sought to determine whether lifestyle factors, including smoking, alcohol consumption, physical activity level, and body mass index, are risk factors for Graves' hyperthyroidism. This analysis was conducted using data from the Nurses' Health Study II, among 115109 women aged 25 to 42 at entry. Incident reports of women with Graves' hyperthyroidism, confirmed to have the disorder, were included. During 1 328 270 person-years of follow-up, incident diagnoses of Graves' hyperthyroidism were confirmed in 543 women; the 12-year incidence was 4.6 per 1000 women. Cigarette smoking was a predictor of Graves' hyperthyroidism. The hazard ratio among current smokers was 1.93 (95% confidence interval [CI], 1.54-2.43), and among past smokers it was 1.27 (95% CI, 1.03-1.56), after adjusting for recent pregnancy, parity, and other variables. Among current smokers, the hazard ratio increased with the intensity of smoking and was 2.63 (95% CI, 1.71-4.04) among women who smoked 25 or more cigarettes daily. Obesity was associated with a decreased risk of Graves' hyperthyroidism. The hazard ratio for the disorder among women with a body mass index of 30 kg/m(2) or higher was 0.68 (95% CI, 0.49-0.92). Alcohol intake and physical activity level were not associated with risk of Graves' hyperthyroidism. Smoking is a risk factor for Graves' hyperthyroidism in women. Obesity may be associated with a reduced risk, although weight loss as the first manifestation of hyperthyroidism cannot be excluded.

  7. Assessment of ventricular function by radionuclide ventriculography in hyperthyroidism

    International Nuclear Information System (INIS)

    Dong Weiyu; He Pinyu; Zhuang Weite

    1996-01-01

    Left ventricular(LV) and right ventricular(RV) function were determined using radionuclide ventriculography in 50 patients with hyperthyroidism. LVEF, LVPFR, SV of the hyperthyroidism group were decreased in comparison with the normal group (P<0.01), whereas CO of the hyperthyroidism patients were higher than that of normal (P<0.01). Except LVPER, the LVEF, SV had significant difference between two groups. Compared to normal group, RVEF, RVPER, RVPFR were also decreased (P<0.01). Besides 30 cases of the hyperthyroidism were examined by impedance cardiogram (ICG) and impedance pulmonary rheogram (IPR), all showed closely correlation with the parameters determined by ventriculography. There was the involvement of right ventricular function insufficiency, especially in ejection phase. When compared with pre-therapy, pos-therapy cases showed significant improvement in EF, PER, PFR of left and right ventricular

  8. Study of serum osteocalcin levels in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Qiu Ningyan; Zhang Jingxin; Li Huiping; Gong Yiming

    2001-01-01

    In order to study the serum osteocalcin (OC) level in hyperthyroidism, serum osteocalcin, FT 3 , FT 4 and TSH were measured by radioimmunoassay in 87 patients with hyperthyroidism and 52 healthy volunteers. The results indicated that the serum osteocalcin level was decreased with age increasing in healthy volunteers and there was no significant difference in sex (P > 0.05). Serum concentration of OC was significantly higher in untreated hyperthyroid patients than that in healthy volunteers (P 3 , FT 4 (FT 3 :r 0.84 - 0.27, P 4 :r = 0.58 - 0.29, P < 0.01), but not with TSH. Conclusion: Thyroid hormones might speed up bone turnover directly with increased bone resorption to induce bone mass loss. These results indicate that OC is a highly sensitive marker for altered bone metabolism in hyperthyroidism

  9. Hypothalamic mTOR pathway mediates thyroid hormone-induced hyperphagia in hyperthyroidism.

    Science.gov (United States)

    Varela, Luis; Martínez-Sánchez, Noelia; Gallego, Rosalía; Vázquez, María J; Roa, Juan; Gándara, Marina; Schoenmakers, Erik; Nogueiras, Rubén; Chatterjee, Krishna; Tena-Sempere, Manuel; Diéguez, Carlos; López, Miguel

    2012-06-01

    Hyperthyroidism is characterized in rats by increased energy expenditure and marked hyperphagia. Alterations of thermogenesis linked to hyperthyroidism are associated with dysregulation of hypothalamic AMPK and fatty acid metabolism; however, the central mechanisms mediating hyperthyroidism-induced hyperphagia remain largely unclear. Here, we demonstrate that hyperthyroid rats exhibit marked up-regulation of the hypothalamic mammalian target of rapamycin (mTOR) signalling pathway associated with increased mRNA levels of agouti-related protein (AgRP) and neuropeptide Y (NPY), and decreased mRNA levels of pro-opiomelanocortin (POMC) in the arcuate nucleus of the hypothalamus (ARC), an area where mTOR co-localizes with thyroid hormone receptor-α (TRα). Central administration of thyroid hormone (T3) or genetic activation of thyroid hormone signalling in the ARC recapitulated hyperthyroidism effects on feeding and the mTOR pathway. In turn, central inhibition of mTOR signalling with rapamycin in hyperthyroid rats reversed hyperphagia and normalized the expression of ARC-derived neuropeptides, resulting in substantial body weight loss. The data indicate that in the hyperthyroid state, increased feeding is associated with thyroid hormone-induced up-regulation of mTOR signalling. Furthermore, our findings that different neuronal modulations influence food intake and energy expenditure in hyperthyroidism pave the way for a more rational design of specific and selective therapeutic compounds aimed at reversing the metabolic consequences of this disease. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  10. Both Hypothyroidism and Hyperthyroidism Increase Atrial Fibrillation Inducibility in Rats

    Science.gov (United States)

    Zhang, Youhua; Dedkov, Eduard I.; Teplitsky, Diana; Weltman, Nathan Y.; Pol, Christine J.; Rajagopalan, Viswanathan; Lee, Bianca; Gerdes, A. Martin

    2014-01-01

    Background Evidence indicates that cardiac hypothyroidism may contribute to heart failure (HF) progression. It is also known that HF is associated with an increased risk of atrial fibrillation (AF). While it is established that hyperthyroidism increases AF incidence, the effect of hypothyroidism on AF is unclear. This study investigated the effects of different thyroid hormone levels, ranging from hypothyroidism to hyperthyroidism on AF inducibility in thyroidectomized rats. Methods and Results Thyroidectomized rats with serum confirmed hypothyroidism 1 month after surgery were randomized into hypothyroid (n=9), euthyroid (n=9) and hyperthyroid (n=9) groups. Rats received placebo, 3.3mg L-thyroxine (T4), or 20 mg T4 pellets (60 day release form) for 2 months, respectively. At the end of treatment, hypothyroid, euthyroid and hyperthyroid status was confirmed. Hypothyroid animals showed cardiac atrophy and reduced cardiac systolic and diastolic function, while hyperthyroid rats exhibited cardiac hypertrophy and increased cardiac function. Hypothyroidism and hyperthyroidism produced opposite electrophysiological changes in heart rates and atrial effective refractory period, but both significantly increased AF susceptibility. AF incidence was 78% in hypothyroid, 67% in hyperthyroid, and the duration of induced AF was also longer, compared with 11% in the euthyroid group (all phyperthyroidism lead to increased AF vulnerability in a rat thyroidectomy model. Our results stress that normal thyroid hormone levels are required to maintain normal cardiac electrophysiology and prevent cardiac arrhythmias and AF. PMID:24036190

  11. Hyperthyroidism as a cause of persistent vomiting.

    Science.gov (United States)

    Hoogendoorn, E H; Cools, B M

    2004-09-01

    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 free thyroxine level was still high. Hyperthyroidism is an uncommon, but previously reported cause of persistent vomiting.

  12. Hyperthyroidism as a cause of persistent vomiting.

    OpenAIRE

    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 free thyroxine level was still high. Hyperthyroidism is an uncommon, but previously reported cause of persistent vomiting.

  13. Clinical research of juvenile hyperthyroidism treatment with radioiodine

    International Nuclear Information System (INIS)

    Qiu Ling; Zhang Chunying; Chen Yue

    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 131 I therapy. 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 65 patients (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

  14. [Heart failure as early manifestation of neonatal hyperthyroidism. Case report].

    Science.gov (United States)

    Alvarado S, Jorge Luis; Fernández V, Zhirly Andrea

    2014-04-01

    Neonatal hyperthyroidism is usually a self-limited condition frequently associated with transplacental passage of thyroid stimulating antibodies secondary to maternal autoimmune disorders. To timely detect mothers with this medical antecedents decreases the risk for fetal adverse events. To report a case of neonatal hyperthyroidism associated with intrauterine growth restriction and heart failure. A 36 week-old newborn with birth weight of 1,240 g. Symptoms were tachycardia, distal coldness, exophthalmos, hepatomegaly and tremors. Echocardiogram ruled out structural heart disorders. Due to maternal symptoms suggestive of hyperthyroidism, TSH tests were performed showing 0.01 ulU/ml, free T4 7.7 ng/dl, so the diagnosis of neonatal hyperthyroidism was confirmed. It was treated with methimazole and propanol, alleviating the symptoms and decreasing the levels of free T4. To know the maternal history helps identify and manage neonatal complications of hyperthyroidism. Heart failure and other cardiopulmonary disorders are determinants of mortality during early neonatal period. High-risk newborns should receive follow up assessments.

  15. Hyperthyroidism-associated hypercalcemic crisis: A case report and review of the literature.

    Science.gov (United States)

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

    2017-01-01

    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. 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. She was diagnosed as hyperthyroidism-associated hypercalcemic crisis. Treatment with methimazole to correct the hyperthyroidism and treatment of the patient's hypercalcaemia was achieved by physiological saline, salmon calcitonin and furosemide. After treatment for hypercalcaemia and hyperthyroidism, her symptoms and serum calcium levels quickly returned to normal. 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.

  16. [Thyroid diseases in old age. Clinical aspects and therapy. Part 1: Hyperthyroidism].

    Science.gov (United States)

    Rudorff, K H; Fahrenkrog, U; Jahnke, K

    1981-08-27

    The clinical signs of thyroid disease in older people may differ considerably from those in younger patients. The symptoms are often incorrectly interpreted and attributed to old age. The age is also important to the kind of therapy. The normal clinical hyperthyroidism-indices are not relevant in the diagnosis of hyperthyroidism in older patients. Organic symptoms predominate in old age (loss of weight, muscular asthenia, tremor, cardiac arrhythmia, stenocardia, congestive cardiomyopathy). Most of the time they are wrongly interpreted as additional symptoms of old age. Probably it is not the age that causes the difficulties in hyperthyroidism-diagnostics in old age, but the atypical symptoms of solitary or multilocular adenomas, which increase with advancing age. A special symptom of hyperthyroidism in old age, often misinterpreted, is "apathetic" hyperthyroidism. Radioiodotherapy is indicated in older patients with hyperthyroidism.

  17. Clinical study on bone mineral density and bone metabolism biochemical marker in hyperthyroidism

    International Nuclear Information System (INIS)

    Xu Ying; Xu Xiaohui

    2004-01-01

    To investigate the mechanism and relationship between hyperthyroidism and osteoporosis, bone mineral density was observed using dual-energy X-ray absorptiometry in 149 cases of hyperthyroidism, while serum FT 3 , FT 4 , TSH, alkaline phosphatase (ALP), BGP, and D-pyd levels were measured in 81 cases of hyperthyroidism. The osteopenia rate is 30.2% and the osteoporosis rate is 24.1% in hyperthyroidism patients. Compare with control group, bone metabolic biochemical markers in all cases of hyperthyroidism showed a significant increase, which displays high turnover osteoporosis. In order to find out the case of osteoporosis as soon as possible, bone mineral density of all patients with hyperthyroidism should be measured in the period of treatment. (authors)

  18. Benefit of Anticoagulation Therapy in Hyperthyroidism-Related Atrial Fibrillation.

    Science.gov (United States)

    Chan, Pak-Hei; Hai, Jojo; Yeung, Chun-Yip; Lip, Gregory Y H; Lam, Karen Siu-Ling; Tse, Hung-Fat; Siu, Chung-Wah

    2015-08-01

    Existing data on the risk of ischemic stroke in hyperthyroidism-related atrial fibrillation (AF) and the impact of long-term anticoagulation in these patients, particularly those with self-limiting AF, remain inconclusive. Risk of stroke in hyperthyroidism-related AF is the same as nonhyperthyroid counterparts. This was a single-center observational study of 9727 Chinese patients with nonvalvular AF from July 1997 to December 2011. Patients with AF diagnosed concomitantly with hyperthyroidism were identified. Primary and secondary endpoints were defined as hospitalization with ischemic stroke and intracranial hemorrhage in the first 2 years. Patient characteristics, duration of AF, and choice of antithrombotic therapy were recorded. Self-limiting AF was defined as hyperthyroidism and AF at diagnosis. For stroke prevention, 136 and 243 patients (21.1% and 37.9%) were prescribed warfarin and aspirin, respectively, whereas the remaining patients (41.0%) received no therapy. Ischemic stroke occurred in 50 patients (7.8%), and no patient developed hemorrhagic stroke. Patients with CHA2 DS2 -VASc of 0 did not develop stroke. Warfarin effectively reduced the incidence of stroke compared with aspirin or no therapy in patients with CHA2 DS2 -VASc ≥1 and non-self-limiting AF, but not in those with self-limiting AF or CHA2 DS2 -VASc of 0. Presence of hyperthyroidism did not confer additional risk of ischemic stroke compared with nonhyperthyroid AF. Patients with hyperthyroidism-related AF are at high risk of stroke (3.9% per year). Warfarin confers stroke prevention in patients with CHA2 DS2 -VASc ≥1 and non-self-limiting AF. Overall stroke risk was lower in hyperthyroid non-self-limiting AF patients compared with nonhyperthyroid counterparts. © 2015 Wiley Periodicals, Inc.

  19. Relapse rate following antithyroid drug therapy of immunogenic and non-immunogenic hyperthyroidism

    International Nuclear Information System (INIS)

    Voth, E.; Dickmann, N.; Schicha, H.; Emrich, D.

    1990-01-01

    Data of 196 patients treated for hyperthyroidism exclusively with anthyroid drugs were analyzed retrospectively concerning the relapse rate within a follow-up period of four years. Patients were subdivided for primary or recurrent disease, and for immunogenic or non-immunogenic hyperthyroidism, respectively. In immunogenic as well as in non-immunogenic hyperthyroidism, the relapse rate was significantly lower for patients with primary disease (35% and 52%, respectively) compared to those with recurrent hyperthyroidism (82%, p [de

  20. 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.

  1. [Pharmacokinetics of digoxin in hyperthyroidism. Effect of methimazole].

    Science.gov (United States)

    Izbicka, Maria; Gasińska, Teresa; Dec, Renata

    2010-01-01

    Cardiovascular abnormalities may be the only manifestations of overt hyperthyroidism. In patients with heart failure and atrial fibrillation digoxin can be beneficial in controlling the symptoms and signs, but hyperthyroid patients show an impaired response or even resistance to digoxin treatment. The aim of the study is to establish: 1. Are there any differences in the pharmacokinetics of a single oral dose of digoxin between hypertyroid and euthyroid patients? 2. Does simultaneous administration of digoxin and methimazole affect the pharmacokinetics of a single oral dose of dogoxin? 3. Does methimazole-induced euthyroidism change the pharmacokinetics of a single oral dose of digoxin? The subject of the study were 28 patients with hyperthyroidism and 15 healthy persons. We evaluated the pharmacokinetics of a single oral dose of digoxin. Moreover we evaluated pharmacokinetics of a single dose of digoxin after simultaneous administration of digoxin and methimazole in 12 patients and 12 methimazole treated patients werere-assessed once they had become euthyroid. Hyperthyroid patients showed significantly lower serum digoxin concentrations, shorter T1/2 beta and a significantly smaller area under the concentration curve (AUC) that the control group. Administration of methimazole did not affect digoxin pharmacokinetics. In hyperthyroid patients: 1. the pharmacokinetics of a single oral dose of digoxin does differ from that observed in healthy subjects. 2.methimazole do not alter digoxin pharmacokinetics.

  2. [Hyperthyroidism and anemia].

    Science.gov (United States)

    Hambsch, K; Fischer, H; Langpeter, D; Müller, P

    1981-03-15

    In a random test of 100 patients with hyperthyroidism with clinical and paraclinical ascertainment of the diagnosis in 38 cases normo-hypochromic, normocytary anaemias of different expression were found. In the patients with anaemia the serum hormone values were statistically significantly higher than in the 62 patients without anaemia. Also cardiotoxic and hepatotoxic findings were more frequently to be proved in patients with anaemia. A causal iron deficiency, deficit of vitamin B12 or folic acid as well as a haemolytic component of the induction of anaemia could vastly be excluded. By means of the treatment of the basic disease and metabolic balance a normalisation of hemoglobin was achieved without additional medication. From the results of the examinations is concluded that above all a thyreotoxic damage is responsible for the development of the anaemia. In cases of oligo-symptomatic hyperthyroidism part from hepatotoxicity and cardiotoxicity also anaemias may become a leading symptom.

  3. The influential factors of 131I treatment for hyperthyroidism

    International Nuclear Information System (INIS)

    Tan Benxu

    2003-01-01

    Many factors such as iodine-131 uptake, effective half-life, thyroid volume, and antithyroid drugs affect the iodine-131 dose for every hyperthyroid patient. The outcome of radioiodine therapy in hyperthyroidism is decided by all of these factors

  4. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  5. [Children with hyperthyroidism due to elevated hCG levels].

    Science.gov (United States)

    Jöbsis, Jasper J; van Trotsenburg, A S Paul; Merks, Johannes H M; Kamp, Gerdine A

    2014-01-01

    We describe two children with hyperthyroidism secondary to elevated hCG levels: one patient with gestational trophoblastic disease and one patient with choriocarcinoma. hCG resembles other glycoproteins that can lead to hyperthyroidism through TSH receptor activation. Also, through its LH-mimicking effect, hCG can induce high oestradiol levels, resulting in stormy pubertal development. False negative hCG tests due to the high-dose hook effect may complicate the diagnostic process. In patients with antibody-negative thyrotoxicosis, the diagnosis of hCG-induced hyperthyroidism must be considered.

  6. [Congenital hyperthyroidism in maternal Basedow disease].

    Science.gov (United States)

    Meden, H; Rath, W

    1989-09-01

    A case of congenital hyperthyroidism, after pregnancy complicated by Graves' disease is presented. Fetal tachycardia was the cardial symptom. Caesarean section was performed in the 29 years old patient with normal thyroid function in the 29th week of pregnancy. The neonate showed symptoms of a congenital hyperthyroidism with goitre. Antithyroid antibodies were found in the serum of both mother and child. At the age of ten weeks, after a short course of thyrostatic treatment, the infant was discharged with normal thyroid function following complicationfree progress.

  7. Asymptomatic hyperthyroidism in older adults: is it a distinct clinical and laboratory entity?

    Science.gov (United States)

    Mooradian, Arshag D

    2008-01-01

    Hyperthyroidism is the result of increased serum free thyroid hormone levels and is associated with a well recognized set of clinical signs and symptoms. However, older patients who develop hyperthyroidism tend to have fewer hyperadrenergic signs and an increased incidence of weight loss, cardiac arrhythmias and, occasionally, apathetic mood. This article highlights the paucity of clinical signs and symptoms of hyperthyroidism in older people and reviews the potential biochemical changes in thyroid hormone physiology that may account for an altered clinical presentation in older people with hyperthyroidism. First, a brief vignette from our own clinical practice is described to highlight an unusual presentation of hyperthyroidism in an older woman. The subject is then reviewed on the basis of relevant articles identified through a MEDLINE search of the English literature, using the key words 'hyperthyroidism' and 'aging'. The available evidence indicates that the clinical syndrome of asymptomatic hyperthyroidism in older adults appears to be distinct from the more widely recognized syndromes of apathetic hyperthyroidism or thyroid hormone resistance. Age-related changes in thyroid hormone economy and reduced cellular uptake of thyroid hormone as well as changes in thyroid hormone regulation of gene expression may account for reduced manifestations of hyperthyroidism in older adults. Thus, in addition to the well known changes in thyroid gland anatomy and function with aging, there may be an age-related resistance to thyroid hormone action. Asymptomatic hyperthyroidism may well be a syndrome that is currently under-diagnosed.

  8. Serum Cystatin C Concentrations in Cats with Hyperthyroidism and Chronic Kidney Disease.

    Science.gov (United States)

    Williams, T L; Dillon, H; Elliott, J; Syme, H M; Archer, J

    2016-07-01

    Currently, no test can accurately predict the development of azotemia after treatment of hyperthyroidism. Serum cystatin C concentrations (sCysC) might be less influenced by changes in body muscle mass and so better indicate the presence of concurrent chronic kidney disease (CKD) in hyperthyroidism. sCysC will be higher in hyperthyroid cats that develop azotemia compared with hyperthyroid cats that remain nonazotemic after treatment; sCysC will be higher in nonhyperthyroid cats with azotemic CKD than healthy older cats and, sCysC will decrease after treatment of hyperthyroidism. Ninety-one cats treated in first opinion practice. Case-control study. sCysC were compared between hyperthyroid cats which developed azotemia within 4 months of successful treatment of hyperthyroidism (pre-azotemic group) and hyperthyroid cats which remained nonazotemic after treatment (nonazotemic group), and between nonhyperthyroid cats with azotemic CKD and healthy older cats. sCysC were also compared between hyperthyroid cats before treatment and at time of establishment of euthyroidism. Data are presented as median [25th, 75th percentile]. Baseline sCysC were not different between the pre-azotemic and nonazotemic groups (1.9 [1.4, 2.3] mg/L versus 1.5 [1.1, 2.2] mg/L, respectively; P = .22). sCysC in nonhyperthyroid cats with azotemic CKD and healthy older cats were not significantly different (1.5 [1.0, 1.9] mg/L versus 1.2 [0.8, 1.4] mg/L, respectively; P = .16). sCysC did not change significantly after treatment of hyperthyroidism (pretreatment 1.8 [1.2, 2.3] mg/L, after treatment 1.6 [1.1, 2.4] mg/L; P = .82). sCysC do not appear to be a reliable marker of renal function in hyperthyroid cats. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  9. 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...

  10. Haemodynamic changes following treatment of subclinical and overt hyperthyroidism

    DEFF Research Database (Denmark)

    Faber, J; Wiinberg, N; Schifter, S

    2001-01-01

    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...

  11. 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.

  12. Sympathovagal response to orthostatism in overt and in subclinical hyperthyroidism.

    Science.gov (United States)

    Goichot, B; Brandenberger, G; Vinzio, S; Perrin, A E; Geny, B; Schlienger, J L; Simon, C

    2004-04-01

    Heart rate variability (HRV) is a measure of the physiological variation of R-R intervals, reflecting the sympathovagal balance. In both overt and subclinical hyperthyroidism, a relative increase in sympathetic activity has been demonstrated, mainly due to a decrease in vagal activity. The modifications of HRV during orthostatism in normal subjects resemble those seen in hyperthyroidism. We have studied the response of 19 patients with overt hyperthyroidism and 12 with subclinical hyperthyroidism during orthostatism using HRV and compared the results to those of 32 healthy controls. In the three groups, the R-R intervals decreased in the same proportion after orthostatism. The low frequency power (LF)/[LF + high frequency power (HF)] ratio, which reflects the sympathetic tone, also increased in the same proportion in the three groups. However, the mechanisms of the modulation of the sympathovagal balance during orthostatism were different among the three groups. In controls, the relative increase of sympathetic tone after orthostatism was due principally to a decrease in vagal tone (reflected by decreased power in the HF band), while in overt hyperthyroidism, where the power in the HF band was already minimal in the lying position, there was a clear increase in the LF band power during orthostatism. The results were intermediate in the subclinical hyperthyroidism group, reflecting a continuum of effects of the thyroid hormone excess on the autonomic nervous system. Our study shows that despite an apparent normal cardiovascular adaptation to orthostatism in hyperthyroidism, the modulation of the autonomic nervous system is profoundly modified.

  13. Nature of altered growth hormone secretion in hyperthyroidism.

    Science.gov (United States)

    Iranmanesh, A; Lizarralde, G; Johnson, M L; Veldhuis, J D

    1991-01-01

    Hyperthyroidism is accompanied by various neuroendocrine regulatory disturbances that affect not only the thyrotropic, but also the gonadotropic, corticotropic, and somatotropic axes. To examine the nature of alterations in neuroendocrine control mechanisms that direct the somatotropic axis in hyperthyroidism, we have applied a novel deconvolution technique designed to estimate the number, amplitude, and mass of significant underlying GH secretory events after the influence of GH metabolic clearance has been removed mathematically. To this end, blood was sampled at 10-min intervals for 24 h in seven hyperthyroid and seven age-matched euthyroid men. The subsequent GH time series were assayed by immunoradiometric assay (sensitivity, 0.08 ng/mL) and submitted to quantitative deconvolution analysis. We found that hyperthyroid compared to euthyroid men 1) had significantly more GH secretory bursts per 24 h (viz. 15 +/- 1.0 vs. 10 +/- 1.1; P = 0.017); 2) secreted 3 times as much GH per burst (3.7 +/- 0.80 vs. 1.3 +/- 0.42 ng/mL distribution vol; P = 0.013); 3) achieved a maximal rate of GH secretion in each burst 2.3-fold higher than that in control men (0.14 +/- 0.028 vs. 0.060 +/- 0.015 ng/mL.min; P = 0.017); and 4) had 3.7-fold higher 24-h endogenous GH production rates (P less than 0.01). Neither hyperthyroid nor euthyroid men had significant interburst (tonic) GH secretion. We conclude that the somatotropic axis in hyperthyroid men is marked by a higher frequency of spontaneous GH secretory bursts, a higher rate of maximal GH secretion attained per burst, and a larger mass of GH released per burst. These neuroregulatory disturbances result in a nearly 4-fold increase in the 24-h production rate of GH in thyrotoxicosis.

  14. Ocena wybranych zachowań zdrowotnych przez i po zdiagnozowaniu choroby wśród kobiet z nowotworem piersi w oparciu o Inwentarz Zachowań Zdrowotnych Juczyńskiego – badanie wstępne = Evaluation of selected health behaviors before and after the diagnosis among women with breast cancer based on the Health-Related Behaviour Inventory (HBI questionnaire developed by Juczyński - preliminary study

    Directory of Open Access Journals (Sweden)

    Urszula Jolanta Bojakowska

    2016-05-01

    2. SKN przy Samodzielnej Pracowni Epidemiologii, Uniwersytet Medyczny w Lublinie       Słowa kluczowe: rak piersi, zachowania zdrowotne, profilaktyka Key words: brest cancer, health behaviors, prophylaxis   Abstrakt Cel pracy Celem pracy była ocena wybranych zachowań zdrowotnych przed i po leczeniu wśród kobiet  z nowotworem piersi. Materiał i metoda W badaniu zastosowano metodę sondażu diagnostycznego z techniką ankiety. Do realizacji badań posłużył kwestionariusz Inwentarz Zachowań Zdrowotnych (IZZ Juczyńskiego. Badaniami objęto 70 kobiet z rakiem piersi, w przedziale wieku między35 a77 rokiem życia zamieszkujących województwo lubelskie. Analizy statystyczne przeprowadzono w oparciu o program Statistica 10.0. Wyniki W oparciu o skalę IZZ przed chorobą wyniki niskie uzyskało 80% badanych, przeciętne – 11,4%, zaś wysokie – 8,6%. Po rozpoznaniu choroby wyniki niskie uzyskało 17,1%, przeciętne – 30%, a wysokie 52,9%.  Wskaźnik zachowań zdrowotnych dla ogółu badanych wyniósł  średnio 66,23 przed chorobą i 90,5 po rozpoznaniu. Po rozpoznaniu choroby we wszystkich kategoriach uzyskano wyższe wyniki niż przed. Wnioski Doświadczenia związane z chorobą mają istotny wpływ na wzrost ogólnego wskaźnika nasilenia zachowań zdrowotnych wśród kobiet z nowotworem piersi.  Po rozpoznaniu choroby we wszystkich analizowanych kategoriach zaobserwowano wyższy poziom deklarowanych zachowań zdrowotnych.         Abstract Aim The aim of this study was to evaluate selected health behaviors before and after diagnosis of the disease among women with breast cancer. Material and methods In the study the diagnostic survey method was applied in combination with the questionnaire technique. To conduct the research we used Juczyński’s inventory of health behaviours questionnaire. The survey included 77 women with breast cancer, aged from 35 to 77, living in the Lubelskie Voivodeship. The statistical analyses were conducted with

  15. Ocena urodynamiczna nietrzymania moczu po radykalnej prostatektomii - studium przypadku

    Directory of Open Access Journals (Sweden)

    Rafał Święcicki

    2010-06-01

    Full Text Available Nietrzymanie moczu po radykalnej prostatektomii we wczesnym okresie po zabiegu występuje u około 30% operowanych, natomiast w okresie późnym, ponad rok po zabiegu, objawy wysiłkowego nietrzymania moczu utrzymują się u około 5% badanych chorych. Obiektywnych danych na temat przyczyn i nasilenia nietrzymania moczu może dostarczyć kompleksowe badanie urodynamiczne. Zasadnicze znaczenie dla rokowania zależne jest od stopnia dysfunkcji aparatu zwieraczowego. Cel pracy: Celem pracy była ocena możliwości diagnostycznych pooperacyjnego nietrzymania moczu u chorego po prostatektomii radykalnej, na podstawie diagnostyki urodynamicznej. Materia! i metody: W pracowni urodynamicznej 10. Wojskowego Szpitala Klinicznego z Polikliniką (WSKzP wykonano kompleksowe badanie urodynamiczne u chorego skarżącego się na nietrzymanie moczu 12 miesięcy po radykalnej prostatektomii. W ramach badania wykonano przepływ cewkowy, cystometrię, badanie ciśnieniowo-przepływowe oraz profiłometrię spoczynkową. Wyniki: Maksymalne ciśnienie zamknięcia cewki moczowej było wyraźnie obniżone, do wartości 8 cm H20, c o sugerowało obecność wysiłkowego nietrzymania moczu. Stwierdzono również objawy niestabilności wypieracza oraz cechy uszkodzenia mechanizmu zwieraczowego. Wynik ten miał duże znaczenie dla dalszych możliwości leczenia chorego. Wnioski: Kompleksowe badanie urodynamiczne ma istotne znaczenie w diagnozowaniu chorych z pooperacyjnym nietrzymaniu moczu.

  16. Thyroid cancer in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Kabir, M.F.; Nahar, N.; Haque, F.S.; Alam, F.; Hasan, M.

    2007-01-01

    Full text: The coexistence of hyperthyroidism and thyroid cancer is a rare event. The aim of this study was to evaluate the relevance of the association of hyperthyroidism and thyroid cancer. Method: From 1st January 2006 to 31st December 2006, a total of 388 new hyperthyroid patients attended the Institute of Nuclear Medicine and Ultrasound for radioiodine therapy. Eighty-two of them were selected before radioiodine therapy, on the basis of findings on palpation and ultrasound (USG) examination, to undergo fine needle aspiration cytology (FNAC) for cytological diagnosis. USG examination was performed to localize and mark the position of nodule/nodules for FNAC and, in cases of nonpalpable nodules, USG guided FNAC was done. In the case of non-nodular patients, guided FNAC was done in sonographically suspicious areas. Results: FNAC report was positive for thyroid cancer in 4 patients. Histopathology examination revealed the presence of papillary carcinoma. Among the four positive cases, one had multi-nodular goitre, two had uni-nodular goiters and one had no nodule. Another patient had a negative FNAC report but due to a huge goiter, the patient underwent surgery and histopathology revealed the presence of papillary carcinoma. Conclusion: Although the occurrence of thyroid cancer in hyperthyroid patients is rare, the presence of a nodule should be carefully evaluated to exclude the presence of concurrent malignancy. FNAC (USG guided in case of non-palpable nodules) is found helpful before radioiodine therapy or surgery. (author)

  17. The influence of hyperthyroidism on pharmacologically induced contractions of isolated resistance arteries

    NARCIS (Netherlands)

    Zwaveling, J.; Prins, E. A.; Maas, M. A.; Pfaffendorf, M.; van Zwieten, P. A.

    1996-01-01

    We investigated the effect of hyperthyroidism on the responses of small mesenteric resistance arteries to several contractile and dilator agents. Hyperthyroidism was established by feeding rats for 28 days with 5 mg/kg L-thyroxine-containing rat chow. This treatment produced a stable hyperthyroid

  18. Regression of the carotid intima media thickness by propylthiouracil therapy in Graves' hyperthyroidism.

    Science.gov (United States)

    Bilir, Cemil; Gökosmanoglu, Feyzi; Caliskan, Mustafa; Cinemre, Hakan; Akdemir, Ramazan

    2012-04-01

    One of the cardiovascular effects of hyperthyroidism is increased carotid intima media thickness (CIMT). The aim of this study is to investigate the CIMT in patients with Graves' hyperthyroidism and the effect of propylthiouracil (PTU) therapy on CIMT. Twenty-six patients with Graves' hyperthyroidism and 33 healthy controls were included in the study. CIMT was measured at the right and left external carotid arteries in every patient in both groups. CIMT was measured before and after the PTU therapy in patients with Graves' hyperthyroidism. There was a significant difference in CIMT between the group of Graves' hyperthyroid patients and the control group (0.72 versus 0.55 mm, P treatment, CIMT decreased significantly compared with the baseline values [0.84 (0.54-1.3) to 0.72 (0.50-1.2), change 0.12 mm, P hyperthyroidism is associated with atherosclerosis as assessed by CIMT. Treatment of Graves' hyperthyroidism with PTU decreases the CIMT.

  19. Role of Cholestyramine in Refractory Hyperthyroidism: A Case Report and Literature Review.

    Science.gov (United States)

    Alswat, Khaled A

    2015-07-24

    Hyperthyroidism is a common disease that usually responds to the conventional therapy of anti-thyroidal medications (methimazole or PTU) and beta-blocker. Refractory hyperthyroidism is a rare condition in which hyperthyroidism fails to respond to the above therapy. Cholestyramine has been shown to decrease thyroid hormone level when added to the ongoing anti-thyroidal medications. A 52-year-old woman with past medical history of enlarging goiter presented with obstructive symptoms of worsening shortness of breath and snoring. Admission thyroid function test showed mild hyperthyroidism (suppressed TSH, slightly high FT4, and high normal FT3) that worsened after she received a CT scan with contrast and failed to respond to a 3-week course of high-dose dexamethasone, high-dose carbimazole, and up-titrated propranolol. Five days after cholestyramine was added, her FT4 decreased by 30% and normalized after 12 days. The patient underwent total thyroidectomy as definitive treatment for the hyperthyroidism and for the obstructive symptoms. Cholestyramine is an effective additional treatment for hyperthyroidism and may be an effective treatment for refractory iodine-induced hyperthyroidism. The possibility of self-remission (natural course) is less likely given the dramatic and rapid response to cholestyramine.

  20. Increased risk of hyperthyroidism among patients hospitalized with bipolar disorder

    DEFF Research Database (Denmark)

    Thomsen, Anders F; Kessing, Lars V

    2005-01-01

    OBJECTIVES: Hyperthyroidism has been associated with affective disorder in many cross-sectional studies, but longitudinal studies in this connection are scarce. We assessed whether hospitalization with depressive disorder or bipolar disorder was a risk factor for development of hyperthyroidism....... METHODS: We conducted a historical cohort study using the Danish register data. The observational period was 1977--99. Three study cohorts were identified: all patients with a first hospital admission with resulting index discharge diagnoses of depression, bipolar disorder, or osteoarthritis. The risks...... with depressive disorder did not have an increased risk of hyperthyroidism, whereas patients with bipolar disorder had an increased of risk on the margin of statistical significance, when compared to patients with osteoarthritis. Patients with bipolar disorder had a significantly increased risk of hyperthyroidism...

  1. [Secretion of growth hormone in hyperthyroidism].

    Science.gov (United States)

    Hervás, F; Morreale de Escobar, G; Escobar Del Rey, F; Pozuelo, V

    1976-01-01

    The authors studied growth hormone (GH) secretion in a group of adult controls and another group of hyperthyroid patients after stimulation with intravenous insulin-induced (0,1 IU/kg) hypoglycemia, aiming to clear out the problem of discrepancies in literature concerning GH secretion in hyperthyroidism. They concluded that in this syndrome, GH levels are significantly higher than those of controls. The GH releasing response is normal, though it could be expected to be decreased due to decreased pituitary GH contents as a result of permanent somatotrophic cell stimulation.

  2. Delayed cerebral development in twins with congenital hyperthyroidism.

    Science.gov (United States)

    Kopelman, A E

    1983-09-01

    Twins had congenital hyperthyroidism and delayed cerebral development manifested as ventriculomegaly, increased space in the interhemispheric fissure, and an exaggerated gyral pattern on cranial computed tomographic scans. At 3 1/2 years of age, both children had delayed development. Fetal and neonatal hyperthyroidism may interfere with normal brain growth and maturation with both neuranatomic and developmental sequelae.

  3. Breed, Coat Color, and Hair Length as Risk Factors for Hyperthyroidism in Cats.

    Science.gov (United States)

    Crossley, V J; Debnath, A; Chang, Y M; Fowkes, R C; Elliott, J; Syme, H M

    2017-07-01

    Hyperthyroidism is very common in older cats, but the etiopathogenesis is poorly understood. Decreased risk of hyperthyroidism has been reported in certain colorpoint breeds, and this observation previously has been hypothesized to result from relatively greater tyrosine availability for thyroid hormone production because of limited ability to convert tyrosine to melanin pigment. However, studies investigating a potential link between coat pigmentation and risk of hyperthyroidism are limited. To identify associations between coat phenotype and hyperthyroidism by investigation of breed, coat color, and hair length as risk factors for the disease. Data were used from 4,705 cats aged ≥10 years, referred to a single veterinary teaching hospital (2006-2014) in the United Kingdom. Retrospective, epidemiological, cross-sectional study using Bayesian multivariable logistic regression to assess risk factors for hyperthyroidism. Burmese (odds ratio [OR], 0.01; 0.00-0.23; P = .004), Tonkinese (OR, 0.05; 0.00-0.95; P = .046), Persian (OR, 0.21; 0.10-0.44; P hyperthyroidism compared to domestic shorthairs. Longhaired, nonpurebred cats (OR, 1.30; 1.03-1.64; P = .028) were at increased risk of hyperthyroidism. Coat color/pattern was not associated with hyperthyroidism in nonpurebred cats. We identified decreased risk of hyperthyroidism in the Tonkinese, Abyssinian, and British shorthair breeds, identified an association between risk of hyperthyroidism and hair length, and confirmed decreased risk in Burmese, Siamese, and Persian breeds. Additional studies are warranted to further investigate these findings. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  4. [Prevention of recurrent amiodarone-induced hyperthyroidism by iodine-131].

    Science.gov (United States)

    Hermida, J S; Jarry, G; Tcheng, E; Moullart, V; Arlot, S; Rey, J L; Schvartz, C

    2004-03-01

    Amioradone-induced hyperthyroidism is a common complication of amiodarone therapy. Although definitive interruption of amiodarone is recommended because of the risks of aggravation of the arrhythmias, some patients may require the reintroduction of amiodarone several months after normalisation of thyroid function. The authors undertook a retrospective study of the effects of preventive treatment of recurrences of amiodarone-induced hyperthyroidism with I131. The indication of amiodarone therapy was recurrent, symptomatic, paroxysmal atrial fibrillation in 13 cases and ventricular tachycardia in 5 cases (M = 14, average age 64 +/- 13 years). The underlying cardiac disease was dilated cardiomyopathy (N = 5), ischaemic heart disease (N = 3), hypertensive heart disease (N = 2), arrhythmogenic right ventricular dysplasia (N = 2) or valvular heart disease (N = 2). Two patients had idiopathic atrial fibrillation. An average dose of 576 +/- 184 MBq of I131 was administered 34 +/- 37 months after an episode of amiodarone-induced hyperthyroidism. Amiodarone was reintroduced in 16 of the 18 patients after a treatment-free period of 98 +/- 262 days. Transient post-radioiodine hyperthyroidism was observed in 3 cases (17%). Sixteen patients (89%) developed hypothyroidism requiring replacement therapy with L-thyroxine. There were no recurrences of amiodarone-induced hyperthyroidism. After 24 +/- 17 months follow-up, the arrhythmias were controlled in 13 of the 16 patients (81%) who underwent the whole treatment sequence. The authors conclude that preventive treatment with I131 is an effective alternative to prevent recurrence of amiodarone-induced hyperthyroidism in patients requiring reintroduction of amiodarone to control their arrhythmias.

  5. 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.

  6. Montmorillonite ameliorates hyperthyroidism of rats and mice attributed to its adsorptive effect.

    Science.gov (United States)

    Cai, Yan; Meng, Xin-fang; Cao, Yong-xiao; Lu, Hua; Zhu, Shao-fei; Zhou, Liang-zhen

    2006-12-03

    The present study aims to evaluate the adsorbing effect of montmorillonite on thyroid hormone in the entero-hepatic circulation. The concentration of thyroid hormone in the serum of hyperthyroidism model rats and in solution was measured by radioimmunoassay and ultraviolet spectrometry, respectively. The body weight, temperature, and consumption of food and water were observed in hyperthyroidism model rats. Furthermore, hypoxia tolerance, sodium-pentobarbital-induced sleep time, spontaneous activities were measured on hyperthyroidism model mice after being treated with montmorillonite. Results showed that montmorillonite adsorbed thyroxin (T(4)) and triiodothyronine (T(3)) in vitro. Montmorillonite at dosage of 1.0 g/kg and 0.3 g/kg decreased thyroid hormone levels on hyperthyroidism model rats; Montmorillonite (2.0 g/kg and 0.6 g/kg) prolonged the sleep time, improved the hypoxia tolerant capacity and reduced the spontaneous activities of the hyperthyroidism model mice. These results suggest montmorillonite has anti-hyperthyroidism effect attributed to its adsorptive effect.

  7. Management of Hyperthyroidism during the Preconception Phase, Pregnancy, and the Postpartum Period.

    Science.gov (United States)

    Sarkar, Sudipa; Bischoff, Lindsay A

    2016-11-01

    Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use. The use of treatment modalities for hyperthyroidism during pregnancy such as surgery is also discussed. Studies of maternal, fetal, and neonatal complications of hyperthyroidism are examined in this article. Moreover, the evidence regarding antithyroid drugs, specifically methimazole and propylthiouracil, during lactation is considered. Other disease conditions that can take place during pregnancy and the postpartum period such as hyperemesis gravidarum, subclinical hyperthyroidism, gestational trophoblastic disease, and postpartum thyroiditis and their treatments are also presented. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Hyperthyroidism differentially regulates neuropeptide S system in the rat brain.

    Science.gov (United States)

    González, Carmen R; Martínez de Morentin, Pablo B; Martínez-Sánchez, Noelia; Gómez-Díaz, Consuelo; Lage, Ricardo; Varela, Luis; Diéguez, Carlos; Nogueiras, Rubén; Castaño, Justo P; López, Miguel

    2012-04-23

    Thyroid hormones play an important role in the regulation of energy balance, sleep and emotional behaviors. Neuropeptide S (NPS) is a recently discovered neuropeptide, regulating feeding, sleep and anxiety. Here, we examined the effect of hyperthyroidism on the gene and protein expression of neuropeptide S and its receptor (NPS-R) in the hypothalamus, brainstem and amygdala of rats. Our results showed that the expression of NPS and NPS-R was differentially modulated by hyperthyroidism in the rat brain. NPS and NPS-R mRNA and protein levels were decreased in the hypothalamus of hyperthyroid rats. Conversely NPS-R expression was highly increased in the brainstem and NPS and NPS-R expression were unchanged in the amygdala of these rats. These data suggest that changes in anxiety and food intake patterns observed in hyperthyroidism could be associated with changes in the expression of NPS and NPS-R. Thus, the NPS/NPS-R system may be involved in several hyperthyroidism-associated comorbidities. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Ablative radiodine therapy for hyperthyroidism: long term follow-up study

    International Nuclear Information System (INIS)

    Kendall-Taylor, P.; Keir, M.J.; Ross, W.M.

    1984-01-01

    A total of 225 patients were treated for hyperthyroidism with 555 MBq (15 mCi) radioiodine to ablate the thyroid and induce early hyperthyroidism. The efficacy of this treatment in eradicating hyperthyroidism and problems of follow up were assessed one to six years later from case records and questionnaires. Information was received from 197 out of 219 live patients (90%) and from 160 doctors concerning 207 patients (92%). Only three patients were not traced and six had died since treatment. The modal time to hyperthyroidism was three months, and 64% of patients were hyperthyroid at one year; 5.6% had failed to become euthyroid within one year. Ninety five per cent of patients had been seen by the doctor and 82% had had a thyroid test done within the past two years. Most doctors preferred patients to be returned to their care once thyroxine treatment was stabilised. An ablative dose of 131 I is recommended as an effective means of treatment which has clear advantages over conventional methods. Good communications and effective follow up should ensure success. (author)

  10. Iodine-131 therapy for the treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Enkhtuya, B.; Tsevelmaa, L.; Erdenechimeg, S.

    2005-01-01

    Full text: Since 1997, radioactive iodine (I-131) has become the most widely used therapy for patients with hyperthyroidism cased by Graves' disease in the Mongolia. Our seven years clinical experience was reviewed to evaluate the efficacy of the therapy. We treated 150 patients (119 female and 31 male) with hyperthyroidism with I-131 (mean dose 8.2 mCi) between 1997 and 2004. The dose calculation was based on 24 hours thyroid uptake, thyroid gland size and degree of toxicity. We determined their thyroid status after 1 year in relation to age, pretreatment with an antithyroid drug, pretreatment thyroid size and whether or not there are thyroid nodules. Out of the 150 patients, 87(58%) were euthyroid, 30 (20%) hypothyroid at 1 year after treatment, and 33 patients (22%) had persistent hyperthyroidism and required second treatment. The patients who had persistent hyperthyroidism were younger in age, had larger thyroid glands, some of them had thyroid nodules and 27 patients (81%) pretreatment with anti-thyroid drugs for more than 6 months. Our results showed that the majority of patients with Graves' hyperthyroidism had a effective treatment. However, 22% of patients with younger age, larger thyroid glands, patients with thyroid nodules and who had anti-thyroid drugs for more than 6 months had undergone repeated treatment. A higher dose of I-131 maybe advisable in such patients. In order to establish correct treatment dose we may need more precise dosimetry study. (author)

  11. Weight gain in patients after therapy for hyperthyroidism | Brunova ...

    African Journals Online (AJOL)

    Objective. To determine the prevalence of obesity following therapy for hyperthyroidism and to assess the contributing factors associated with an undesirable weight gain. Design. A retrospective analysis was undertaken of clinical records for 160 hyperthyroid patients attending an endocrine clinic in Bloemfontein (1994 ...

  12. Hyperthyroidism and thyroid cancer risk: a population-based cohort study.

    Science.gov (United States)

    Yeh, N-C; Chou, C-W; Weng, S-F; Yang, C-Y; Yen, F-C; Lee, S-Y; Wang, J-J; Tien, K-J

    2013-07-01

    Thyroid hormones regulate the rate of metabolism and affect the differentiation and growth of many tissues in the body. We investigated the association between hyperthyroidism and cancer risk in Taiwan. A random sample of 1 000 000 individuals from Taiwan's National Health Insurance database was enrolled. We found 17 033 patients to have newly diagnosed hyperthyroidism between 2000 and 2005. These patients were recruited along with a match cohort of 34 066 patients without hyperthyroidism. Starting from index date, we followed up all patients for 4 years to identify those who developed cancer. During the 4-year follow-up study, cancer was diagnosed in 1.23% of patients with hyperthyroidism and 1.02% of the member of the comparison cohort. Regression analysis showed that patients with hyperthyroidism were at greater risk of cancer incidence, especially thyroid cancer, compared the comparison cohort (HR: 1.213; 95% CI: 1.022-1.440; phyperthyroidism remained at increased risk of cancer incidence and thyroid cancer (Adjusted HR: 1.206; 95% CI: 1.015-1.433 and 6.803; 95% CI: 3.584-12.91, respectively) (both phyperthyroidism, the greater the risk of thyroid cancer. This 4-year follow up study suggests that patients with hyperthyroidism are at increased risk of cancer, especially thyroid cancer. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  13. Speech and language delay in two children: an unusual presentation of hyperthyroidism.

    Science.gov (United States)

    Sohal, Aman P S; Dasarathi, Madhuri; Lodh, Rajib; Cheetham, Tim; Devlin, Anita M

    2013-01-01

    Hyperthyroidism is rare in pre-school children. Untreated, it can have a profound effect on normal growth and development, particularly in the first 2 years of life. Although neurological manifestations of dysthyroid states are well known, specific expressive speech and language disorder as a presentation of hyperthyroidism is rarely documented. Case reports of two children with hyperthyroidism presenting with speech and language delay. We report two pre-school children with hyperthyroidism, who presented with expressive speech and language delay, and demonstrated a significant improvement in their language skills following treatment with anti-thyroid medication. Hyperthyroidism must be considered in all children presenting with speech and language difficulties, particularly expressive speech delay. Prompt recognition and early treatment are likely to improve outcome.

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

    Directory of Open Access Journals (Sweden)

    I.V. Pankiv

    2016-03-01

    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.

  15. [Conservative treatment of hyperthyroidism (author's transl)].

    Science.gov (United States)

    Schumm, P M; Usadel, K H; Schulz, F; Schumann, J; Schöffling, K

    1981-01-09

    Antithyroid medication was given to 158 patients with hyperthyroidism over a period of 3 to 60 months. After cessation of therapy patients were followed up for 18 to 90 months. Permanent euthyroidism was seen in 70 patients (44.3%) after stopping treatment, however, 88 patients (55.7%) showed recurrence of hyperthyroidism occurring 1 to 56 months after ceasing treatment. In more than 50% recurrence of hyperthyroidism was within the first 3 months and in almost 80% within the first year after end of treatment. There was no connection either between the length of thyrostatic treatment and the recurrence rate or between the length of treatment and recurrence time. Comparison of patients with and without recurrence according to various parameters prior, during and after thyrostatic treatment indicates that there is a high risk of recurrence in patients with 1) nodular and (or) large goitres, 2) marked clinical symptomatology and delayed attainment of a euthyroid state after starting conservative treatment, and 3) the symptom of sweating remaining uninfluenced by antithyroid treatment.

  16. Effects of Hyperthyroidism on Coronary Artery Disease: A Computed Tomography Angiography Study.

    Science.gov (United States)

    Beyer, Christoph; Plank, Fabian; Friedrich, Guy; Wildauer, Matthias; Feuchtner, Gudrun

    2017-10-01

    Changes in thyroid hormone concentration can negatively affect the cardiovascular system. Subclinical hyperthyroidism has been linked to an increase of cardiovascular heart disease, however, clinical effects and significance are still uncertain. Therefore, we analyzed coronary computed tomography angiographies of patients with overt and subclinical hyperthyroidism for quantitative parameters and plaque morphology. Seven hundred forty-four (47.1% female) patients who underwent coronary computed tomography angiography were stratified into 3 groups: 51 patients with overt, 74 patients with subclinical hyperthyroidism, and 619 patients with euthyroidism. Analysis included grades of stenosis (no stenosis = 0, mild 70%) and plaque types (noncalcified, mixed, and calcified), segment involvement score (SIS), noncalcified SIS, and high-risk plaque features (napkin ring sign, low attenuation plaque, spotty calcifications, positive remodelling). Patients with overt and subclinical hyperthyroidism had more high-grade stenoses (39.2% vs 37.8% vs 24.2%; P = 0.007) and a higher coronary calcium score (456.5 vs 199.5 vs 155.9; P hyperthyroidism, followed by those with subclinical hyperthyroidism, had the most high-risk plaque features: napkin ring (21.6% vs 9.5% vs 6.0%, P hyperthyroid patients. Patients with subclinical and overt hyperthyroidism showed more high-grade coronary stenoses, plaque burden, and high-risk plaque features than patients with euthyroidism, which indicates that an increase of thyroid hormones might lead to coronary vascular degeneration and plaque instability. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  17. Prevalence of and risk factors for feline hyperthyroidism in South Africa.

    Science.gov (United States)

    McLean, Joanne L; Lobetti, Remo G; Mooney, Carmel T; Thompson, Peter N; Schoeman, Johan P

    2017-10-01

    Objectives Hyperthyroidism is a disorder of older cats that may have a geographical variation in prevalence. Prevalence studies have not yet been performed in South Africa, a geographical area where hyperthyroidism in cats has recently been observed and where, reportedly, the incidence appears to be increasing. The purpose of this study was to determine the prevalence of feline hyperthyroidism in South Africa and to identify any potential risk factors. Further information on the worldwide prevalence and possible causative factors would increase our understanding of the aetiology of this disease and help identify any preventive measures. Methods Serum total thyroxine (tT4) and canine thyroid-stimulating hormone (cTSH) were measured in 302 cats aged 9 years and older that were presented at various veterinary clinics throughout South Africa. In cats with equivocal tT4 and undetectable cTSH values, serum free thyroxine (fT4) was also measured. At the time of blood sampling a questionnaire was completed regarding vaccination history, internal and external parasite control, diet and environment. Results Prevalence of hyperthyroidism (tT4 >50 nmol/l or tT4 between 30 and 50 nmol/l with TSH 50 pmol/l) was 7% (95% confidence interval 4.4-10.4), with no significant difference between healthy (5%) and sick (8%) cats. Cats ⩾12 years of age (odds ratio [OR] 4.3, P = 0.02) and cats eating canned food (OR 2.1, P = 0.1) were more likely to be diagnosed with hyperthyroidism. No significant relationship between vaccinations, parasite control or indoor environment and hyperthyroidism was observed. Hyperthyroid cats were more likely to present with weight loss (OR 3.2, P = 0.01) and with a heart rate ⩾200 beats per min (OR 5, P = 0.01) than cats without the disease. Conclusions and relevance Hyperthyroidism does not appear to be uncommon in the South African cat population. Risk factors for hyperthyroidism, specifically older age and eating canned food, were present in this as in

  18. Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area.

    Science.gov (United States)

    Bree, Laura; Gallagher, Barbara A; Shiel, Robert E; Mooney, Carmel T

    2018-01-01

    Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T 4 ) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T 4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre ( P  weight loss ( P  hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant ( P  hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.

  19. Embolic Risk in Atrial Fibrillation that Arises from Hyperthyroidism

    Science.gov (United States)

    Traube, Elie; Coplan, Neil L.

    2011-01-01

    Atrial fibrillation, the most common cardiac complication of hyperthyroidism, occurs in an estimated 10% to 25% of overtly hyperthyroid patients. The prevalence of atrial fibrillation increases with age in the general population and in thyrotoxic patients. Other risk factors for atrial fibrillation in thyrotoxic patients include male sex, ischemic or valvular heart disease, and congestive heart failure. The incidence of arterial embolism or stroke in thyrotoxic atrial fibrillation is less clear. There are many reports of arterial thromboembolism associated with hyperthyroidism, including cases of young adults without coexisting risk factors other than thyrotoxic atrial fibrillation. The use of anticoagulative agents to prevent thromboembolic sequelae of thyrotoxic atrial fibrillation is controversial: national organizations provide conflicting recommendations in their practice guidelines. Herein, we review the medical literature and examine the evidence behind the recommendations in order to determine the best approach to thromboembolic prophylaxis in patients who have atrial fibrillation that is associated with hyperthyroidism. PMID:21720457

  20. Hyperthyroidism and Graves' disease: Is an ultrasound examination needed?

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Varadhan

    2016-01-01

    Full Text Available Aim: The aim of our study was to assess the limitation of clinical examination in determining the morphology of thyroid gland in patients with hyperthyroidism and its implications. Methods: A retrospective analysis of consecutive patients with hyperthyroidism seen in a tertiary endocrine clinic were analyzed. Sub-analysis was performed on patients with proven Graves' disease. Results: Of the 133 patients included in this study with hyperthyroidism, 60 (45% patients had significant nodularity on ultrasound (US. However, only 67% of these were identified on clinical examination. In patients with confirmed Graves' disease (n = 73, the discordance between US and clinical examination was very similar (18 of 30 patients, 60%. Conclusion: US should form an essential part of the evaluation of hyperthyroidism as the morphology of thyroid gland could be variable and nodules in these glands would also need to be appropriately investigated. This would also significantly influence decision-making and appropriate immediate and follow-up management plan.

  1. 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.

  2. Effects of hyperthyroidism on the rectus muscles in mice

    Directory of Open Access Journals (Sweden)

    Chyong Jy eNien

    2010-11-01

    Full Text Available Background: Structural details of vertebrate extraocular muscles (EOMs have shown an anatomically and functionally distinct laminar organization into an outer orbital (OL and an inner global layer (GL. Since hyperthyroidism alters tissue oxidative metabolism through mitochondrial enzymes, it is expected that structural/mitochondrial changes may be seen in hyperthyroid EOMs. We investigated the alterations in the laminar organization and mitochondrial changes in hyperthyroid mouse EOMs. Methods: Hyperthyroidism was induced in C57BL/6 mice and fresh rectus muscles were obtained to identify functional mitochondria using MitoTracker® Green and confocal microscopy; frozen sections from rectus muscles were stained with anti-rabbit Troponin T (selectively present in the OL to demonstrate changes in the OL and GL of the EOMs. Ultrastructural features of EOMs were studied using transmission electron microscopy (TEM.Results: Of all 4 rectus EOMs studied, the maximum change was seen in the inferior rectus muscle (IR followed by medial rectus (MR. Myofiber cross sectional area measurements and Troponin T staining in the control IR EOMs demonstrated a smaller OL (113.2 ± 3.66 μm2 and higher density staining with Troponin T (90% and a larger GL (411 ± 13.84 μm2 with low intensity staining (10%, while hyperthyroidism resulted in an increased OL (205.9 ± 5.3 μm2 and decreased GL (271.7 ± 7.5 μm2 p=0.001. Confocal microscopy demonstrated an intense staining especially in the outer rims in the hyperthyroid IR which was confirmed by TEM showing structural alterations in the mitochondria and a subsarcolemmal migration. Conclusions: The outer, thinner, orbital layer (OL of the mouse EOM contains smaller diameter myofibers and fewer mitochondria while the inner, larger global layer (GL contains larger diameter myofibers and larger density of mitochondria. Hyperthyroidism results in a significant alteration in the laminar organization and mitochondria of

  3. Intractable diarrhea in hyperthyroidism: management with beta-adrenergic blockade.

    Science.gov (United States)

    Bricker, L A; Such, F; Loehrke, M E; Kavanaugh, K

    2001-01-01

    To describe a patient with intractable diarrhea and thyrotoxic Graves' disease, for whom b-adrenergic blockade ultimately proved to be effective therapy for the diarrhea, and to review the types of hyperthyroidism-associated diarrhea. We present the clinical course of a young man with a prolonged siege of diarrhea that proved elusive to diagnostic inquiries and resistant to all means of management until its endocrine basis was discovered. Control of such cases with b-adrenergic blockade is discussed, as are the pathophysiologic bases of intestinal hypermotility in hyperthyroidism. A 26-year-old man with Down syndrome, and no prior gastrointestinal disorder, had insidious, chronic, constant diarrhea, which was associated with loss of 14 kg during a 5-month period. Numerous laboratory and imaging studies and endoscopic examinations failed to disclose the cause of the diarrhea. Furthermore, a broad range of antibiotics and other empiric remedies failed to control the problem. No other symptoms of hyperthyroidism were reported, but when the endocrinopathy was suspected and identified, the diarrhea was promptly controlled by treatment with propranolol. In patients with hyperthyroidism, two types of diarrheal disorders have been described-secretory diarrhea and steatorrhea; bile acid malabsorption may have a role in either of these settings. In addition to its capacity for blocking the peripheral effects of thyroid hormone on the heart and central nervous system, b-adrenergic blockade is effective in slowing intestinal transit time and ameliorating the uncommon diarrhea associated with hyperthyroidism. Thyroid hormone in excess, among its other possible effects on the gastrointestinal tract, may exert a stimulatory effect by means of intermediary sympathetic activation, as it does with the heart. Thus, sympathetic blockade can mimic the salutary effects on the gastrointestinal tract conventionally brought about by direct antithyroid therapy, and well before the

  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. Treatment of subclinical hyperthyroidism

    DEFF Research Database (Denmark)

    Mark, Peter D; Andreassen, Mikkel; Petersen, Claus L

    2015-01-01

    PURPOSE: The aim of this study was to investigate structure and function of the heart in subclinical hyperthyroidism (SH) before and after obtaining euthyroidism by radioactive iodine treatment, using high precision and observer-independent magnetic resonance imaging (MRI) technology. METHODS...

  6. 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.

  7. Unstable Angina with Normal Coronary Angiography in Hyperthyroidism: A Case Report

    OpenAIRE

    Tsung-Hsien Lin; Ho-Ming Su; Wen-Chol Voon; Wen-Ter Lai; Sheng-Hsiung Sheu

    2005-01-01

    Hyperthyroidism is associated with an increase in myocardial oxygen consumption that, due to an imbalance of oxygen demand and supply, can cause angina. However, subclinical hyperthyroidism rarely presents as chest pain in the resting state. Herein, we present a case of subclinical hyperthyroidism involving a 58-year-old male who complained of frequent chest tightness and typical electrocardiographic changes while in a resting state. Coronary angiography showed no significant lesion. Laborato...

  8. Percutaneous transvenous mitral commissurotomy in patients with mitral stenosis and coexistent hyperthyroidism.

    Science.gov (United States)

    Wang, P W; Hung, J S; Fu, M; Yeh, K H; Wu, J J

    1996-01-01

    Percutaneous transvenous mitral commissurotomy (PTMC) was performed successfully without complications in 3 patients with severe mitral stenosis and hyperthyroidism. All 3 patients had pliable, noncalcified mitral valves. One patient who had been treated with methimazole for 6 months was still in a hyperthyroid state when she presented with intractable congestive heart failure and was found to have severe mitral stenosis. The heart failure improved immediately after PTMC, but the patient remained in New York Heart Association functional class 2 until a euthyroid state was achieved with I131 therapy. In the other 2 patients, hyperthyroidism was unsuspected at the time of PTMC. Unexpectedly suboptimal symptom improvement led to the diagnosis of hyperthyroidism 1 month after the intervention. In all 3 patients, PTMC resulted in an immediate hemodynamic and clinical improvement. However, complete clinical improvement occurred only when euthyroid state was achieved after antithyroid treatment. The present study suggests that PTMC is a safe and effective intervention modality in patients with coexisting hyperthyroidism and severe mitral stenosis. The procedure may be considered a therapeutic option in patients with hyperthyroidism and severe mitral stenosis.

  9. Plasmatic endothelin-1 levels in hyperthyroid patients before and after antithyroid therapy.

    Science.gov (United States)

    Cesareo, R; Tarabuso, A; Di Benedetto, M; Lacerna, F; Reda, G

    2000-03-01

    The Endothelin-1 (ET-1) is a powerful vasoconstrictor peptide produced by endothelial cells in many vascular diseases probably as a response to vessel damage. In hyperthyroidism as in other endocrinological diseases elevated ET-1 plasma levels have been found. The effect of antithyroid therapy on ET-1 plasmatic levels was evaluated by measuring ET-1 plasma levels before and 2 and 6 months after treatment with methimazole in 14 patients affected by hyperthyroidism. The hyperthyroid patients had significantly higher ET-1 levels than the controls (18.85 +/- 5.7 vs 10.9 +/- 2.1 pg/ml), while after treatment no difference was found. The ET-1 plasma levels of hyperthyroid patients correlated closely with the raised thyroid metabolic activity independently of its cause. It is possible that the increased ET-1 levels in hyperthyroid patients are the expression of blood vessel damage caused by high thyroid hormone levels. Moreover the results of this study could suggest that, in future, ET-1 plasmatic levels might be considered as a functional thyroid index in hyperthyroid diseases.

  10. Pulmonary hypertension and isolated right heart failure complicating amiodarone induced hyperthyroidism.

    Science.gov (United States)

    Wong, Sean-Man; Tse, Hung-Fat; Siu, Chung-Wah

    2012-03-01

    Hyperthyroidism is a common side effect encountered in patients prescribed long-term amiodarone therapy for cardiac arrhythmias. We previously studied 354 patients prescribed amiodarone in whom the occurrence of hyperthyroidism was associated with major adverse cardiovascular events including heart failure, myocardial infarction, ventricular arrhythmias, stroke and even death [1]. We now present a case of amiodarone-induced hyperthyroidism complicated by isolated right heart failure and pulmonary hypertension that resolved with treatment of hyperthyroidism. Detailed quantitative echocardiography enables improved understanding of the haemodynamic mechanisms underlying the condition. Copyright © 2011 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  11. 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.

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

    Science.gov (United States)

    Aksoy, Duygu Yazgan; Gedik, Arzu; Cinar, Nese; Soylemezoglu, Figen; Berker, Mustafa; Gurlek, Omer Alper

    2013-11-01

    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.

  13. Radioiodine treatment for complicated hyperthyroidism using a fixed dose regime

    International Nuclear Information System (INIS)

    Paul, A.K.; Rahman, S.H.; Ansari, S.M.

    2005-01-01

    Full text: Hyperthyroidism in the elderly and all those with cardiovascular and psychiatric problem has increased mortality and morbidity rate. These patients need special care to cure the disease promptly and permanently for avoidance of complications. Radioactive I-131 is one of the accepted forms of treatment for hyperthyroidism and increasingly being considered for the patients in whom rapid and permanent control of disease is desirable. To evaluate the success of I-131 to cure disease in-patients with complicated hyperthyroidism, we prospectively studied the outcome of radioiodine therapy using a fixed dose regime. Ninety-three patients with toxic diffuse goitre (65 female, 28 male) age ranging from 29-67 years (mean ? SD 41.35 ? 11.02 years) were evaluated. The subjects included 71 cases with cardiovascular problem, 13 elderly patients, 5 with poor drug compliance and 4 with associated psychiatric disease. The individual was excluded from the study who had autonomous toxic nodule. Every patient was pre-treated with antithyroid drugs for 4 weeks and the drug was discontinued for 3 days before administering I-131. No patients had post-treatment antithyroid drugs. All the patients were treated with a fixed oral dose of 15 mCi I-131 sodium iodide. Post-treatment follow-up examinations were done at 6 weeks without biochemical tests, at 3 months, 6 months, 9 months and 1 year and then annually with biochemical tests. Patients were classified as cured if the biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. Of the 93 cases, 82 patients became euthyroid or hypothyroid requiring no further treatment for hyperthyroidism with an overall cure of 88.17%. Hypothyroidism was developed in 49 (52.69%) patients at one year of whom 39 became hypothyroid within 6 months and another 10 patients within 1 year. 4 patients were subclinical hyperthyroid at 6 months and still hyperthyroid at 9 months. 7

  14. How Does Subclinical Hyperthyroidism Affect Right Heart Function and Mechanics?

    Science.gov (United States)

    Tadic, Marijana; Celic, Vera; Cuspidi, Cesare; Ilic, Sanja; Zivanovic, Vladimir; Marjanovic, Tamara

    2016-02-01

    Right heart function and mechanics have not been investigated in patients with subclinical hyperthyroidism. Our aim was to investigate right ventricular (RV) and right atrial (RA) function and deformation as evaluated by 3-dimensional echocardiography (3DE) and speckle-tracking 2-dimensional echocardiography (2DE) in these individuals. We included 39 untreated women with endogenous subclinical hyperthyroidism and 39 healthy women matched by age. All participants underwent laboratory analyses that included thyroid hormone levels and comprehensive 2DE and 3DE examinations. Three-dimensional echocardiographic RV volumes were significantly elevated in the patients with subclinical hyperthyroidism (P < .05), whereas the 3DE RV ejection fraction was reduced in this group, but with borderline significance. Two-dimensional echocardiographic longitudinal RV and RA strain were significantly reduced in the patients with subclinical hyperthyroidism. Two-dimensional echocardiographic RV systolic and early diastolic strain rates were reduced, whereas late diastolic strain rates were increased in the patients with subclinical hyperthyroidism. The same changes were detected in RA mechanics among the patients with subclinical hyperthyroidism. The thyrotropin (TSH) level correlated with the left ventricular mass index, transmitral early diastolic peak flow velocity (E)/late diastolic flow velocity (A) ratio, tricuspid E/A ratio, 2DE RV global strain, 2DE RA, strain, and 3DE RV end-diastolic volume. A multivariate regression analysis showed that the mitral E/A ratio, 2DE RV global strain, and 3DE RV end-diastolic volume were independently associated with the TSH level. Right ventricular and RA function as evaluated by 3DE and speckle-tracking 2DE is significantly impaired in patients with subclinical hyperthyroidism. The TSH level correlated with parameters for RV function and mechanics in the whole study population. © 2016 by the American Institute of Ultrasound in Medicine.

  15. Morbidity before and after the Diagnosis of Hyperthyroidism: A Nationwide Register-Based Study

    Science.gov (United States)

    Brandt, Frans; Thvilum, Marianne; Almind, Dorthe; Christensen, Kaare; Green, Anders; Hegedüs, Laszlo; Brix, Thomas Heiberg

    2013-01-01

    Background 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 and after the diagnosis of hyperthyroidism. Methods Observational cohort study. From nationwide Danish health registers 2631 hyperthyroid singletons and 375 twin pairs discordant for hyperthyroidism were identified and followed for an average of 6 years (range 0–13). Data on the occurrence of cardiovascular diseases, lung diseases, diabetes mellitus, rheumatic diseases and malignant diseases was obtained by person-to-person record linkage with the National Danish Patient Register and/or the Danish National Prescription Registry (lung diseases and diabetes mellitus). Logistic and Cox regression models were used to assess the risk of morbidity before and after the diagnosis of hyperthyroidism, respectively. All Cox regression analyses were adjusted for the degree of co-morbidity preceding the diagnosis of hyperthyroidism, using the Charlson score. Results Hyperthyroid individuals had a significantly higher risk of being diagnosed with cardiovascular diseases (odds ratio (OR) 1.65; 95% confidence interval (CI): 1.45–1.87), lung diseases (OR 1.53; 95% CI: 1.29–1.60), and diabetes mellitus (OR 1.43, 95% CI: 1.20–1.72), but not with malignant diseases (OR 1.16, 95% CI: 0.99–1.36) prior to the diagnosis of hyperthyroidism. After the diagnosis of hyperthyroidism, subjects had a significantly higher risk of being diagnosed with cardiovascular diseases (hazard ratio (HR) 1.34; 95% CI: 1.15–1.56), lung diseases (HR 1.28; 95% CI: 1.10–1.49), and diabetes mellitus (HR 1.46; 95% CI: 1.16–1.84), but not with rheumatic diseases (HR 1.39, 95% CI: 0.92–2.09) or malignant diseases (HR 1.18, 95% CI 0.97–1.42). Conclusions We demonstrate a significantly increased

  16. Diagnosis and management of feline hyperthyroidism: current perspectives

    OpenAIRE

    Grauer, Gregory F; Schermerhorn,Thomas; Armbrust,Laura; Vaske,Heather

    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. Subclinical hyperthyroidism: to treat or not to treat?

    OpenAIRE

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

    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 hyperthyroidism, for example, effects on heart and bone mass, are discussed. Guidelines for treatment are given, based on expert opinion.

  18. [Iatrogenic hyperthyroidism secondary to weight loss medication. Predictive factors for their precocious detention].

    Science.gov (United States)

    Goday, A; Recasens, A; Manresa, J M; Vila, J; Moix, S

    1998-05-01

    To establish the differential clinical characteristics between the Iatrogenic hyperthyroidism for not conventional medication for obesity treatment (weight losers) and the endogenous by Graves Basedow disease. Observational and analytical study, populational based, in the one which prospectively were compared cases with Iatrogenic hyperthyroidism (secondary to weight losers) with those with endogenous hyperthyroidism (Graves Basedow disease) as controls. Consisted of the variable clinical record of 100 correlative patients that consulted in specialized attention of endocrinology for Iatrogenic hyperthyroidism secondary to weight losers and for Graves Basedow disease. The differences observed between Iatrogenic hyperthyroidism (secondary to weight losers) (n = 43) as compared to endogenous hyperthyroidism (Graves Basedow disease) (n = 57) were: smaller age (31.8 +/- 10 as compared to 37.8 +/- 12.6 years), greater body mass index (27.6 +/- 7.2 as compared to 23.4 +/- 3.1), smaller goiter frequency (16.3% as compared to 84.2%) as well as absence of signs of ophthalmopathy (0% as compared to 57.9%). Both groups had low levels of TSH, and the difference rests in the values of free T4, low in the first group and increased in the endogenous hyperthyroidism. The odds ratio were: IMC > 27: 3.92 (0.91-16.72), age weight losers use was not selective of the first group, being detected in a 12.3% of cases of endogenous hyperthyroidism, though in periods of time remoter in relationship to the beginning of the clinic. In the differential diagnosis of a case of hyperthyroidism, it can be suspected Iatrogenic hyperthyroidism (secondary to weight losers) for medication for the obesity in patients of the feminine sex with overweight, without previous or familiar history of thyroid disease, and in those which in the physical exploration is not verified goiter neither ophthalmopathy.

  19. 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.

  20. Mitral valve prolapse and hyperthyroidism: effect of patient selection.

    Science.gov (United States)

    Zullo, M A; Devereux, R B; Kramer-Fox, R; Lutas, E M; Brown, W T

    1985-11-01

    Patients with mitral valve prolapse and hyperthyroidism have common symptoms; the most outstanding symptom is palpitation. To determine whether or not common symptoms contributed to the reported association of these conditions, we evaluated 220 patients with symptomatic mitral valve prolapse and 216 first-degree relatives in 72 families; 65 relatives with mitral valve prolapse and 151 relatives without mitral valve prolapse, all greater than or equal to 16 years of age. Thirty subjects, aged 49 +/- 13 years (p less than 0.025 vs entire study group), had thyroid disease (23 subjects had definite thyroid disease, seven subjects had probable); 27 of 30 subjects with thyroid disease (90%) were female (p less than 0.005). The age- and sex-adjusted prevalence of hyperthyroidism was significantly higher in probands with mitral valve prolapse than in family members without mitral valve prolapse (3.5% vs 0%, p = 0.03), while an intermediate prevalence of hyperthyroidism (2.2%) was observed in family members with mitral valve prolapse. Thus, the prevalence of hyperthyroidism is increased among symptomatic patients with mitral valve prolapse as compared to family members without mitral valve prolapse, but the prevalence of thyroid conditions is similar among family members with or without this condition. These findings are explained by the effect of common symptoms on clinical detection of both mitral valve prolapse and hyperthyroidism.

  1. Hyperthyroidism presenting as isolated tricuspid regurgitation and right heart failure.

    Science.gov (United States)

    Whitner, Tanya E; Hudson, Christopher J; Smith, Timothy D; Littmann, Laszlo

    2005-01-01

    Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolution of tricuspid incompetence on echocardiography. In a case of isolated, unexplained tricuspid regurgitation, it is important to consider indolent hyperthyroidism in the differential diagnosis.

  2. Nursing of patients with hyperthyroidism treated by using iodine-131

    International Nuclear Information System (INIS)

    Chen Dongju; Cao Guoxiang

    2002-01-01

    Hyperthyroidism was a common endocrine disease, its clinic treatment mainly include anti thyroid drug treatment, surgical operation and iodine-131 therapy. The latter have unique superiority, which was adapted by clinic doctors. The nursing method was distinguished from that of others because the principle of iodine-131 therapy was different from other therapy in course of the treatment of hyperthyroidism. Combining the nursing experiences with related documents, this article was about to sum up briefly the nursing and matters needing attention in course of treatment of iodine-131 in patients with hyperthyroidism

  3. Advances in assessment, diagnosis, and treatment of hyperthyroidism in children.

    Science.gov (United States)

    Amer, Kim Siarkowski

    2005-04-01

    The thyroid gland is responsible for regulating multiple complex metabolic processes that affect most organs. Physical growth and cognitive development are dependent on proper levels of thyroid hormone. This article will review common challenges in the diagnosis of hyperthyroidism in children, the approaches to treatment, and the nursing interventions guided toward child and family responses to thyroid disease. A comparison of signs and symptoms of hypothyroidism and hyperthyroidism is also included. The nursing interventions addressed in the article integrate the biological, psychological, social, and environmental stresses and adaptations necessary to cope with hyperthyroid disease.

  4. Weight loss and severe jaundice in a patient with hyperthyroidism.

    Science.gov (United States)

    Breidert, M; Offensperger, S; Blum, H E; Fischer, R

    2011-09-01

    Thyrotoxicosis may significantly alter hepatic function and is associated with autoimmune disorders of the liver. We report the case of a thyrotoxic patient with Graves' disease and histologically established cholestatic hepatitis. Medical treatment of hyperthyroidism normalized liver function tests. In patients with elevated liver function parameters and jaundice of unknown origin, thyroid function should generally be tested. Moreover, medical treatment of hyperthyroidism with thyrostatics may cause severe hepatitis whereas untreated hyperthyroid patients are at risk of developing chronic liver failure. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Consequences of hyperthyroidism in male and female fertility: pathophysiology and current management.

    Science.gov (United States)

    Mintziori, G; Kita, M; Duntas, L; Goulis, D G

    2016-08-01

    Thyroid hormone acts on the oocytes, sperm and embryo during fertilization, implantation and placentation. Both hypothyroidism and hyperthyroidism may influence fertility. However, evidence of the association of hyperthyroidism with infertility is scarce and sometimes conflicting. Thyroid hormone influences human reproduction via a variety of mechanisms at both the central and the peripheral level. Infertility may occur in hyperthyroid men and women, but it is usually reversible upon restoration of euthyroidism. This review aims to summarize the available data on the association of hyperthyroidism and infertility in both men and women and to provide practical suggestions for the management of these patients.

  6. 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.

  7. Dietary hyperthyroidism in dogs.

    Science.gov (United States)

    Köhler, B; Stengel, C; Neiger, R

    2012-03-01

    Evaluation of dogs with elevated plasma thyroxine concentration fed raw food before and after changing the diet. Between 2006 and 2011 all dogs presented with an elevated plasma thyroxine concentration and a dietary history of feeding raw food were included. Thyroxine (reference interval: 19·3 to 51·5 nmol/L) and in many cases also thyroid-stimulating hormone concentrations (reference interval: weight loss, aggressiveness, tachycardia, panting and restlessness while six dogs had no clinical signs. After changing the diet eight dogs were examined: thyroxine concentration normalised in all dogs and clinical signs resolved. Dietary hyperthyroidism can be seen in dogs on a raw meat diet or fed fresh or dried gullets. Increased plasma thyroxine concentration in a dog, either with or without signs of hyperthyroidism, should prompt the veterinarian to obtain a thorough dietary history. © 2012 British Small Animal Veterinary Association.

  8. Hyperthyroidism and radioactive iodine

    International Nuclear Information System (INIS)

    Corstens, F.H.M.

    1980-01-01

    The study details the results of treatment of patients with hyperthyroidism using a combination of fractionated low doses radioactive iodine and anthithyroid drug therapy. The patients studied were treated according to this regimen after August 1968 and all reached euthyroidism before March 1979. None of the patients had been treated with radioactive iodine prior to the start of the protocol. A subgroup of the patients had received an unsuccessfull course with antithyroid drug therapy and, or, surgical therapy before the start of the protocol. Patients who had never been treated for hyperthyroidism were given antithyroid drug therapy for at least 6 months in an attempt to reach euthryroidism without the use of 131 I therapy. Therefore, all patients had experienced a course of unsuccessfull therapy prior to the start of the treatment protocol using combined fractionated low doses of 131 I and antithyroid drug therapy. (Auth.)

  9. Role of the renin-angiotensin system in cardiac hypertrophy induced in rats by hyperthyroidism

    OpenAIRE

    KOBORI, HIROYUKI; ICHIHARA, ATSUHIRO; SUZUKI, HIROMICHI; TAKENAKA, TSUNEO; MIYASHITA, YUTAKA; HAYASHI, MATSUHIKO; SARUTA, TAKAO

    1997-01-01

    This study was conducted to examine whether the renin-angiotensin system contributes to hyperthyroidism-induced cardiac hypertrophy without involving the sympathetic nervous system. Sprague-Dawley rats were divided into control-innervated, control-denervated, hyperthyroid-innervated, and hyperthyroid-denervated groups using intraperitoneal injections of thyroxine and 6-hydroxydopamine. After 8 wk, the heart-to-body weight ratio increased in hyperthyroid groups (63%), and this increase was onl...

  10. 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.

  11. Iodine-induced hyperthyroidism in a patient with a normal thyroid gland.

    OpenAIRE

    Shilo, S.; Hirsch, H. J.

    1986-01-01

    Iodine-induced hyperthyroidism can develop even in the presence of an otherwise normal gland. One of the less common sources of iodine is tablets of seaweed, sold over the counter without prescription. We report the case of a 72 year old female who developed clinical and laboratory evidence of hyperthyroidism while ingesting sea-kelp (Vitalia) tablets. Six months after stopping the tablets, the symptoms and laboratory evidence of hyperthyroidism had disappeared. No evidence of pre-existing th...

  12. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study.

    Science.gov (United States)

    Yuan, Lili; Tian, Yanghua; Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction.

  13. 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.

  14. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study

    Science.gov (United States)

    Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Introduction Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Methods Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Results Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Conclusions Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction. PMID:26090955

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

    Science.gov (United States)

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

    2009-01-01

    Psychiatric symptoms have been reported quite frequently in certain thyroid diseases, but more frequently in association with hypothyroidism. Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. Psychotic symptoms in the context of hyperthyroidism typically present as an affective psychosis. 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. We present the case of young woman who was followed over 2 years and who initially presented to psychiatric consultation for depressive symptoms, after being diagnosed with hyperthyroidism and specific therapy instituted, but who developed psychotic symptoms.

  16. 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

  17. Assessment of bone metabolism in premenopausal females with hyperthyroidism and hypothyroidism.

    Science.gov (United States)

    Tuchendler, Dominika; Bolanowski, Marek

    2013-01-01

    Osteoporosis is one of the commonest metabolic diseases of bone. Its possible causes may include thyroid hormonal dysfunction. The objective of this study was to evaluate the effects of hyperthyroidism and hypothyroidism on osseous tissue metabolism in premenopausal women. 38 women with hyperthyroidism, 40 with hypothyroidism and 41 healthy women participated in this study. Initially after 6 and 12 months, each patient underwent selected hormonal, immunological and biochemical tests, measurement of concentrations of bone turnover markers and densitometry were also performed. On initial evaluation, lower cortical bone density was found in patients with hyperthyroidism (femoral neck). After 12 months, an increase in BMD was seen, but it was still lower than in the control group. Statistically significantly higher concentrations of bone turnover markers, decreasing from the sixth month of treatment, were noted only in the group with hyperthyroidism. Statistically significant differences were not noted in the femoral neck nor in the lumbar spine BMD in patients with hypothyroidism. Hyperthyroidism poses a negative effect on bone metabolism. Hypothyroidism in premenopausal females does not have any influence on bone density.

  18. Radioiodine therapy of hyperthyroidism at 25 years experience in Vietnam

    International Nuclear Information System (INIS)

    Mai Trong Khoa; Phan Sy An; Phan Van Duyet; Tran Dinh Ha

    2004-01-01

    In Vietnam, hyperthyroidism is a common problem with a local prevalence of 1.48%, higher in females (1.78%) and 1.19% in males. Radioiodine (I-131) is used successfully since more than 60 years in the world and more than 20 years in Vietnam for treatment of hyperthyroidism. Hyperthyroidism can be due to Graves' disease (diffuse toxic goiter); toxic multinodular goiter and solitary toxic nodule; thyroiditis; iodine - induced hyperthyroidism (Job-Basedow's disease)... In Vietnam, the most common cause of hyperthyroidism is toxic diffuse goiter. There are 3 main Methods for treatment of hyperthyroidism: antithyroid drug; surgery; radioiodine. In our country, less than half of the patients with hyperthyroidism are treated primarily with radioiodine in recent years. Since 1978, 13226 patients with hyperthyroidism (1784 males and 11442 females) have been treated and have been followed-up at the Nuclear Medicine Departments in other parts of Vietnam (North, Middle, South Vietnam). After treatment with I-131, these patients were followed up at 3 to 4 months interval for the first year and 6 to 12 monthly henceforth. The average dose of I-131 was 6.8 ± 1.9 mCi. Out of the 13226 patients, 5216 (39.4%) became clinically hypothyroid, 7841 (59.3 %) were euthyroid and 169 (1.3%) remained hyperthyroidism.Administration of a single dose resulted in control of thyrotoxicosis in 9911 (74.9%) patients. 2581 (19.5%) patients required 2 doses and a further 734 (5.5%) needed 3 doses of 1-131.At the end of the first year, 511 (3.9%) of patients were clinically hypothyroid. From the second to tenth year, there was a 2.2% annual increase in incidence of hypothyroidism. From the eleventh year on wards, the incidence of hypothyroidism was 1% per year. There was no significant difference in prevalence of hypothyroidism at the time of review in patients treated with a single dose and those requiring repeated treatment (p>0.05). There was no statistically significant difference in the

  19. [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.

  20. Cholestasis and Acute Cholecystitis in Hyperthyroidism Treated With Methimazole

    OpenAIRE

    Chen, Wei-Che; Zhu, Zheng-Xin; Wang, Chao-Hung; Chien, Ming-Nan

    2009-01-01

    Hepatic dysfunction and jaundice are usually present in patients with hyperthyroidism. It may be the clinical manifestation of the disease or the adverse effect of antithyroid therapy. We report a 69-year-old male with hyperthyroidism who developed cholestasis and acute cholecystitis after a 4-day course of methimazole. After withdrawal of methimazole, his cholestasis subsided.

  1. Cholestasis and Acute Cholecystitis in Hyperthyroidism Treated With Methimazole

    Directory of Open Access Journals (Sweden)

    Wei-Che Chen

    2009-12-01

    Full Text Available Hepatic dysfunction and jaundice are usually present in patients with hyperthyroidism. It may be the clinical manifestation of the disease or the adverse effect of antithyroid therapy. We report a 69-year-old male with hyperthyroidism who developed cholestasis and acute cholecystitis after a 4-day course of methimazole. After withdrawal of methimazole, his cholestasis subsided.

  2. Hyperthyroidism in a population with Down syndrome (DS).

    Science.gov (United States)

    Goday-Arno, Alberto; Cerda-Esteva, Mariaina; Flores-Le-Roux, Juana Antonia; Chillaron-Jordan, Juan José; Corretger, Josep Maria; Cano-Pérez, Juan Francisco

    2009-07-01

    Thyroid disorders are frequent in patients with Down syndrome (DS). It is well-known that the prevalence of hypothyroidism is high but data on hyperthyroidism are scarce. To assess the prevalence, aetiology, clinical characteristics, evolution and treatment of hyperthyroidism in a population with DS attending a specialized medical centre. Data were gathered by systematic review of 1832 medical records from the Catalan DS Foundation, in Spain, registered between January 1991 and February 2006. Patients with the diagnosis of hyperthyroidism were identified and data on clinical features, physical examination, laboratory and imaging tests, treatment and evolution were collected. Twelve patients with hyperthyroidism were recorded (6.5 cases/1000 patients with DS). There were 5 males and 7 females, with a mean age at diagnosis of 16.8 years. The most common presenting symptoms were decreased heat tolerance, sweating, increased irritability and weight loss. All patients had diffuse goitre at physical examination and two patients presented with exophthalmia. Clinical diagnosis was confirmed biochemically. Thyroid-stimulating immunoglobulin levels were raised (mean 128.1 U/l) and imaging tests confirmed the diagnosis of Graves' disease in all cases. Patients started treatment with carbimazole at diagnosis and after a mean period of 40 months without clinical remission, they required definitive therapy with radioactive iodine. Subjects developed hypothyroidism after radio-iodine therapy and replacement therapy with levothyroxine was necessary. Hyperthyroidism is more prevalent in patients with DS than in the general population and has no gender predominance. It is caused mainly by Graves' disease. Anti-thyroid drugs were not effective in achieving remission and radioactive iodine as a definitive treatment was required in all cases.

  3. Amiodarone induced pneumonitis and hyperthyroidism: case report.

    Science.gov (United States)

    Grabczak, Elzbieta Magdalena; Zielonka, Tadeusz M; Wiwała, Joanna; Bareła, Anna Dagmara; Opuchlik, Andrzej; Potulska, Anna; Ambroziak, Urszula; Chazan, Ryszarda

    2008-09-01

    Amiodarone is a highly effective antiarrhythmic agent used in life-threatening ventricular and supraventricular arrhythmias. Its long-term use may however lead to several adverse effects, including corneal deposits, liver and thyroid gland dysfunction, lung lesions, bone marrow injury, skin lesions, or neurological abnormalities. The article presents the case of a 56-year-old man with a history of a stroke, who after a few days of amiodarone therapy for an episode of atrial fibrillation was diagnosed with amiodarone-induced hyperthyroidism and interstitial pulmonary lesions. Clinical and laboratory symptoms of hyperthyroidism and radiographic signs of pulmonary involvement did not occur until several weeks after discontinuation of amiodarone therapy. Differential diagnosis of causes of hyperthyroidism and diseases causing nodular pulmonary lesions did not demonstrate any other pathologies. Empirical antibiotic therapy and administration of thiamazole and high doses of propranolol failed to improve the patient's clinical status. It was not until thiamazole was given in combination with glucocorticosteroids, when a slow relief of hyperthyroidism symptoms and resolution of radiographic pulmonary signs were observed. Based on the presented case, the risk of appearance of 2 serious concomitant adverse effects was demonstrated, even following a short-term amiodarone therapy. This paper also contains an overview of adverse effects which may be encountered during or after therapy with this effective antiarrhythmic agent. It was emphasized how important it is to select patients appropriately, and to monitor potential adverse effects during amiodarone therapy.

  4. Effects of 131I therapy on blood borne leucocytes in hyperthyroid patients

    International Nuclear Information System (INIS)

    Lundell, G.

    1975-01-01

    The different types of circulating leucocytes were examined in 54 patients before and 2 to 4 months after 131 I therapy for hyperthyroidism. An absolute and differential percentage increase in the number of juvenile segmented neutrophils, eosinophilic and basophilic granulocytes was demonstrated in the patients free from signs of hyperthyroidism after therapy. This increase was statistically significant. No changes occurred in the 11 patients remaining hyperthyroid. (author)

  5. 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.

  6. 131I-iodine treatment of hyperthyroidism in children and adolescents

    International Nuclear Information System (INIS)

    Zhao Deshan

    2004-01-01

    Purpose: To evaluate the efficacy of 131 I-iodine treatment of hyperthyroidism in children and adolescents. Methods: Twenty-nine, patients aged 11-18 years (mean 15.9±2.32 years old), with hyperthyroidism received 131 I-iodine treatment in a dose of 25-90μCi/g (median 50μCi/g) of thyroid. Of the 29 patients, 3 patient required 2 doses, 14 received ATD therapy before 131 I, 11 patients suffered from TAO(thyroid associated ophthalmopathy). The total maximum and minimum doses were 15 and 1.6 mCi respectively. Results: All patients treated with 131 I-iodine, follow-up after the most recent treatment (median 14, range 4 to 60 months), 15 patients were euthyroid, 5 suffered from late-onset hypothyroidism, 9 were still hyperthyroidism, but their symptoms and signs of hyperthyroidism were improved or markedly. Of the 16 patients with TAO, TAO in 11 patients disappeared or were improved, TAO in 5 patients didn't or mildly change. The size of thyroid in all patients had largely been reduced. Conclusions: 131 I-iodine is effective for initial treatment of hyperthyroidism, the treatment of medical treatment failures and the patients with TAO in children and adolescents. (authors)

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

    Directory of Open Access Journals (Sweden)

    Joanne L. McLean

    2014-11-01

    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.

  8. The management of hyperthyroidism. A surgeon's perspective

    International Nuclear Information System (INIS)

    Falk, S.A.

    1990-01-01

    Surgery for the treatment of hyperthyroidism is rapid and permanent, highly safe, and highly successful and has an important and complementary role with medical therapy and 131 I. In Grave's disease cases total thyroidectomy, performed only if parathyroid glands are preserved, prevents recurrent hyperthyroidism. Bilateral subtotal thyroidectomy or total lobectomy with contralateral subtotal lobectomy are done if at least one parathyroid cannot be preserved on each side. In terms of recurrent laryngeal nerve preservation, all three operations are equally safe if the nerve is positively identified and traced throughout its course. 91 references

  9. Severe fetal and neonatal hyperthyroidism years after surgical treatment of maternal Graves' disease.

    Science.gov (United States)

    Dierickx, I; Decallonne, B; Billen, J; Vanhole, C; Lewi, L; De Catte, L; Verhaeghe, J

    2014-02-01

    Fetal/neonatal hyperthyroidism is a well-known complication of maternal Graves' disease with high concentrations of TSH-receptor antibodies (TRAb). Few data are available on the management of fetal hyperthyroidism in surgically treated Graves' disease. Clinical, ultrasound and biochemical data are reported in a fetus/neonate whose mother underwent a thyroidectomy > 10 years before and whose sibling was thin and hyperthyroid at birth. Maternal TRAb were persistently > 40 U/l; unequivocal signs of fetal hyperthyroidism were identified at 29 weeks gestational age (GA). The fetus was treated through maternal antithyroid drug (ATD) administration; the dose was reduced gradually once fetal tachycardia and valve dysfunction disappeared and normal T4 was confirmed by fetal blood sampling. Maternal euthyroidism was maintained. The neonate showed normal growth for GA and T4 concentration at birth but severe hyperthyroidism relapsed from day 13 until day 58. TSH remained strongly suppressed throughout the pre- and postnatal course. Prenatal ATD in a taper-off regime allowed normal T4 and growth in a hyperthyroid fetus from a thyroidectomised Graves' mother. Fetal TSH cannot be used to adjust the ATD dose. Prenatal ATD appears to postpone the onset but does not affect the severity or duration of the neonatal hyperthyroid flare.

  10. Sclerostin Blockade and Zoledronic Acid Improve Bone Mass and Strength in Male Mice With Exogenous Hyperthyroidism.

    Science.gov (United States)

    Tsourdi, Elena; Lademann, Franziska; Ominsky, Michael S; Rijntjes, Eddy; Köhrle, Josef; Misof, Barbara M; Roschger, Paul; Klaushofer, Klaus; Hofbauer, Lorenz C; Rauner, Martina

    2017-11-01

    Hyperthyroidism in mice is associated with low bone mass, high bone turnover, and high concentrations of sclerostin, a potent Wnt inhibitor. Here, we explored the effects of either increasing bone formation with sclerostin antibodies (Scl-Ab) or reducing bone turnover with bisphosphonates on bone mass and strength in hyperthyroid mice. Twelve-week-old C57BL/6 male mice were rendered hyperthyroid using l-thyroxine (T4; 1.2 µg/mL added to the drinking water) and treated with 20 mg/kg Scl-Ab twice weekly or 100 µg/kg zoledronic acid (ZOL) once weekly or phosphate-buffered saline for 4 weeks. Hyperthyroid mice displayed a lower trabecular bone volume at the spine (-42%, P hyperthyroid mice increased trabecular bone volume at the spine by threefold and twofold, respectively. Serum bone formation and resorption markers were increased in hyperthyroid mice and suppressed by treatment with ZOL but not Scl-Ab. Trabecular bone stiffness at the lumbar vertebra was 63% lower in hyperthyroid mice (P hyperthyroidism, was increased by Scl-Ab by 71% and ZOL by 22% (both P hyperthyroid mice was restored by treatment with Scl-Ab and ZOL. Thus, bone-forming and antiresorptive drugs prevent bone loss in hyperthyroid mice via different mechanisms. Copyright © 2017 Endocrine Society.

  11. Evaluation of Serum Thyroid-Stimulating Hormone Concentration as a Diagnostic Test for Hyperthyroidism in Cats.

    Science.gov (United States)

    Peterson, M E; Guterl, J N; Nichols, R; Rishniw, M

    2015-01-01

    In humans, measurement of serum thyroid-stimulating hormone (TSH) concentration is commonly used as a first-line discriminatory test of thyroid function. Recent reports indicate that canine TSH (cTSH) assays can be used to measure feline TSH and results can help diagnose or exclude hyperthyroidism. To investigate the usefulness of cTSH measurements as a diagnostic test for cats with hyperthyroidism. Nine hundred and seventeen cats with untreated hyperthyroidism, 32 euthyroid cats suspected of having hyperthyroidism, and 131 clinically normal cats. Prospective study. Cats referred to the Animal Endocrine Clinic for suspected hyperthyroidism were evaluated with serum T4, T3, free T4 (fT4), and TSH concentrations. Thyroid scintigraphy was used as the gold standard to confirm or exclude hyperthyroidism. Median serum TSH concentration in the hyperthyroid cats (hyperthyroid cats had measurable TSH concentrations (≥0.03 ng/mL), whereas 114 (69.9%) of the 163 euthyroid cats had detectable concentrations. Combining serum TSH with T4 or fT4 concentrations lowered the test sensitivity of TSH from 98.0 to 97.0%, but markedly increased overall test specificity (from 69.9 to 98.8%). Serum TSH concentrations are suppressed in 98% of hyperthyroid cats, but concentrations are measurable in a few cats with mild-to-moderate hyperthyroidism. Measurement of serum TSH represents a highly sensitive but poorly specific test for diagnosis of hyperthyroidism and is best measured in combination with T4 and fT4. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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

    OpenAIRE

    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 h...

  13. 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.

  14. GLP-1 and GIP Levels in Patients With Hyperthyroidism: The Effect of Antithyroid Treatment.

    Science.gov (United States)

    Cira, Duygu Kalkan; Sari, Ramazan; Ozdem, Sebahat; Yilmaz, Nusret; Bozkurt, Selen

    2017-08-01

    Incretin hormones (glucagon-like peptide-1 [GLP-1] and gastric inhibitory polypeptide [GIP]) may play a role in the development of glucose intolerance and hyperglycemia in patients with hyperthyroidism. We aimed to assess both incretin levels and treatment-induced changes in incretin levels in those with hyperthyroidism. A total of 24 subjects (12 with hyperthyroidism and 12 healthy) were enrolled in the study. Oral glucose tolerance test was performed and serum glucose, insulin GLP1, and GIP levels were evaluated at 0 (baseline), 30, 60, 90, and 120 minutes using ELISA. Measurements were repeated after euthyroidism was reached in subjects with hyperthyroidism. The baseline glucose level was higher in those with hyperthyroidism compared with controls ( P = 0.03). GLP-1 and GIP responses to oral glucose load did not differ significantly between those with hyperthyroidism and controls. Peak GLP-1 and GIP levels were reached in both groups at 60 and 90 minutes, respectively. Areas under the curve (AUCs) for GLP1 and GIP were similar in those with hyperthyroidism and controls. Although GLP-1 and GIP levels did not change before and after antithyroid treatment in subjects with hyperthyroidism, time to peak GLP-1 and GIP levels were reached at 30 minutes after euthyroid state was achieved. Reversal of hyperthyroid to euthyroid status did not induce significant changes in AUCs for incretins. The findings of the present study suggest that the total incretin response to oral glucose load is preserved in patients with hypertyhroidism, but peak incretin responses may change after achieving euthyroid state.

  15. Activation of adenosine A(1) receptors alters behavioral and biochemical parameters in hyperthyroid rats.

    Science.gov (United States)

    Bruno, Alessandra Nejar; Fontella, Fernanda Urruth; Bonan, Carla Denise; Barreto-Chaves, Maria Luiza M; Dalmaz, Carla; Sarkis, João José Freitas

    2006-02-28

    Adenosine acting on A(1) receptors has been related with neuroprotective and neuromodulatory actions, protection against oxidative stress and decrease of anxiety and nociceptive signaling. Previous studies demonstrated an inhibition of the enzymes that hydrolyze ATP to adenosine in the rat central nervous system after hyperthyroidism induction. Manifestations of hyperthyroidism include increased anxiety, nervousness, high O(2) consumption and physical hyperactivity. Here, we investigated the effects of administration of a specific agonist of adenosine A(1) receptor (N(6)-cyclopentyladenosine; CPA) on nociception, anxiety, exploratory response, locomotion and brain oxidative stress of hyperthyroid rats. Hyperthyroidism was induced by daily intraperitoneal injections of l-thyroxine (T4) for 14 days. Nociception was assessed with a tail-flick apparatus and exploratory behavior, locomotion and anxiety were analyzed by open-field and plus-maze tests. We verified the total antioxidant reactivity (TAR), lipid peroxide levels by the thiobarbituric acid reactive species (TBARS) reaction and the free radicals content by the DCF test. Our results demonstrated that CPA reverted the hyperalgesia induced by hyperthyroidism and decreased the exploratory behavior, locomotion and anxiety in hyperthyroid rats. Furthermore, CPA decreased lipid peroxidation in hippocampus and cerebral cortex of control rats and in cerebral cortex of hyperthyroid rats. CPA also increased the total antioxidant reactivity in hippocampus and cerebral cortex of control and hyperthyroid rats, but the production of free radicals verified by the DCF test was changed only in cerebral cortex. These results suggest that some of the hyperthyroidism effects are subjected to regulation by adenosine A(1) receptor, demonstrating the involvement of the adenosinergic system in this pathology.

  16. [Surgical Diagnosis and Treatment of Primary Hyperthyroidism Complicated with Occult Thyroid Carcinoma].

    Science.gov (United States)

    Wu, Xin; Yu, Jian-chun; Kang, Wei-ming; Ma, Zhi-qiang; Ye, Xin

    2015-08-01

    To evaluate the surgical diagnosis and treatment of primary hyperthyroidism complicated with occult thyroid carcinoma. Data of 51 cases of primary hyperthyroidism complicated with occult thyroid carcinoma admitted during January 2004 to November 2014 were analyzed retrospectively. The incidence of occult thyroid carcinoma was 5.03% in hyperthyroidism,and 47 cases (92.16%) were female. The preoperative diagnosis of all these 51 cases was primary hyperthyroidism and 11 cases were diagnosed thyroid carcinoma at the same time;25 cases were diagnosed thyroid carcinoma by frozen section and the remaining 26 cases were diagnosed by postoperative pathology. Finally,26 cases underwent subtotal thyroidectomy,4 cases underwent total thyroidectomy, and 21 cases underwent total thyroidectomy with lymphadenectomy. The tumor size ranged from 0.1 to 1.0 cm [mean:(0.63 ± 0.35) cm]. The lesions were less than or equal to 0.5 cm in 28 cases (54.9%). The follow-up lasted from 1 to 121 months [mean:(28.6 ± 22.7)months] in 43 patients,and all of them survived. Primary hyperthyroidism complicated with occult thyroid carcinoma is commonly found in female patients. Preoperative diagnosis is difficult. Ultrasound is the major examining method. Frozen section can increase the detection rate. The postoperative prognosis of hyperthyroidism complicated with occult thyroid carcinoma is satisfactory.

  17. Hypothyroidism and hyperthyroidism and breast cancer risk: a nationwide cohort study.

    Science.gov (United States)

    Søgaard, Mette; Farkas, Dóra Körmendiné; Ehrenstein, Vera; Jørgensen, Jens Otto Lunde; Dekkers, Olaf M; Sørensen, Henrik Toft

    2016-04-01

    The association between thyroid disease and breast cancer risk remains unclear. We, therefore examined the association between hypothyroidism, hyperthyroidism and breast cancer risk. This was a population-based cohort study. Using nationwide registries, we identified all women in Denmark with a first-time hospital diagnosis of hypothyroidism or hyperthyroidism, 1978-2013. We estimated the excess risk of breast cancer among patients with hypothyroidism or hyperthyroidism compared with the expected risk in the general population, using standardized incidence ratios (SIRs) as a measure of risk ratio. Breast cancer diagnoses in the first 12 months following diagnosis of thyroid disease were excluded from the calculations to avoid diagnostic work-up bias. We included 61, 873 women diagnosed with hypothyroidism and 80, 343 women diagnosed with hyperthyroidism. Median follow-up time was 4.9 years (interquartile range (IQR): 1.8-9.5 years) for hypothyroidism and 7.4 years (IQR: 3.1-13.5 years) for hyperthyroidism. Hyperthyroidism was associated with a slightly increased breast cancer risk compared with the general population (SIR: 1.11, 95% CI: 1.07-1.16), which persisted beyond 5 years of follow-up (SIR: 1.13, 95% CI: 1.08-1.19). In comparison, hypothyroidism was associated with a slightly lower risk of breast cancer (SIR: 0.94, 95% CI: 0.88-1.00). Stratification by cancer stage at diagnosis, estrogen receptor status, age, comorbidity, history of alcohol-related disease and clinical diagnoses of obesity produced little change in cancer risk. We found an increased risk of breast cancer in women with hyperthyroidism and a slightly decreased risk in women with hypothyroidism indicating an association between thyroid function level and breast cancer risk. © 2016 European Society of Endocrinology.

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

    International Nuclear Information System (INIS)

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

    1986-01-01

    Hypothyroxinemia and hypertriiodothyroninemia may occur in the course of antithyroid drug or 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

  19. Subclinical hyperthyroidism due to a thyrotropin receptor (TSHR) gene mutation (S505R).

    Science.gov (United States)

    Pohlenz, Joachim; Pfarr, Nicole; Krüger, Silvia; Hesse, Volker

    2006-12-01

    To identify the molecular defect by which non-autoimmune subclinical hyperthyroidism was caused in a 6-mo-old infant who presented with weight loss. Congenital non-autoimmune hyperthyroidism is caused by activating germline mutations in the thyrotropin receptor (TSHR) gene. Therefore, the TSHR gene was sequenced directly from the patient's genomic DNA. Molecular analysis revealed a heterozygous point mutation (S505R) in the TSHR gene as the underlying defect. A constitutively activating mutation in the TSHR gene has to be considered not only in patients with severe congenital non-autoimmune hyperthyroidism, but also in children with subclinical non-autoimmune hyperthyroidism.

  20. Testicular effects of 131radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Ceccarelli, Claudia; Canale, Domenico; Carolina, Caglieresi; Moschini, Cecilia; Grasso, Lucia; Pinchera, Aldo; Vitti, Paolo

    2005-01-01

    Full text: Little data is available on possible untoward effects of 131 I therapy for hyperthyroidism on gonad male function. FSH, LH, Total Testosterone(T), Inhibin B and spermiogram were evaluated in 15 hyperthyroid males (mean age 38.5+/-6.7 years, m +/- SD) before, and at day 45, month 3, 6 and 12 after 131 I therapy. Mean basal FSH was 5.6 +/- 3.8 mU/ml. After 131 I, FSH remained unchanged in 13 patients. In two, one of whom with basal FSH in the upper normal limits (16.4 mU/ml), a mild increase was observed after therapy. Basal LH and T were in normal range and did not vary significantly after 131 I, but T/LH ratio significantly decreased at month 3 and 6 (basal: 1.34 +/- 0.6; month 3: 0.85 +/- 0.3, p=0.02, month 6: 0.8 +/- 0.1, p= 0.06). Basal Inhibin B values did not vary significantly after 131 I. Basal mean sperm concentration did not differ from that found in a control group of 20 normal men (51.0 +/- 6.9 x 106 E/ml, vs. 57.6 +/- 7.5 x 106 E/ml) and did not vary significantly after 131 I therapy. Sperm progressive motility (SPM) was 39.1+/-4.7 % in hyperthyroid patients and 54.4 +/- 1.8 % in the controls (p=0.02). Ten patients (67%) were asthenospermic (SPM 131 I treatment of hyperthyroidism may account for a marginal and transient damage of Leydig cells, as highlighted by T/LH ratio. The lower SPM and increased theratospermia observed in patients before treatment could be due to hyperthyroidism per se, as suggested by the normalization of SPM in 5/10 patients after therapy. (author)

  1. Effects of Arginase Inhibition in Hypertensive Hyperthyroid Rats.

    Science.gov (United States)

    Rodríguez-Gómez, Isabel; Manuel Moreno, Juan; Jimenez, Rosario; Quesada, Andrés; Montoro-Molina, Sebastian; Vargas-Tendero, Pablo; Wangensteen, Rosemary; Vargas, Félix

    2015-12-01

    This study analyzed the effects of chronic administration of N[omega]-hydroxy-nor-l-arginine (nor-NOHA), an inhibitor of arginase, on the hemodynamic, oxidative stress, morphologic, metabolic, and renal manifestations of hyperthyroidism in rats. Four groups of male Wistar rats were used: control, nor-NOHA-treated (10 mg/kg/day), thyroxine (T4)-treated (75 μg/rat/day), and thyroxine- plus nor-NOHA-treated rats. All treatments were maintained for 4 weeks. Body weight, tail systolic blood pressure (SBP), and heart rate (HR) were recorded weekly. Finally, morphologic, metabolic, plasma, and renal variables were measured. Arginase I and II protein abundance and arginase activity were measured in aorta, heart, and kidney. The T4 group showed increased arginase I and II protein abundance, arginase activity, SBP, HR, plasma nitrates/nitrites (NOx), brainstem and urinary isoprostanes, proteinuria and cardiac and renal hypertrophy in comparison to control rats. In hyperthyroid rats, chronic nor-NOHA prevented the increase in SBP and HR and decreased proteinuria in association with an increase in plasma NOx and a decrease in brainstem and urinary isoprostanes. In normal rats, nor-NOHA treatment did not significantly change any hemodynamic, morphologic, or renal variables. Acute nor-NOHA administration did not affect renal or systemic hemodynamic variables in normal or T4-treated rats. Hyperthyroidism in rats is associated with the increased expression and activity of arginase in aorta, heart, and kidney. Chronic arginase inhibition with nor-NOHA suppresses the characteristic hemodynamic manifestations of hyperthyroidism in association with a reduced oxidative stress. These results indicate an important role for arginase pathway alterations in the cardiovascular and renal abnormalities of hyperthyroidism. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. [The evaluation of selected oxidative stress parameters in patients with hyperthyroidism].

    Science.gov (United States)

    Andryskowski, Grzegorz; Owczarek, Tomasz

    2007-07-01

    Hyperthyroidism induces the acceleration of the basic metabolism and increases cellular oxygen utilization, consequently intensifies reactive oxygen species production and disturbs the oxidant-antioxidant balance. The objective of this study was to evaluate the selected oxidative stress parameters in patients with hyperthyroidism by analysis of the reactive oxygen species neutralizing enzymes activity--superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase (CAT), the estimation of free radical processes intensity--concentration of malondialdehyde (MDA), sulfhydryl groups (SH) in proteins and by quantification of the serum total antioxidant status (TAS). . Twenty-seven patients treated for hyperthyroidism and 12 healthy individuals were enrolled in the study. Enzyme activity (SOD, GSHPx, CAT), MDA and concentration of SH groups were analysed in erythrocytes, while TAS was measured in serum. Patients with hyperthyroidism compared with healthy subjects were characterized by a higher GSHPx activity in erythrocytes, lower serum TAS, the lower content of SH groups in proteins and the lower MDA concentration in erythrocytes. Our results suggest that hyperthyroidism increases oxidative stress and disturbs oxidant-antioxidant balance in the body. Thyreostatic treatment, if not leads to whole metabolic compensation, may only reduce oxidant-antioxidant disorders, however is not able to eliminate them entirely.

  3. Comparison of propranolol and practolol in the management of hyperthyroidism.

    Science.gov (United States)

    Murchison, L E; Bewsher, P D; Chesters, M I; Ferrier, W R

    1976-04-01

    Twenty-one hyperthyroid patients participated in an 8-week double-blind crossover trial of propranolol and practolol, and the effecte of these drugs on the clinical and metabolic features of the disease were studied. Propranolol was marginally more effective than practolol, as measured by the hyperthyroid diagnostic index and anxiety scale. Propranolol produced a significant reduction in the serum concentration ratio of tri-iodothyronine to thyroxine, compatible with partial inhibition of peripheral deiodination of thyroxine. Adverse reactions occurred more frequently with propranolol than with practolol. In veiw of the efficacy of practoloo, further trials in hyperthyroid patients of newer beta1-adrenoceptor antagonists, preferably without partial agonist activity, are indicated.

  4. [Severe neonatal hyperthyroidism which reveals a maternal Graves' disease].

    Science.gov (United States)

    Guérin, B; Vautier, V; Boin-Gay, V; Estrade, G; Choulot, J-J; Doireau, V

    2004-04-01

    Two of every thousand pregnancies are complicated by Graves' disease. Diagnosis is suggested by maternal disorders (tachycardia, exophthalmia, weight loss.) or fetal disorders (tachycardia, intra-uterine growth retardation, preterm birth.). Due to transfer into the fetal compartment of maternal antibodies which stimulate the fetal thyroid by binding to the thyroid thyrotropin (TSH) receptor, only 1% of children born to these mothers are described as having hyperthyroidism. Neonatal thyrotoxicosis disappears with clearance of the maternal antibodies; clinical signs usually disappear during the first four Months of life. The most frequent neonatal clinical signs of thyrotoxicosis are tachycardia, goiter, hyperexcitability, poor weight gain, hepatosplenomegaly, stare and eyelid retraction. Diagnosis is based on determination of the blood level of triiodothyronine (T3), thyroxine (T4) and TSH. To confirm the nature of hyperthyroidism, thyroid-stimulating immunoglobulins (TSI) should be assayed. The kinetics of TSI provides a guide for therapeutic adaptation and disappearance of TSI is a sign of recovery. Rare cases of familial non-autoimmune hyperthyroidism have been shown to be caused by germline mutation of the thyrotropin receptor. We report a case of severe neonatal hyperthyroidism which led to the diagnosis of maternal Graves' disease.

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

    International Nuclear Information System (INIS)

    Sahlmann, C.O.; Siefker, U.; Lehmann, K.; Harms, E.; Conrad, M.; Meller, J.

    2004-01-01

    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 99m TcO 4 - offered rapid and reliable differentiation between hyperthyroid GD and AIT. (orig.)

  6. Fixed dose of I-131 therapy for the treatment of Graves' hyperthyroidism

    International Nuclear Information System (INIS)

    Li Lin; Lee, K.

    2004-01-01

    Objectives: To evaluate short-term (6 month) efficacy of fixed-dose (555 MBq, 15 mCi) approach in the treatment of Graves' hyperthyroidism and analyze the relationship between clinical outcome (hyperthyroidism, hypothyroidism, and euthyroidism) and variances (patient age, thyroid weight, absorbed activity per gram of thyroid tissue, and radioactive iodine uptake value). Methods: 38 patients of Graves' hyperthyroidism were treated with 555MBq of radioactive iodine (in the form of capsule). Follow-up was done 3 and 6 months post therapy and the following clinical outcome was monitored: persistent hyperthyroidism, hypothyroidism, and euthyroidism. Statistical analysis was performed with SPSS software (version 11.5). P<0.05 was taken as indicating a statistically significant effect. Results: Of the 38 subjects, 14 (36.8%) were identified as euthyroidism, 18 (47.4%) hypothyroidism, and 6 (15.8%) hyperthyroidism. Cure rate (euthyroidism+hypothyroidism) was 84.2%. Statistical analysis revealed that there is a statistically significant difference of absorbed activity per gram of thyroid tissue and thyroid weight (F=17.639, P=0.000; F=28.453, P=0.000), but there is no statistically significant difference in terms of patient age and RAIU (F=1.375, P-0.266; F=2.453, P=0.101) among euthyroidism, hypothyroidism, and hyperthyroidism patients. Conclusion: We concluded that fixed-dose approach is very effective in the quickly restoration of thyroid function. There is a statistically significant difference of absorbed activity per gram of thyroid tissue and thyroid weight, but there is no statistically significant difference in terms of patient age and RAIU among euthyroidism, hypothyroidism, and hyperthyroidism patients. (authors)

  7. Clinical significance of determination of plasma ADM concentrations in hyperthyroid patients complicated with pulmonary hypertension

    International Nuclear Information System (INIS)

    Wang Kaiqin; Zhang Jing

    2006-01-01

    Objective: To investigate the plasma adrenomedullin (ADM) concentrations in hyperthyroid patients with or without pulmonary hypertension. Methods: Plasma ADM levels were measured with RIA in: (1) 30 hyperthyroid patients without pulmonary hypertension, (2) 27 hyperthyroid patients with pulmonary, hypertension, and (3) 32 controls. Results: (1) In this study, 27 of the 57 hyperthyroid patients were complicated with pulmonary hypertension (47.37%), (2) Plasma ADM concentrations in the patients with pulmonary hypertension were significantly higher than those in patients without pulmonary hypertension and controls (P 3 , T 4 (thyroid hormones) were positively correlated with those of ADM while there were no correlations in controls. Conclusion: Plasma ADM concentrations increased in hyperthyroid patients, especially in those complicated with pulmonary hypertension. The clinicians should look for pulmonary hypertension in hyperthyroid patients with substantially elevated levels of ADM. (authors)

  8. [Changes in the blood picture in hyperthyroidism].

    Science.gov (United States)

    Hambsch, K; Herrmann, F; Fischer, H; Langpeter, D; Mäller, P; Sorger, D

    1989-05-15

    On the basis of a retrospective study about 276 clinically and paraclinically ascertained cases of hyperthyroidism in 34% of the patients above all mild anaemias could be proved which under thyreostatic therapy with thiamazol which after repeated incidence of an euthyroid metabolic situation vastly normalized themselves also without an anaemia-specific additional medication. Leukocytopenias (5.8%) and thrombocytopenias (3.3%) had only a low frequency in untreated hyperthyroidism. Nevertheless an unequivocal parallelity of the haematologic changes was to be observed in erythro-, granulo- and thrombopoiesis. There was a clear correlation between the activity of hyperthyroidism, measured at the T3- or T4 level, and anaemia and haemocytopenia, respectively. Lacking substance deficiency conditions and signs of haemolysis let us first of all think of a causal thyrotoxic bone-marrow damage on account of the dependence of the haematologic changes on the activity of hyperthyroidism and their immediate influencibility by aimed thyrostatic therapy. A relatively low dosed thiamazol therapy has influence on haematopoiesis and peripheral blood picture only at a very small percentage, in which cases the changes mostly are fully reversible. Thereby the initial haematologic situation before the therapy does not provide any predictability for perhaps appearing haematotoxic or allergic side-effects under thyreostatic treatment. The thiamazol therapy does not show any recognizable side-effects in the dosage administered on the investigated leukocytic functions agglomeration, adhesion and phyagocytosis. Only for the adhesion of leukocytes was proved a significant functional disturbance of leukocytes, which was, however, reversible with normalization of metabolism and with high probability was also directly thyreotoxically induced.

  9. Oscillating hypothyroidism and hyperthyroidism – a case-based review

    Directory of Open Access Journals (Sweden)

    WuQiang Fan

    2014-11-01

    Full Text Available Objective/Background: To discuss a unique clinical entity where inappropriate activity of inhibitory and stimulatory thyroid antibodies resulted in alternating hypothyroidism and hyperthyroidism. Methods: We report the clinical history, laboratory data, and results of imaging studies, along with the pathophysiological mechanism and the subsequent treatment in a patient with fluctuating thyroid functional status. Results: A 52-year-old female was treated for hypothyroidism for more than two decades. She started having symptoms of hyperthyroidism along with a suppressed thyroid-stimulating hormone (TSH. She continued to have persistent symptoms despite stopping her levothyroxine. Her free T3 and T4 were elevated along with an increased radioactive uptake scan. She was diagnosed with Graves’ disease and started on methimazole, which relieved her symptoms for a few months. Subsequently, her TSH began to rise beyond expected level, her hypothyroid symptoms reappeared, and methimazole was discontinued. Following this, she again developed symptoms of hyperthyroidism and thyroid values revealed an undetectable TSH. She had at least two such documented cycles of hyperthyroidism alternating with hypothyroidism. She was eventually treated with radioactive iodine ablation followed by levothyroxine replacement. Swinging dominance of TSH-blocking autoantibodies (TBAb and thyroid-stimulating autoantibodies (TSAb triggered by methimazole and levothyroxine, respectively, is likely the underlying mechanism. Conclusions: Physicians should be vigilant to the phenomenon of spontaneous conversion of hypothyroidism to hyperthyroidism, or vice versa, in a subset of patients with autoimmune thyroid disease. Repeated assessment of thyroid function along with measurement of TBAb and TSAb are invaluable in identifying this rare clinical entity.

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

    Science.gov (United States)

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

    2016-12-01

    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. To evaluate the functional changes in papillary muscles isolated from animals with induced hyperthyroidism. 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. 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). 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.

  11. Excess Mortality in Treated and Untreated Hyperthyroidism Is Related to Cumulative Periods of Low Serum TSH.

    Science.gov (United States)

    Lillevang-Johansen, Mads; Abrahamsen, Bo; Jørgensen, Henrik Løvendahl; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2017-07-01

    Cumulative time-dependent excess mortality in hyperthyroid patients has been suggested. However, the effect of antithyroid treatment on mortality, especially in subclinical hyperthyroidism, remains unclarified. We investigated the association between hyperthyroidism and mortality in both treated and untreated hyperthyroid individuals. Register-based cohort study of 235,547 individuals who had at least one serum thyroid-stimulating hormone (TSH) measurement in the period 1995 to 2011 (7.3 years median follow-up). Hyperthyroidism was defined as at least two measurements of low serum TSH. Mortality rates for treated and untreated hyperthyroid subjects compared with euthyroid controls were calculated using multivariate Cox regression analyses, controlling for age, sex, and comorbidities. Cumulative periods of decreased serum TSH were analyzed as a time-dependent covariate. Hazard ratio (HR) for mortality was increased in untreated [1.23; 95% confidence interval (CI), 1.12 to 1.37; P hyperthyroid patients. When including cumulative periods of TSH in the Cox regression analyses, HR for mortality per every 6 months of decreased TSH was 1.11 (95% CI, 1.09 to 1.13; P hyperthyroid patients (n = 1137) and 1.13 (95% CI, 1.11 to 1.15; P hyperthyroidism, respectively. Mortality is increased in hyperthyroidism. Cumulative periods of decreased TSH increased mortality in both treated and untreated hyperthyroidism, implying that excess mortality may not be driven by lack of therapy, but rather inability to keep patients euthyroid. Meticulous follow-up during treatment to maintain biochemical euthyroidism may be warranted. Copyright © 2017 by the Endocrine Society

  12. [Body weight gain after radioiodine therapy in hyperthyroidism].

    Science.gov (United States)

    Scheidhauer, K; Odatzidu, L; Kiencke, P; Schicha, H

    2002-02-01

    Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas.

  13. Thymolipoma combined with hyperthyroidism discovered by neurological symptoms.

    Science.gov (United States)

    Takahashi, Hidenobu; Harada, Masahiko; Kimura, Masakazu; Kato, Harubumi

    2007-04-01

    Thymolipomas are rare slow-growing mediastinal thymic neoplasms. Most cases are asymptomatic and are sometimes discovered as a huge mass on chest x-ray films. A few cases have been discovered during examinations for other diseases. We report the second case of thymolipoma combined with hyperthyroidism in the English language literature. Neurological symptoms suddenly appeared in a 45-year-old woman. Central nervous system disorder was suggested but no significant abnormalities were found on brain MR nor were there any neurological signs. Several months later, neurological and systemic examinations on admission revealed hyperthyroidism and an anterior mediastinal tumor, 9.0x5.0x3.0 cm in size on chest CT films. Despite treatment of hyperthyroidism by medication, her neurological symptoms remained. Neurologists recommended resection of the mediastinal tumor. Malignancy could not be ruled out because of the irregularity of the tumor appearance on contrast-enhanced chest CT. Furthermore, the tumor appeared to be attached to the ascending aorta, so cytological and/or pathological diagnosis by CT-guided needle biopsy before operation were contraindicated. Extended thymectomy was performed in May 2005. The pathological diagnosis was benign thymolipoma consisting of mature fatty tissue and thymic tissue structures with Hassall's corpuscles. Her neurological symptoms seemed slightly but not markedly improved. The relationship between thymolipoma and hyperthyroidism is still unknown.

  14. 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...

  15. Clinical significance of metabolic superscan in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Kotb, M.; Khalafallah, K.; Omar, W.; El-Maghraby, T.; Grace, G.

    2007-01-01

    Hyperthyroid patients commonly complain of generalized bony aches, which are frequently overlooked due to the more prominent symptoms of cardiovascular and nervous disturbances. Hyperthyroid patients are expected to have abnormal bone metabolism as part of the generalized hypermetabolic status. The aim of this study is to verify the presence of metabolic bone superscan in association with the hypermetabolic stats in various groups of hyperthyroidism. Secondly, to correlate these superscan features with the various laboratory results in hyperthyroid patients. Forty-five hyperthyroid patients confirmed by clinical and laboratory results were enrolled in this work. In all patients, a 99 m T c-pertechnetate thyroid uptake scan was acquired. On a different day, total body bone scan was acquired three hours post IV injection of 555-925 MBq of 99 m T c-MDP. Serum FT3, FT4, TSH, Ca ++ , alkaline phosphatase (AP) and parathyroid hormone (PTH) were monitored in all patients as markers of thyroid and bone metabolism. Ten cases with no thyroid diseases were included as a control group. Patients with thyroiditis or long history of antithyroid drugs for more than one year were excluded from the study. The patients were subdivided into three groups: Graves' disease (GD) (n = 30), toxic nodular goiter (TNG) (n = 10) and autonomous toxic adenoma (AT) (n = 5). The TSH for the whole group was significantly suppressed compared to the control group with higher suppression in the Graves' disease group than in the TNG or AT groups. 99m Tc-pertechnetate uptake values in the Graves' disease group were significantly higher than the TNG and AT groups (p + , AP and PTH between the Graves' and non-Graves' groups (p ≥ 0.05). Disturbances in bone metabolism are more prevalent in Graves' disease than in other types of hyperthyroidism. The addition of the bone scan to the diagnostic work up of patients with Graves' disease is a sensitive indicator for metabolic bone changes and could help in the

  16. New-onset atrial fibrillation is a predictor of subsequent hyperthyroidism: a nationwide cohort study.

    Directory of Open Access Journals (Sweden)

    Christian Selmer

    Full Text Available AIMS: 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. METHODS AND RESULTS: All patients admitted with new-onset AF in Denmark from 1997-2009, and their present and subsequent use of anti-thyroid medication was identified by individual-level linkage of nationwide registries. Patients with previous thyroid diagnosis or thyroid medication use were excluded. Development of hyperthyroidism was assessed as initiation of methimazole or propylthiouracil up to a 13-year period. Risk of hyperthyroidism was analysed by Poisson regression models adjusted for important confounders such as amiodarone treatment. Non-AF individuals from the general population served as reference. A total of 145,623 patients with new-onset AF were included (mean age 66.4 years [SD ±13.2] and 55.3% males of whom 3% (4,620 events; 62.2% women developed hyperthyroidism in the post-hospitalization period compared to 1% (48,609 events; 82% women in the general population (n = 3,866,889. In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population. The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation. The results were confirmed in a substudy analysis of 527,352 patients who had thyroid screening done. CONCLUSION: New-onset AF seems to be a predictor of hyperthyroidism. Increased focus on subsequent risk of hyperthyroidism in patients with new-onset AF is warranted.

  17. New-onset atrial fibrillation is a predictor of subsequent hyperthyroidism: a nationwide cohort study.

    Science.gov (United States)

    Selmer, Christian; Hansen, Morten Lock; Olesen, Jonas Bjerring; Mérie, Charlotte; Lindhardsen, Jesper; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager; Schmidt, Ulla; Faber, Jens; Hansen, Peter Riis; Pedersen, Ole Dyg; Torp-Pedersen, Christian; Gislason, Gunnar Hilmar

    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. All patients admitted with new-onset AF in Denmark from 1997-2009, and their present and subsequent use of anti-thyroid medication was identified by individual-level linkage of nationwide registries. Patients with previous thyroid diagnosis or thyroid medication use were excluded. Development of hyperthyroidism was assessed as initiation of methimazole or propylthiouracil up to a 13-year period. Risk of hyperthyroidism was analysed by Poisson regression models adjusted for important confounders such as amiodarone treatment. Non-AF individuals from the general population served as reference. A total of 145,623 patients with new-onset AF were included (mean age 66.4 years [SD ±13.2] and 55.3% males) of whom 3% (4,620 events; 62.2% women) developed hyperthyroidism in the post-hospitalization period compared to 1% (48,609 events; 82% women) in the general population (n = 3,866,889). In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population. The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation. The results were confirmed in a substudy analysis of 527,352 patients who had thyroid screening done. New-onset AF seems to be a predictor of hyperthyroidism. Increased focus on subsequent risk of hyperthyroidism in patients with new-onset AF is warranted.

  18. New-Onset Atrial Fibrillation Is a Predictor of Subsequent Hyperthyroidism: A Nationwide Cohort Study

    Science.gov (United States)

    Selmer, Christian; Hansen, Morten Lock; Olesen, Jonas Bjerring; Mérie, Charlotte; Lindhardsen, Jesper; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager; Schmidt, Ulla; Faber, Jens; Hansen, Peter Riis; Pedersen, Ole Dyg; Torp-Pedersen, Christian; Gislason, Gunnar Hilmar

    2013-01-01

    Aims 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. Methods and Results All patients admitted with new-onset AF in Denmark from 1997–2009, and their present and subsequent use of anti-thyroid medication was identified by individual-level linkage of nationwide registries. Patients with previous thyroid diagnosis or thyroid medication use were excluded. Development of hyperthyroidism was assessed as initiation of methimazole or propylthiouracil up to a 13-year period. Risk of hyperthyroidism was analysed by Poisson regression models adjusted for important confounders such as amiodarone treatment. Non-AF individuals from the general population served as reference. A total of 145,623 patients with new-onset AF were included (mean age 66.4 years [SD ±13.2] and 55.3% males) of whom 3% (4,620 events; 62.2% women) developed hyperthyroidism in the post-hospitalization period compared to 1% (48,609 events; 82% women) in the general population (n = 3,866,889). In both women and men we found a significantly increased risk of hyperthyroidism associated with new-onset AF compared to individuals in the general population. The highest risk was found in middle-aged men and was consistently increased throughout the 13-year period of observation. The results were confirmed in a substudy analysis of 527,352 patients who had thyroid screening done. Conclusion New-onset AF seems to be a predictor of hyperthyroidism. Increased focus on subsequent risk of hyperthyroidism in patients with new-onset AF is warranted. PMID:23469097

  19. Hyperthyroid and Hypothyroid Status Was Strongly Associated with Gout and Weakly Associated with Hyperuricaemia

    Science.gov (United States)

    See, Lai-Chu; Kuo, Chang-Fu; Yu, Kuang-Hui; Luo, Shue-Fen; Chou, I-Jun; Ko, Yu-Shien; Chiou, Meng-Jiun; Liu, Jia-Rou

    2014-01-01

    Objectives The aim of this study was to estimate the risk of hyperuricaemia and gout in people with hypothyroid or hyperthyroid status. Methods This study analyzed data from individuals who participated in health screening programs at Chang Gung Memorial Hospital in northern Taiwan (2000–2010). Participants were categorized as having euthyroid, hypothyroid, or hyperthyroid status according to their thyroid-stimulating hormone (TSH) levels. Multinomial logistic regression models were used to calculate the odds ratios (95% CI) for hyperuricaemia and gout in participants with thyroid dysfunction compared to euthyroid participants. Results A total of 87,813 (euthyroid, 83,502; hypothyroid, 1,460; hyperthyroid, 2,851) participants were included. The prevalence of hyperuricaemia was higher in hyperthyroid subjects (19.4%) than in euthyroid subjects (17.8%) but not in hypothyroid subjects (19.3%). The prevalence of gout was significantly higher in both hypothyroid (6.0%) and hyperthyroid (5.3%) subjects than in euthyroid subjects (4.3%). In men, hypothyroid or hyperthyroid status was not associated with hyperuricaemia. However, hypothyroid or hyperthyroid status was associated with ORs (95% CI) of 1.47 (1.10–1.97) and 1.37 (1.10–1.69), respectively, for gout. In women, hypothyroid status was not associated with hyperuricaemia or gout. However, hyperthyroid status was associated with ORs (95% CI) of 1.42 (1.24–1.62) for hyperuricaemia and 2.13 (1.58–2.87) for gout. Conclusions Both hyperthyroid and hypothyroid status were significantly associated with gout and weakly associated with hyperuricaemia. A thyroid function test for gout patients may by warranted. PMID:25486420

  20. 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.

  1. [Absence of effect of propranolol on urinary excretion of 3-methylhistidine in hyperthyroidism].

    Science.gov (United States)

    Beylot, M; Riou, J P; Sautot, G; Mornex, R

    Lean body mass and muscle protein breakdown were evaluated in euthyroid and hyperthyroid subjects by measuring the urinary excretion of creatinine and 3-methylhistidine. Since catecholamines probably have an inhibitory effect on muscle protein catabolism through a beta-receptor mechanism, the effects of propranolol on 3-methylhistidine excretion were also evaluated in hyperthyroid subjects. Hyperthyroid subjects had a lower lean body mass (34.9 +/- 6.3 kg versus 47.7 +/- 8.9 kg, p less than 0.001) and a greater 3-methylhistidine excretion (25.1 +/- 7.4 versus 19.0 +/- 4.8 mumol/mmol creatinine, p less than 0.05) than euthyroid subjects. Propranolol administered orally to hyperthyroid subjects decreased pulse rate (p less than 0.01) and plasma triiodothyronine concentrations (from 5.40 +/- 2.28 to 3.61 +/- 1.61 nmol/l, p less than 0.01), but did not modify urinary 3-methylhistidine excretion (24.8 +/- 8.7 versus 25.1 +/- 7.4 mumol/mmol creatinine). These results suggest that muscle wasting in hyperthyroidism is related to increased protein catabolism. This increased protein breakdown is not modified by short term administration of propranolol, a beta-blocking agent widely used in the management of hyperthyroidism.

  2. Hyperthyroidism association with SLE, lessons from real-life data--A case-control study.

    Science.gov (United States)

    Watad, Abdulla; Cohen, Arnon D; Comaneshter, Doron; Tekes-Manova, Dorit; Amital, Howard

    2016-01-01

    Despite the frequently encountered association between thyroid disease and systemic lupus erythematosus (SLE) is well known, it is of surprise that only several reports compromised of small population size support this observation. To investigate the association of comorbid SLE and hyperthyroidism. Using the database of the largest health maintenance organization (HMO) in Israel, the Clalit Health Services, we searched for the co-existence of SLE and hyperthyroidism. Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of hyperthyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study included 5018 patients with SLE and 25,090 age- and sex- matched controls. The prevalence of hyperthyroidism in patients with SLE was increased compared with the prevalence in controls (2.59% and 0.91%, respectively, p hyperthyroidism (odds ratio 2.52, 95% confidence interval 2.028-3.137). Patients with SLE have a greater prevalence of hyperthyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of this possibility of this thyroid dysfunction.

  3. Better adherence to antithyroid drug is associated with decreased risk of stroke in hyperthyroidism patients.

    Science.gov (United States)

    Tsai, M-S; Chuang, P-Y; Huang, C-H; Shih, S-R; Chang, W-T; Chen, N-C; Yu, P-H; Cheng, H-J; Tang, C-H; Chen, W-J

    2015-12-01

    An increased risk for ischaemic stroke has been reported in young hyperthyroidism patients independent of atrial fibrillation (AF). However, whether the use of antithyroid drugs in hyperthyroidism patients can reduce the occurrence of ischaemic stroke remains unclear. A total of 36,510 newly diagnosed hyperthyroidism patients during 2003-2006 were identified from the Taiwan National Health Insurance Research database. Each patient was individually tracked for 5 years from their index date (beginning the antithyroid drugs) to identify those who suffered from new episode of ischaemic stroke. Medication possession ratio (MPR) was used to represent the antithyroid drug compliance. The association between the MPR and the risk of stroke was examined. The stroke incidence rates for hyperthyroidism patients with age hyperthyroidism patients without AF, good antithyroid drugs compliance also reduced the incidence of stroke significantly (adjusted HR, range: 1.52-1.61; p = 0.02); but not in hyperthyroidism with AF. Hyperthyroidism patients with good antithyroid drug compliance had a lower risk of ischaemic stroke than patients with poor compliance. © 2015 John Wiley & Sons Ltd.

  4. Cechy somatyczne i sprawność dzieci i młodzieży z wybranych szkół regionu bydgoskiego = Somatic features and efficiency of children and youth from the selected school of Bydgoszcz region

    OpenAIRE

    Wierzbowski, Łukasz Piotr et al.

    2017-01-01

    Napierała Marek Red., Zukow Walery Red. (2017). Cechy somatyczne i sprawność dzieci i młodzieży z wybranych szkół regionu bydgoskiego = Somatic features and efficiency of children and youth from the selected school of Bydgoszcz region. RSW. Radom. 160 s. ISBN 9781387327102 DOI http://dx.doi.org/10.5281/zenodo.1039563 PBN Poland https://pbn.nauka.gov.pl/sedno-webapp/works/835498 Radomska Szkoła Wyższa w Radomiu ...

  5. [Agranulocytosis and acute coronary syndrome in apathetic hyperthyroidism].

    Science.gov (United States)

    Ivović, Miomira; Radiojković, Biljena; Penezić, Zorana; Stojković, Mirjana; Tancić, Milina; Vujović, Svetlana; Bogdanović, Andrija; Drezgić, Milka

    2003-01-01

    Tissue expose to excessive levels of circulating thyroid hormones results in thyrotoxicosis. In most cases, thyrotoxicosis is due to hyperactivity of the thyroid gland. Cardiovascular and myopathic manifestations are predominant clinical features in most hyperthyroid patients, aged 60 years and older. Some of patients have apathetic hyperthyroidism which presents with weight loss, small goiter, severe depression and without clinical features of increased sympathetic activity [3, 6]. About 50% of patients with cardiovascular manifestations have no evidence of underlying heart disease. Cardiac problems resolve when euthyroid state is established [3]. Three treatment modalities are available in hyperthyroidism, namely medicament therapy, surgery and radioactive iodine. Antithyroid drug therapy complications, can be mild such as rash, which is managed without cessation of therapy by antihistamines administration. On the other hand, very serious complications such as agranulocytosis, necessitate immediate discontinuation of the medication and appropriate treatment. Although extremely rear, it is life-threatening with highly variable recovery time. A 62-year-old woman with recurrent hyperthyroidism was admitted after treatment of agranulocytosis due to antithyroid drugs in another institution with G-CSF. The patient presented with clinical features of apathetic hyperthyroidism with extremely elevated thyroid hormone levels (total and free T4) and suppressed TSH. Radioactive iodine (5 mCi) was administered after increased thyroid uptake was confirmed. Echocardiography on admission was normal. ECG revealed moderately inverted T waves in standard and V1, V2 precordial leads. Laboratory analysis revealed mild normocytic anemia with normal white blood cell count, hypokaliemia and normal concentration of creatine phosphokinase, lactic dehydrogenase and mildly elevated aspartate transminase in sera. Chest X-ray was consistent with pulmonary emphysema. Because the worsening of

  6. Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

    Directory of Open Access Journals (Sweden)

    Nattakarn Suwansaksri

    2018-01-01

    Full Text Available Hyperthyroidism is a common endocrine disease. Although thionamide antithyroid drugs are the cornerstone of hyperthyroidism treatment, some patients cannot tolerate this drug class because of its serious side effects including agranulocytosis, hepatotoxicity, and vasculitis. Therefore, nonthionamide antithyroid drugs (NTADs still have an important role in controlling hyperthyroidism in clinical practice. Furthermore, some situations such as thyroid storm or preoperative preparation require a rapid decrease in thyroid hormone by combination treatment with multiple classes of antithyroid drugs. NTADs include iodine-containing compounds, lithium carbonate, perchlorate, glucocorticoid, and cholestyramine. In this narrative review, we summarize the mechanisms of action, indications, dosages, and side effects of currently used NTADs for the treatment of hyperthyroidism. In addition, we also describe the state-of-the-art in future drugs under development including rituximab, small-molecule ligands (SMLs, and monoclonal antibodies with a thyroid-stimulating hormone receptor (TSHR antagonist effect.

  7. Takotsubo Myocardiopathy and Hyperthyroidism: A Case Report and Literature Review.

    Science.gov (United States)

    Rueda, Darío; Aguirre, Rafael; Contardo, Damián; Finocchietto, Paola; Hernandez, Silvia; di Fonzo, Horacio

    2017-08-07

    BACKGROUND Takotsubo cardiomyopathy (TM), also called stress myocardiopathy or transient left ventricular apical ballooning syndrome, is characterized by acute left ventricular dysfunction with reversible wall motion abnormalities. TM resembles acute coronary syndrome (ACS) in the absence of coronary artery disease (CAD). In several reports, TM has been described in association with hyperthyroidism, suggesting the potential role of thyrotoxicosis in the pathophysiology. CASE REPORT We present the case of a 34-year-old man with TM associated with hyperthyroidism caused by Graves' disease. In this case, TM was also preceded by an emotional trigger. The diagnosis of TM was based on clinical manifestations, electrocardiographic and echocardiographic abnormalities, and the absence of coronary artery disease (CAD) in the angiography. A diagnosis of hyperthyroidism was made based on hormonal and antibody measurements. The patient had a favorable outcome, and the cardiac and thyroid disorders resolved. CONCLUSIONS Our case illustrates that thyroid disease, mainly hyperthyroidism, should be considered in patients with TM with or without previous emotional triggers. As in our patient, the outcome in TM is usually favorable, with reversibility of cardiac abnormalities.

  8. Autoimmune hyperthyroidism due to secondary adrenal insufficiency: resolution with glucocorticoids.

    Science.gov (United States)

    Skamagas, Maria; Geer, Eliza B

    2011-01-01

    To describe the course of autoimmune hyperthyroid disease in a patient with corticotropin (ACTH) deficiency treated with glucocorticoids. We report the clinical presentation, laboratory data, imaging studies, and management of a patient with weight loss, fatigue, apathy, hallucinations, and arthritis. Autoimmune hyperthyroidism (positive thyroperoxidase and thyroglobulin antibodies and borderline positive thyrotropin receptor antibody) was diagnosed in a 71-year-old woman. New psychotic symptoms prompted brain magnetic resonance imaging, which revealed a partially empty sella. Undetectable morning cortisol, undetectable ACTH, and failure to stimulate cortisol with synthetic ACTH (cosyntropin 250 mcg) secured the diagnosis of long-standing secondary adrenal insufficiency. Hydrocortisone replacement improved the patient's symptoms, resolved the thyroid disease, and decreased thyroid antibody titers. In retrospect, the patient recalled severe postpartum hemorrhage requiring blood transfusion at age 38 years. A Sheehan event probably occurred 33 years before the patient presented with corticotropin deficiency. Hyperthyroidism accelerated cortisol metabolism and provoked symptoms of adrenal insufficiency. The hypocortisolemic state may precipitate hyperimmunity and autoimmune thyroid disease. Rapid resolution of hyperthyroidism and decreased thyroid antibody titers with glucocorticoid treatment support this hypothesis.

  9. More than just T₄: diagnostic testing for hyperthyroidism in cats.

    Science.gov (United States)

    Peterson, Mark E

    2013-09-01

    In older cats presenting with clinical features of hyperthyroidism, confirmation of a diagnosis of thyroid disease is usually straightforward. However, the potential for false-negative and false-positive results exists with all thyroid function tests (especially in the context of routine screening of asymptomatic cats) and leads to clinical dilemmas. For example, a high serum T₄ value may be found in a cat that lacks clinical signs of hyperthyroidism, or hyperthyroidism may be suspected in a cat with normal total T₄ concentrations. To avoid unnecessary treatment and potentially adverse effects in a euthyroid cat, thyroid function tests must always be interpreted in the light of the cat's history, clinical signs, physical examination findings and other laboratory findings. In this article the author reviews the use of commonly recommended thyroid function tests, focusing on clinical scenarios that present diagnostic difficulties. In doing so, he draws on the veterinary and comparative literature, his own clinical experience, and data, unpublished to date, obtained from a series of 100 hyperthyroid cats consecutively diagnosed at his clinic.

  10. 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.

  11. Juvenile hyperthyroidism: an experience.

    Science.gov (United States)

    Bhadada, S; Bhansali, A; Velayutham, P; Masoodi, S R

    2006-04-01

    To analyze the clinical profile of juvenile hyperthyroidism at presentation, their treatment outcome; predictors of remission and relapse. Retrospective analysis of medical records of 56 patients with juvenile hyperthyroidism seen over a period of 16 years. A cohort of 38 females and 18 males with mean (+/-SD) age of 14.9 +/- 3.4 years (range 3 to 18 years) was analyzed. Majority of patients was in the age group of 12-16 years. Common symptoms observed at presentation were weight loss (82.1%), excessive sweating (78.6%), heat intolerance (76.8%), increased appetite (73.2%) and diarrhea in 48.2%. In addition, accelerated linear growth was observed in 7.1% of patients. Goiter was present in 98.2% of children; 94.5% of which was diffuse and 4.8% was multinodular. The mean ((+/-SD) T3 was 4.8 +/- 3.4 ng/mL (N, 0.6-1.6), T4 was 218 +/- 98 ng/mL (N, 60-155) and TSH was 0.44 +/- 0.36 (N, 0.5-5.5 microIU/mL). TMA positivity seen in 36.9% of patients. All patients were treated with carbimazole; subsequently 4 patients required thyroidectomy and one required radioactive iodine ablation. Mean (+/-SD) duration of follow-up in our patients was 4.9 +/- 3 years, ranging between 1.6 to 16 years and mean (+/-SD) duration of treatment was 34.4 +/- 22.6 months (range 12 to 120 months). Mean (+/-SD) duration to achieve euthyroidism was 5.2 +/- 4.7 months, ranging between 1-33 months. On intention to treat analysis, remission with carbimazole was achieved in 47.6%, remaining patients failed to achieve remission with drug treatment. Graves disease is the commonest cause of juvenile hyperthyroidism. Carbimazole is safe, effective, cheap, and easily available form of therapy. It is occasionally associated with serious side effects but requires prolonged follow up.

  12. Neonatal hyperthyroidism on rat heart: interrelation with nitric oxide and sex.

    Science.gov (United States)

    Rodríguez, L; Detomaso, F; Braga, P; Prendes, M; Perosi, F; Cernadas, G; Balaszczuk, A; Fellet, A

    2015-06-01

    To clarify the mechanism mediating the effect of hyperthyroidism on cardiac function during the second month of life in rats. Male and female Sprague-Dawley rats were assigned to a control or to a triiodothyronine (T3)-treated group. Treatment of each group was started on the third day after birth. Control rats (Eut) received 0.9 NaCl [0.1 ml/100 g body weight (BW)] every second day during 60 days and T3-treated rats (Hyper) received subcutaneous (SC) T3 injections every second day during 60 days. Hyperthyroidism decreased left ventricle volume only in male rats. Female euthyroid rats presented higher atrial nitric oxide synthase (NOS) activity than male rats and hormonal treatment decreased this enzyme's activity in both sexes. Euthyroid male and female rats had similar atrial NOS protein levels, but females had higher caveolin (cav) 3 protein levels. T3 treatment increased this protein only in males. Female rats had lower ventricular NOS activity than male rats; hyperthyroidism increased NOS activity in both sexes but this effect was associated with lower cav 3 protein levels. Hyperthyroidism did not change cav 1 protein levels in both male and female rats. The results of this study demonstrating clinically relevant sex-related differences in the pathophysiology of the hyperthyroid heart have raised new questions regarding the mechanisms responsible for the observed differences. This study suggests that sex-related intrinsic factors such as nitric oxide may modulate the response to hyperthyroidism that leads to cardiovascular dysfunction.

  13. Weight homeostasis & its modulators in hyperthyroidism before & after treatment with carbimazole.

    Science.gov (United States)

    Dutta, Pinaki; Bhansali, Anil; Walia, Rama; Khandelwal, Niranjan; Das, Sambit; Masoodi, Shariq Rashid

    2012-08-01

    Hyperthyroidism is associated with increased food intake, energy expenditure and altered body composition. This study was aimed to evaluate the role of adipocytokines in weight homeostasis in patients with hyperthyroidism. Patients (n=27, 11men) with hyperthyroidism (20 Graves' disease, 7 toxic multinodular goiter) with mean age of 31.3±4.2 yr and 28 healthy age and body mass index (BMI) matched controls were studied. They underwent assessment of lean body mass (LBM) and total body fat (TBF) by dual energy X-ray absorptiometer (DXA) and blood sample was taken in the fasting state for measurement of leptin, adiponectin, ghrelin, insulin, glucose and lipids. Patients were re-evaluated after 3 months of treatment as by that time all of them achieved euthyroid state with carbimazole therapy. The LBM was higher (Phyperthyroid patients even after adjustment for body weight (BW), whereas total body fat was comparable between the two groups. Serum leptin levels were higher in patients with hyperthyroidism than controls (22.3±3.7 and 4.1±0.34 ng/ml, Ptreatment. Serum leptin positively correlated with TBF and this correlation persisted even after adjustment for BW, BMI, gender and age (r=0.62, P=0.001). However, serum leptin and acylated ghrelin did not correlate with the presence or absence of hyperphagia. Patients with hyperthyroidism predominantly had decreased lean body mass which increased after achievement of euthyroidism with carbimazole. The hyperphagia and the alterations in weight homeostasis associated with hyperthyroidism were independent of circulating leptin and ghrelin levels.

  14. Clinical hyperthyroidism due to non-neoplastic inappropriate thyrotrophin secretion.

    OpenAIRE

    Chan, A. W.; MacFarlane, I. A.; van Heyningen, C.; Foy, P. M.

    1990-01-01

    We report a case of hyperthyroidism due to inappropriate thyrotrophin (TSH) secretion in a patient with selective pituitary resistance to thyroid hormone action. Symptoms of hyperthyroidism in patients with this disorder are usually mild, implying some peripheral tissue resistance to the metabolic effects of thyroid hormone. Our patient had unusually severe symptoms, including marked weight loss and cardiac arrythmias which required carbimazole and beta-blocker therapy for control. Somatostat...

  15. Cancer Incidence and Mortality in Patients Treated Either With RAI or Thyroidectomy for Hyperthyroidism.

    Science.gov (United States)

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

    2015-10-01

    Some previous studies have suggested increased cancer risk in hyperthyroid patients treated with radioactive iodine (RAI). It is unclear whether the excess cancer risk is attributable to hyperthyroidism, its treatment, or the shared risk factors of the two diseases. The objective was to assess cancer morbidity and mortality in hyperthyroid patients treated with either RAI or surgery. We identified 4334 patients treated surgically for hyperthyroidism in Finland during 1986-2007 from the Hospital Discharge Registry and 1814 patients treated with RAI for hyperthyroidism at Tampere University Hospital. For each patient, three age- and gender-matched controls were chosen. Information on cancer diagnoses was obtained from the Cancer Registry. The follow-up began 3 months after the treatment and ended at cancer diagnosis, death, emigration, or the common closing date (December 31, 2009). The overall cancer incidence was not increased among the hyperthyroid patients compared to their controls (rate ratio [RR], 1.05; 95% confidence interval [CI], 0.96-1.15). However, the risk of cancers of the respiratory tract (RR, 1.46; 95% CI, 1.05-2.02) and the stomach (RR, 1.64; 95% CI, 1.01-2.68) was increased among the patients. The overall cancer mortality did not differ between the patients and the controls (RR, 1.08; 95% CI, 0.94-1.25). The type of treatment did not affect the overall risk of cancer (hazard ratio for RAI vs thyroidectomy, 1.03; 95% CI, 0.86-1.23) or cancer mortality (hazard ratio, 1.04; 95% CI, 0.91-1.21). In this cohort of Finnish patients with hyperthyroidism treated with thyroidectomy or RAI, the overall risk of cancer was not increased, although an increased risk of gastric and respiratory tract cancers was seen in hyperthyroid patients. Based on this large-scale, long-term follow-up study, the increased cancer risk in hyperthyroid patients is attributable to hyperthyroidism and shared risk factors, not the treatment modality.

  16. Treatment of paediatric hyperthyroidism but not hypothyroidism has a significant effect on weight.

    Science.gov (United States)

    Crocker, Melissa K; Kaplowitz, Paul

    2010-12-01

    Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Prospective and retrospective case series. Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH 20 (N = 29). Almost all patients had at least 2 classic signs or symptoms including goitre, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0·3 kg) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3·4 kg at the first follow-up visit and a mean of 7·1 kg by the second. Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. © 2010 Blackwell Publishing Ltd.

  17. Treatment of pediatric hyperthyroidism but not hypothyroidism has a significant effect on weight

    Science.gov (United States)

    Crocker, Melissa K.; Kaplowitz, Paul

    2010-01-01

    Objective Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Design Prospective and retrospective case series Patients Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH 20 (N=29). Results Almost all patients had at least 2 classic signs or symptoms including goiter, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0.3 kilograms (kg)) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3.4 kg at the first follow-up visit and a mean of 7.1 kg by the second. Conclusions Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. PMID:20874768

  18. 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 loss of muscle mass. Cats showed increases in body 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 hyperthyroid cats lose body 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.

  19. Myocardial Function of Hyperthyroid Rats in Presence of Diazepam in Langendorff Setup

    Directory of Open Access Journals (Sweden)

    Atefeh Asadmobini

    2015-06-01

    Full Text Available Background: Modulation of Ischemia-Reperfusion (I/R injury is highly important in medicine, especially in hyperthyroidism condition. The effect of diazepam as a benzodiazepine on cardiac I/R injury is also clinically important. The chronic effect of diazepam in this case has been reported previously. Objectives: This study aimed to investigate the effect of acute diazepam perfusion on isolated heart of hyperthyroid rats during I/R. Materials and Methods: Male rats (n = 32, weighing 250 - 300 gr were randomly divided into 4 groups: control, hyperthyroid, control diazepam perfused, and hyperthyroid diazepam perfused. Isolated hearts were perfused through Langendorff method. Four sets of data were collected at baseline (20 minutes, diazepam perfusion (10 minutes, 100 µmol/L, ischemia (40 minutes, and reperfusion (45 minutes periods. Cardiac parameters, including Left Ventricular Developed pressure (LVDP; mmHg and Rate Pressure Product (RPP; mmHg × beats/min were measured, as well. Lactate dehydrogenase (LDH; mU/mL was also assessed for evaluation of I/R injury. The data were analyzed using ANOVA and Student t-test and P < 0.05 was considered as statistically significant. Results: RPP significantly declined in the hyperthyroid group after diazepam perfusion compared to the baseline (24046 ± 1381 versus 18269 ± 711, P = 0.012, 95% CI: 1724 - 9828. Besides, RPP and LVDP significantly increased in the hyperthyroid diazepam perfused group compared to the hyperthyroid group at the end of the reperfusion period (12469 ± 1422 versus 4007 ± 258, P < 0.001, CI: 5066 - 11856 and 47 ± 2.8 versus 23 ± 2.8, P < 0.001, CI: 11-35, respectively. These findings were confirmed by LDH levels (19.08 ± 1.06 versus 41.07 ± 8.14, P = 0.002, CI: -34.4 - -9.4-35. Conclusions: The results showed that acute diazepam perfusion to isolated hyperthyroid rats’ hearts could significantly improve cardiac function following ischemia and protect the heart against I

  20. Prevalence of and risk factors for feline hyperthyroidism among a clinic population in Southern Germany.

    Science.gov (United States)

    Köhler, Ines; Ballhausen, Bianca Desiree; Stockhaus, Christian; Hartmann, Katrin; Wehner, Astrid

    2016-06-16

    Feline hyperthyroidism is a common endocrine disorder in older cats. Previous studies have identified nutritional imbalances, thyroid-disrupting compounds, increasing age and being non-purebred as risk factors but the final trigger remains unknown. The purpose of this prospective study was a) to determine the hospital prevalence of hyperthyroidism in a client-owned cat population in Southern Germany, b) to exploit how frequently hyperthyroidism was diagnosed after the initial clinical suspicion and c) to determine putative intrinsic and extrinsic risk factors from the cats' signalment and a questionnaire analysis, respectively. Total thyroxine (T4) was measured in sera of 495 cats ≥ 8 years. Prevalence was calculated with a 95% confidence interval (95% CI) Association between signalment and hyperthyroidism was analysed by Student's unpaired-t-test, chi-square test and Mann-Whitney U-test. Level of significance was set at 0.05. Multivariate logistic regression model was used to determine extrinsic risk factors. Sixty-one cats were diagnosed with hyperthyroidism leading to a prevalence of 12.3% (95% CI: 9.7-15.5). Older (p hyperthyroid than purebred cats (p = 0.016). In 164 cats hyperthyroidism was considered a differential diagnosis and was verified in 20.1% (33/164). In 2.4% (12/495) cases the elevated T4 was an incidental finding. Hyperthyroid cats were more likely to be fed with moist cat food from aluminum tins (p hyperthyroid cats. Older, female non-purebred cats are predisposed to hyperthyroidism which is frequently diagnosed after the initial clinical suspicion leading to a prevalence of 12.3% among the study population. Components of the aluminum tins or the moist food itself or both may play a role in the etiopathogenesis.

  1. Role of the renin-angiotensin system in cardiac hypertrophy induced in rats by hyperthyroidism.

    Science.gov (United States)

    Kobori, H; Ichihara, A; Suzuki, H; Takenaka, T; Miyashita, Y; Hayashi, M; Saruta, T

    1997-08-01

    This study was conducted to examine whether the renin-angiotensin system contributes to hyperthyroidism-induced cardiac hypertrophy without involving the sympathetic nervous system. Sprague-Dawley rats were divided into control-innervated, control-denervated, hyperthyroid-innervated, and hyperthyroid-denervated groups using intraperitoneal injections of thyroxine and 6-hydroxydopamine. After 8 wk, the heart-to-body weight ratio increased in hyperthyroid groups (63%), and this increase was only partially inhibited by sympathetic denervation. Radioimmunoassays and reverse transcription-polymerase chain reaction revealed increased cardiac levels of renin (33%) and angiotensin II (53%) and enhanced cardiac expression of renin mRNA (225%) in the hyperthyroid groups. These increases were unaffected by sympathetic denervation or 24-h bilateral nephrectomy. In addition, losartan and nicardipine decreased systolic blood pressure to the same extent, but only losartan caused regression of thyroxine-induced cardiac hypertrophy. These results suggest that thyroid hormone activates the cardiac renin-angiotensin system without involving the sympathetic nervous system or the circulating renin-angiotensin system; the activated renin-angiotensin system contributes to cardiac hypertrophy in hyperthyroidism.

  2. 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.

  3. Hemodynamic and tissue oxygenation responses to exercise and beta-adrenergic blockade in patients with hyperthyroidism.

    Science.gov (United States)

    Monachini, Maristela C; Lage, Silvia G; Ran, Miguel A N; Cardoso, Rita H A; Medeiros, Caio; Caramelli, Bruno; Sposito, Andrei C; Ramires, José A F

    2004-07-01

    Exercise-induced dyspnea is a frequent feature in patients with hyperthyroidism. Data from clinical studies to elucidate the origin of this symptom are lacking. In the current study, we examined the hemodynamic and oxygenation responses to exercise and beta-adrenergic blockade in patients with hyperthyroidism and their relationship with dyspnea. Hemodynamic studies were performed under resting conditions and after isotonic exercise in 15 patients with hyperthyroidism and 11 control subjects. Exercise was applied using a bicycle ergometer, with progressive loads. In the hyperthyroid group, measurements were repeated at rest and during supine exercise after administering 15 mg of intravenous metoprolol. End-diastolic pulmonary artery pressure and cardiac index were higher in the hyperthyroid group than in controls (18.6 +/- 5.3 vs. 11.2 +/- 4.9 mmHg; p = 0.02, and 6.0 +/- 1.7 vs. 2.8 +/- 0.5 l/min/m2; p = 0.0001, respectively). After exercise, there was an increase in end-diastolic pulmonary artery pressure in the hyperthyroid group (18.6 +/- 5.3 to 25.5 +/- 9.9 mmHg; p = 0.02), revealing impaired cardiocirculatory reserve. Pulmonary arteriolar resistance increased significantly in parallel with end-diastolic pulmonary artery pressure after drug administration, suggesting an inadequate cardiovascular response after beta blockade in patients with hyperthyroidism. We observed that functional left ventricular reserve is impaired in patients with hyperthyroidism, suggesting an explanation for the frequent symptom of dyspnea and impaired exercise tolerance. Moreover, we also suggest that beta-adrenergic blockade may adversely affect cardiovascular function in patients with hyperthyroidism.

  4. 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.

  5. Hyperthyroidism and the Heart.

    Science.gov (United States)

    Osuna, Patricia Mejia; Udovcic, Maja; Sharma, Morali D

    2017-01-01

    Thyroid hormones have a significant impact on cardiac function and structure. Excess thyroid hormone affects cardiovascular hemodynamics, leading to high-output heart failure and, in late stages, dilated cardiomyopathy. In this review, we discuss how hyperthyroidism affects cardiovascular pathophysiology and molecular mechanisms and examine the complications caused by excess thyroid hormone, such as heart failure and atrial fibrillation.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    National Patient Registry and 3036 twin pairs from The Danish Twin Registry, who had participated in nationwide surveys on health conditions. MEASUREMENTS: Among other investigations, survey participants had carried out cognitive tests including a Mini-Mental State Exam (MMSE) and six separate cognitive...... 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......, the hyperthyroid twin scored significantly better in the MMSE than did the healthy co-twin (p=0.023 and p=0.038, respectively). The same tendency was found in the other cognitive tests, and after analysing twins diagnosed with hyperthyroidism more than two years before participating, although none were...

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

    International Nuclear Information System (INIS)

    Lee, Sang Woo; Lee, Jae Tae

    2003-01-01

    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

  8. Treatment's results of hyperthyroid patients with Iodine-131

    International Nuclear Information System (INIS)

    Bastan-Hagh, M.H.; Larijani, B.; Rahim-Tabrizi, P.; Khalili-Fard, A.R.; Baradar-Jalili, R.; Saghari, M.

    2004-01-01

    Introduction: radioiodine ( 131 I) is an effective and inexpensive alternative to surgery in the treatment of thyroid hyper function. The debate today concerns the maximum and minimum ablative doses, and factors leading to hypothyroidism. Patients and method: 1035 hyperthyroid patients treated with weight-adjusted ablative doses of 131 I were retrospectively assessed for treatment outcome or correlated with sex, age, underlying pathology, and administrated dose of 131 I . Results: Thyroid hyper function was more common in women. The greatest proportions of patients were in the 31-40 years age group and the smallest proportion over -70. The commonest underlying pathology was Grave's disease. Men had a lower response rate to 131 I therapy, with 2.4-fold greater probability of persistent hyperthyroidism (P 131 I hypothyroidism decreased with increasing age (P 131 I therapy was seen in patients with toxic adenoma, (P=0.0001). The incidence of hypothyroidism did not show a positive correction with increased administered dose of 131 I (P 131 I was effective in reducing thyroid nodule size. There were 18 cases of temporary hyperthyroidism, all of which recovered to euthyroid status within 12 months. Conclusion: one dose of radioiodine was effective in treatment of hyperthyroid patients in 91.2 % of cases. Age, sex and underlying pathology were determining factors. In most cases the average time to hypothyroidism was reasonably short, obviating the need for long time follow up in these patients

  9. Body weight gain after radioiodine therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Scheidhauer, K.; Odatzidu, L.; Schicha, H.

    2002-01-01

    Aim: Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Methods: Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. Results: All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. Conclusions: An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas. (orig.) [de

  10. 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.

  11. Hyperthyroidism evokes myocardial ceramide accumulation.

    Science.gov (United States)

    Mikłosz, Agnieszka; Łukaszuk, Bartłomiej; Chabowski, Adrian; Rogowski, Filip; Kurek, Krzysztof; Żendzian-Piotrowska, Małgorzata

    2015-01-01

    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. 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. 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). 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. © 2015 S. Karger AG, Basel.

  12. Continued glucose output after re-feeding contributes to glucose intolerance in hyperthyroidism.

    OpenAIRE

    Holness, M J; Sugden, M C

    1987-01-01

    The effects of hyperthyroidism to elicit glucose intolerance after glucose administration were decreased under conditions where hepatic glucose output was suppressed. It is concluded that continued hepatic glucose output contributes to abnormal glucose tolerance in hyperthyroidism.

  13. Leptin, NPY, Melatonin and Zinc Levels in Experimental Hypothyroidism and Hyperthyroidism: The Relation to Zinc.

    Science.gov (United States)

    Baltaci, Abdulkerim Kasım; Mogulkoc, Rasim

    2017-06-01

    Since zinc mediates the effects of many hormones or is found in the structure of numerous hormone receptors, zinc deficiency leads to various functional impairments in the hormone balance. And also thyroid hormones have important activity on metabolism and feeding. NPY and leptin are affective on food intake and regulation of appetite. The present study is conducted to determine how zinc supplementation and deficiency affect thyroid hormones (free and total T3 and T4), melatonin, leptin, and NPY levels in thyroid dysfunction in rats. The experiment groups in the study were formed as follows: Control (C); Hypothyroidism (PTU); Hypothyroidism+Zinc (PTU+Zn); Hypothyroidism+Zinc deficient; Hyperthyroidism (H); Hyperthyroidism+Zinc (H+Zn); and Hyperthyroidism+Zinc deficient. Thyroid hormone parameters (FT 3 , FT 4 , TT 3 , and TT 4 ) were found to be reduced in hypothyroidism groups and elevated in the hyperthyroidism groups. Melatonin values increased in hyperthyroidism and decreased in hypothyroidism. Leptin and NPY levels both increased in hypo- and hyperthyroidism. Zinc levels, on the other hand, decreased in hypothyroidism and increased in hyperthyroidism. Zinc supplementation, particularly when thyroid function is impaired, has been demonstrated to markedly prevent these changes.

  14. Effect of successful 131I treatment on the peripheral blood picture in hyperthyroid patients

    International Nuclear Information System (INIS)

    Li Xiaoping; He Yunnan; Hu Qingwu

    2004-01-01

    Objective: To investigate the effect of successful 131 I therapy on the levels peripheral blood picture in hyperthyroid patients. Methods: Serum T 3 , T 4 , TSH (with ACCESS microparticle chemiluminescence immunoassay) and blood Hb, RBC, WBC and DC, Plt (with COULTER three assortments) counts were determined in 110 controls and 210 hyperthyroid patients both before and after 131 I therapy. Results: 131 I treatment of hyperthyroidism in this group of patients was very successful (P 131 I therapy. Conclusion: The application of 131 I to treat hyperthyroidism was very successful with no remarkable effect on peripheral blood picture. (authors)

  15. Thymic enlargement in patients with hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Jae Sung; Goo, Jin Mo; Im, Jung Gi [College of medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Kim, Mi Young [Sejong General Hospital, Seoul (Korea, Republic of); Park, Yang Hee [National Police Hospital, Seoul (Korea, Republic of)

    2000-08-01

    To evaluate the radiologic findings and clinical feasibility of thymic enlargement in patients with hyperthyroidism. Seven patients with hyperthyroidism and anterior mediastinal bulging revealed by chest radiography were evaluated. The CT findings were analyzed with regard to the shape of the anterior mediastinal mass, surrounding infiltration, and enlargement of mediastinal lymph nodes. Whether or not tumor markers (alpha-fetoprotein, beta-human chorionic gonadotrophin, and chorionic embryonic antigen) showed increased levels was determined, and the size and thickness of the anterior mediastinal mass were measured and compared with previously described age-matched thymus data. In addition, changes in the thyroid gland were evaluated. In all seven patients, anterior mediastinal masses were bi-lobed, with no surrounding infiltration or enlarged mediastinal lymph node, and tumor marker levels showed no increase. The masses were therefore considered to be thymus. In six patients, the size of the thymus exceeded two upper standard deviations of mean value and in one patient, it was smaller than this. In three patients, PCNB (percutaneous needle biopsy) revealed normal thymic tissue and in two, follow-up chest PA demonstrated no interval change. CT showed that in three patients, the thyroid glands were diffusely enlarged. In patients with hyperthyroidism, an anterior mediastinal mass seen on chest radiographs was due to thymic enlargement. The recognition of CT findings of thymic enlargement in such patients may avoid unnecessary biopsy. (author)

  16. Clinical significance of plasma atrial natriuretic factor and endothelin detection in hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Zhu Yalin; Huo Ying; Pan Yunlong

    2005-01-01

    Plasma at rial natriuretic factor (ANF) and endothelin (ET) were detected by RIA in 58 cases of hyperthyroidism and 47 cases of hypothyroidism. Before the ANF and ET concentration of untreatment hyperthyroid patients was much higher than that of treatment hyperthyroid patients, hypothyroid patients before and after treatment and the normal group (P 3 and FT 4 . Compared with the normal group, ANF concentration in treatment hyperthyroid patients, hypothyroid patients before and after treatment was no significantly different (P>0.05), but that in hypothyroid patients before treatment was significantly decreased compared with hypothyroid patients after treatment (P 0.05), but that in hypothyroid patients before treatment was significantly decreased compared with others (P<0.01 and P<0.05). Detection of ANF and ET level may be have a role in supplementary diagnosis and curative effect observation of hyperthyroidism and hypothyroidism. (authors)

  17. Effect of Feeding an Iodine-Restricted Diet in Cats with Spontaneous Hyperthyroidism.

    Science.gov (United States)

    Hui, T Y; Bruyette, D S; Moore, G E; Scott-Moncrieff, J C

    2015-01-01

    Exclusive feeding of an iodine-restricted diet has been proposed as a method for controlling clinical manifestations of hyperthyroidism in hyperthyroid cats. To determine the effect of feeding an iodine-restricted diet on TT4 concentrations and clinical signs in cats with spontaneous hyperthyroidism. Forty-nine client-owned cats with spontaneous hyperthyroidism. Retrospective case series. Hyperthyroid cats were exclusively fed a commercially available iodine-restricted diet. Clinical response was assessed by change in weight and heart rate and serum TT4, blood urea nitrogen (BUN), and creatinine concentrations at various times during dietary management (21-60 days, 60-180 days). Serum TT4 normalized in 20/48 cats (42%) and 39/47 cats (83%) at 21-60 days and 61-180 days, respectively. Cats in which the TT4 concentrations were still above reference range at 21-60 days had a significantly higher starting TT4 than those that normalized their TT4 levels during the same time period (P = .038). Body weight did not significantly increase (P = .34) nor heart rate decrease (P = .64) during the study. There was a significant decrease in serum creatinine (P = .028). Cats in the low reference range for serum TT4 concentrations did not have a significant increase in body weight (P = .41) nor creatinine (P = .54) when compared to those with high reference range. Restricted-iodine diets were effective at maintaining serum TT4 concentrations within reference ranges for a majority of cats with spontaneous hyperthyroidism over 1 year, although not all clinical signs of hyperthyroidism improved. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  18. The Role of Hyperthyroidism as the Predisposing Factor for Superior Sagittal Sinus Thrombosis

    OpenAIRE

    Hwang, Jong-Uk; Kwon, Ki-Young; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

    2012-01-01

    Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who devel...

  19. Increased ratio between anaerobic and aerobic metabolism in lymphocytes from hyperthyroid patients.

    Science.gov (United States)

    Valdemarsson, S; Monti, M

    1994-03-01

    While an increased oxygen consumption is accepted as one consequence of hyperthyroidism, only few data are available on the role of anaerobic processes for the increased metabolic activity in this disease. In this study we evaluated the relative importance of anaerobic and aerobic metabolism for the metabolic activity in lymphocytes from patients before and after treatment for hyperthyroidism. Total lymphocyte heat production rate (P), reflecting total cell metabolic activity, was determined in a plasma lymphocyte suspension using direct microcalorimetry. The contribution from aerobic metabolism (O2-P) was calculated from the product of the lymphocyte oxygen consumption rate and the enthalpy change for glucose combustion, and the anaerobic contribution as the difference between P and O2-P. The total lymphocyte heat production rate P was 3.37 +/- 0.25 (SEM) pW/cell (N = 11) before and 2.50 +/- 0.11 pW/cell (N = 10) after treatment for hyperthyroidism (p hyperthyroid state and to 73.7 +/- 3.2% after treatment (p metabolic activity demonstrated in lymphocytes from hyperthyroid patients cannot be explained by an increased oxygen-dependent consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. 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

  1. Excess mortality in treated and untreated hyperthyroidism is related to cumulative periods of low serum TSH

    DEFF Research Database (Denmark)

    Lillevang-Johansen, Mads; Abrahamsen, Bo; Jørgensen, Henrik Løvendahl

    2017-01-01

    Introduction and Aim: Cumulative time-dependent excess mortality in hyperthyroid patients has been suggested. However, the effect of anti-thyroid treatment on mortality, especially in subclinical hyperthyroidism remains unclarified. We investigated the association between hyperthyroidism and mort...

  2. A comparative study of bone mineral density between premenopausal women with hyperthyroidism and healthy premenopausal women.

    Science.gov (United States)

    Boonya-Ussadorn, Trirat; Punkaew, Boondharika; Sriassawaamorn, Narongchai

    2010-11-01

    To compare bone mineral density (BMD) of the lumbar spine (L1-L4), total hip (TH), and femoral neck (FN) analyzed by Dual Energy X-ray Absorptiometry (DXA) in premenopausal women with hyperthyroidism and in healthy premenopausal women. Cross-sectional study included 49 premenopausal women with hyperthyroidism and 49 healthy premenopausal women. Age, weight and body mass index (BMI) were comparable in both groups. All subjects had a BMD measurement by DXA in the region of L1-L4, TH and FN and the unpaired t-test was used to analyze. The mean BMD of premenopausal women with hyperthyroidism at L1-L4, TH and FN was 0.928, 0.838 and 0.774 g/cm2, which were lower than those of healthy premenopausal women; 0.991, 0.917 and 0.832 g/cm2 respectively (p-value is less than 0.05). Time interval that had elapsed for active hyperthyroidism was not associated with the decrease of BMD at L1-L4, TH and FN in hyperthyroid women. The BMD of L1-L4, TH and FN in premenopausal women with hyperthyroidism were significantly lower than those of healthy premenopausal women. Therefore, overt hyperthyroidism could be associated with bone loss and may be a risk factor for the development of osteoporosis. However, time interval of active hyperthyroidism was not related to the decrease of BMD in hyperthyroid women.

  3. Observations on radioiodide therapy of hyperthyroidism

    International Nuclear Information System (INIS)

    Spencer, R.P.

    1978-01-01

    Procedures for the diagnosis of hyperthyroidism are discussed. Radioiodide therapy is directed against the production site of thyroid hormones and not the initial stimulus or the end organ response to the elevated production of hormone. The principle difficulties involved in radioiodide therapy are considered. Ocular symptoms may be related to secretions from systems other than the thyroid. Increasing quantities of radioiodide must be used in therapy, since uptake values in the population are falling. Radioiodide therapy is contraindicated in pregnancy. Hypothyroidism is in any case a likely end result and its incidence is increased after radioiodide therapy. There are different morphological forms of hyperthyroidism. A sample calculation of the required amount of radioiodine is included, together with a brief summary of practical ways of reducing the whole body radiation dose. (U.K.)

  4. 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. Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.

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

    International Nuclear Information System (INIS)

    Haibach, H.

    1976-01-01

    The radioimmunoassay for T 3 is now widely available and is a useful diagnostic tool for hyperthyroidism, especially in T 3 -thyrotoxicosis. It is an essential tool in the management of hyperthyroidism that persists after treatment with normal T 4 serum levels or, in euthyroid cases, with low T 4 serum levels. In these conditions, it reflects the metabolic state more accurately than serum levels of T 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 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

  6. OCULAR ASPECTS OF HYPERTHYROIDISM WITH SPECIAL REFERENCE TO OCULAR MYOPATHY

    Directory of Open Access Journals (Sweden)

    Mallika O. U

    2017-04-01

    Full Text Available BACKGROUND Hyperthyroidism can result in ocular manifestations even before systemic signs and symptoms develop. It is seen more in females and severe forms are more common in males. Early detection of ocular involvement can prevent vision threatening complications and troublesome discomforts affecting quality of vision. This clinical study highlights the importance of detailed ocular examination in hyperthyroidism. MATERIALS AND METHODS Fifty consecutive patients with ocular signs of hyperthyroidism were evaluated and followed up for an average period of 1 year. Detailed ocular examination included exophthalmometric measurements, ocular movements and Worth four-dot test. T3, T4, TSH, CT scan and antimicrosomal antibodies and antithyroglobulin antibodies were done along with routine investigations. Study Design- Prospective cohort study. RESULTS Statistical analysis did not reveal any correlation between the level of serum T3 and severity of ocular findings. Majority of the cases were euthyroid with moderate ocular myopathy having multiple muscle involvement. Inferior rectus was affected most. CONCLUSION The ocular signs of hyperthyroidism in the present study seem to be mild. The severe eye changes like corneal involvement and optic nerve changes were less common.

  7. 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 ...

  8. 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...

  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. [An operative case of ulcerative colitis associated with hyperthyroidism].

    Science.gov (United States)

    Kohyama, Atsushi; Funayama, Yuji; Fukushima, Kouhei; Shibata, Chikashi; Miura, Koh; Takahashi, Ken-ichi; Ogawa, Hitoshi; Ueno, Tatsuya; Sasaki, Iwao; Hiwatashi, Nobuo

    2009-06-01

    We encountered a rare operative case of hyperthyroidism followed by ulcerative colitis (UC). A 26-year-old mam was referred to our department to undergo an operation. We suspected the possible complication of adrenal insufficiency, since he suffered from severe weight loss, a high fever and palpitation on admission. We diagnosed hyperthyroidism, however, based on the presence of high serum free T3 and T4 levels and a decreased TSH level. After improving the symptoms and the thyroid function by administering thiamazole, we then performed a total proctocolectomy. Although a high rate of association of autoimmune thyroid diseases with UC has been suggested, only 9 cases of hyperthyroidism coexisting with UC have so far been reported in Japan. A common immunological process has been suggested to be implicated in the pathogenesis of this association, however, the exact mechanism needs to be elucidated in the future.

  11. Effects of hyperthyroidism, hypothyroidism, and thyroid autoimmunity on female sexual function.

    Science.gov (United States)

    Oppo, A; Franceschi, E; Atzeni, F; Taberlet, A; Mariotti, S

    2011-06-01

    Thyroid hormones affect male and female sexual functions, but data in hypo- and hyperthyroid women are scanty. To investigate sexual function in hypo- and hyperthyroid women before and immediately after restoration of euthyroidism and in women with euthyroid Hashimoto's thyroiditis (HT). Fifty-six women with thyroid diseases (age 19-50 yr; 22 with hyperthyroidism, 17 with hypothyroidism, and 17 with euthyroid HT) and 30 age-matched healthy women. Hypoactive sexual desire, disorders of sexual arousal, vaginal lubrication, orgasm, satisfaction, and sexual pain (SPD) were assessed by Female Sexual Function Index. Serum TSH, free T4 (FT4) and thyroid autoantibodies (anti-thyroglobulin, anti-thyroperoxidase, and TSH-receptor antibodies) were assessed at the diagnosis; FT4 and TSH were repeated after treatment to confirm normalization of thyroid function. All sexual domains scores were significantly reduced (p ranging hyperthyroid women. Correction of hypothyroidism was associated to normalization of desire, satisfaction, and pain, while arousal and orgasm remained unchanged. In hyperthyroid women therapy normalized sexual desire, arousal/lubrication, satisfaction, and pain, while orgasm remained significantly impaired. Interestingly, euthyroid HT women displayed a significant decrease in sexual desire (phyperthyroidism markedly impair female sexual function. A rapid improvement is observed with the restoration of euthyroidism, although a longer period of time may be needed for full normalization. Preliminary data suggest that thyroid autoimmunity may selectively impair sexual desire, independently from thyroid function.

  12. Serum chromogranin A concentration in hyperthyroidism before and after medical treatment.

    Science.gov (United States)

    Al-Shoumer, Kamal A S; Vasanthy, Bagavathy A

    2009-07-01

    The aim was to evaluate changes in chromogranin A (CgA) concentration in hyperthyroidism and to assess its metabolic correlations. We studied CgA levels in hyperthyroidism. First, 38 hyperthyroid patients matched with 86 normal controls were studied after an overnight fast. Second, 30 if the 38 patients were followed up for 6 months with medical antithyroid drug therapy (carbimazole). In the first study, after 10-12 h overnight fasting, blood was collected for measurement of CgA, glucose, insulin, intact proinsulin, and thyroid function. These variables were remeasured in the second study for the patients after attainment of euthyroidism with the antithyroid drug carbimazole for 6 months. Pretreatment CgA level was significantly higher in patients compared with controls. CgA levels dropped significantly to levels similar to those of controls after antithyroid therapy. Although baseline and follow-up fasting glucose, insulin, and intact proinsulin demonstrated similar pattern of CgA changes before and after medical treatment, CgA did not correlate with any of them. However, CgA levels demonstrated a significant positive correlation with free T(3) and free T(4) only. These studies demonstrate that untreated hyperthyroidism is associated with elevated CgA level that changes in parallel to thyroid status. It is therefore possible to use CgA concentration as a potential marker of disease activity in hyperthyroidism.

  13. Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease.

    Science.gov (United States)

    Bunevicius, Robertas; Velickiene, Dzilda; Prange, Arthur J

    2005-01-01

    To evaluate the prevalence of mood and anxiety disorders in women with treated hyperthyroidism caused by Graves' disease and to compare them with the prevalence of such findings in women without past or present thyroid disease. Thirty inpatient women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease and 45 women hospitalized for treatment of gynecologic disorders such as abnormal vaginal bleeding, benign tumors or infertility were evaluated for the prevalence of mood and anxiety diagnoses using a standard Mini-International Neuropsychiatric Interview and for mood and anxiety ratings using the Profile of Mood States (POMS). At the time of assessment, it was discovered that 14 of 30 women with treated hyperthyroidism caused by Graves' disease were still hyperthyroid, while 16 women were euthyroid. Significantly greater prevalence of social anxiety disorder, generalized anxiety disorder, major depression and total mood and anxiety disorders, as well as higher symptom scores on the POMS, was found in hyperthyroid women with Graves' disease in comparison with the control group. A prevalence of total anxiety disorder, as well as history of mania or hypomania and lifetime bipolar disorder, but not lifetime unipolar depression, was more frequent in both the euthyroid and the hyperthyroid subgroups of study women in comparison with the control group. These results confirm a high prevalence of mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease. Hyperthyroidism plays a major role in psychiatric morbidity in Graves' disease.

  14. Percentage and function of CD4+CD25+ regulatory T cells in patients with hyperthyroidism

    Science.gov (United States)

    Jiang, Ting-Jun; Cao, Xue-Liang; Luan, Sha; Cui, Wan-Hui; Qiu, Si-Huang; Wang, Yi-Chao; Zhao, Chang-Jiu; Fu, Peng

    2018-01-01

    The current study observed the percentage of peripheral blood (PB) CD4+CD25+ regulatory T cells (Tregs) and the influence of CD4+CD25+ Tregs on the proliferation of naïve CD4 T cells in patients with hyperthyroidism. Furthermore, preliminary discussions are presented on the action mechanism of CD4+CD25+ Tregs on hyperthyroidism attacks. The present study identified that compared with the percentage of PB CD4+CD25+ Tregs in healthy control subjects, no significant changes were observed in the percentage of PB CD4+CD25+ Tregs in patients with hyperthyroidism (P>0.05). For patients with hyperthyroidism, CD4+CD25+ Tregs exhibited significantly reduced inhibition of the proliferation of naïve CD4 T cells and decreased secretion capacity on the cytokines of CD4 T cells, compared with those of healthy control subjects (Phyperthyroidism was significantly improved (Phyperthyroidism before treatment, no significant changes were observed in the percentage of PB CD4+CD25+ Tregs in hyperthyroidism patients following treatment (P>0.05). In the patients with hyperthyroidism, following treatment, CD4+CD25+ Tregs exhibited significantly increased inhibition of the proliferation of naïve CD4 T cells and increased secretion capacity of CD4 T cell cytokines, compared with those of the patients with hyperthyroidism prior to treatment (Phyperthyroidism, and its non-proportional decrease may be closely associated with the occurrence and progression of hyperthyroidism. PMID:29207121

  15. Hyperthyroidism affects lipid metabolism in lactating and suckling rats.

    Science.gov (United States)

    Varas, S M; Jahn, G A; Giménez, M S

    2001-08-01

    Two per thousand pregnant women have hyperthyroidism (HT), and although the symptoms are attenuated during pregnancy, they rebound after delivery, affecting infant development. To examine the effects of hyperthyroidism on lactation, we studied lipid metabolism in maternal mammary glands and livers of hyperthyroid rats and their pups. Thyroxine (10 microg/100 g body weight/d) or vehicle-treated rats were made pregnant 2 wk after commencement of treatment and sacrificed on days 7, 14, and 21 of lactation with the litters. Circulating triiodothyronine and tetraiodothyronine concentrations in the HT mothers were increased on all days. Hepatic esterified cholesterol (EC) and free cholesterol (FC) and triglyceride (TG) concentrations were diminished on days 14 and 21. Lipid synthesis, measured by incorporation of [3H]H2O into EC, FC, and TG, fatty acid synthase, and acetyl CoA carboxylase activities increased at day 14, while incorporation into FC and EC decreased at days 7 and 21, respectively. Mammary FC and TG concentrations were diminished at day 14; incorporation of [3H]H2O into TG decreased at days 7 and 21, and incorporation of [3H]H2O into FC increased at day 14. In the HT pups, growth rate was diminished, tetraiodothyronine concentration rose at days 7 and 14 of lactation, and triiodothyronine increased only at day 14. Liver TG concentrations increased at day 7 and fell at day 14, while FC increased at day 14 and only acetyl CoA carboxylase activity fell at day 14. Thus, hyperthyroidism changed maternal liver and mammary lipid metabolism, with decreased lipid concentration in spite of increased liver rate of synthesis and decreases in mammary synthesis. These changes, along with the mild hyperthyroidism of the litters, may have contributed to their reduced growth rate.

  16. Is Traditional Chinese medicine effective for reducing hyperthyroidism?

    Science.gov (United States)

    Chang, Cheng-Chieh; Huang, Sheng-Teng

    2010-11-01

    Graves' disease is an autoimmune disease that can affect a few patients with hyperthyroidism. In this case report, we demonstrated that Traditional Chinese Medicine (TCM) was effective for the patient with hyperthyroidism induced by Graves' disease. The patient also remained in the euthyroid state for several years after the treatment. SUBJECT AND SETTING: A 33-year-old woman had palpitations, fatigability, and weight loss and was diagnosed as having Graves' disease. Urticaria and itching skin appeared after she took an antithyroid drug. Therefore, she sought treatment with TCM. After regular therapy with Jia Wei Xiao Yao San in addition to Xia Ku Cao, Bei Mu, and oyster shell, her symptoms subsided and the thyroid function level returned to normal range with 3 years' treatment. She still remained in the euthyroid state for 3 years after discontinuing the TCM treatment up to the present. Neither complications nor side-effects were noted during the TCM treatment. This case demonstrates that TCM is an effective and alternative option for hyperthyroidism induced by Graves' disease, especially for patients who have an allergic reaction caused by thioamides.

  17. OCULAR ASPECTS OF HYPERTHYROIDISM WITH SPECIAL REFERENCE TO OCULAR MYOPATHY

    OpenAIRE

    Mallika O. U; Suma Job

    2017-01-01

    BACKGROUND Hyperthyroidism can result in ocular manifestations even before systemic signs and symptoms develop. It is seen more in females and severe forms are more common in males. Early detection of ocular involvement can prevent vision threatening complications and troublesome discomforts affecting quality of vision. This clinical study highlights the importance of detailed ocular examination in hyperthyroidism. MATERIALS AND METHODS Fifty consecutive patients with ocu...

  18. Local renin–angiotensin system contributes to hyperthyroidism-induced cardiac hypertrophy

    OpenAIRE

    Kobori, H; Ichihara, A; Miyashita, Y; Hayashi, M; Saruta, T

    1999-01-01

    We have reported previously that thyroid hormone activates the circulating and tissue renin–angiotensin systems without involving the sympathetic nervous system, which contributes to cardiac hypertrophy in hyperthyroidism. This study examined whether the circulating or tissue renin–angiotensin system plays the principal role in hyperthyroidism-induced cardiac hypertrophy. The circulating renin–angiotensin system in Sprague–Dawley rats was fixed by chronic angiotensin II infusion (40 ng/ min, ...

  19. Experience and outcome of radioiodine therapy in hyperthyroidism

    International Nuclear Information System (INIS)

    Miah, S.H.; Paul, A.K.; Rahman, H.A.

    2005-01-01

    Full text: Radioiodine is being increasingly used in the treatment of hyperthyroidism. The primary reasons for choosing radioiodine therapy are its effectiveness, ease of administration, relatively low cost and paucity of side effects. Here we presented our experiences and outcome of radioiodine therapy in hyperthyroidism in a divisional referral centre.We retrospectively analyzed 203 patients receiving radioiodine therapy for hyperthyroidism in Centre for Nuclear Medicine and Ultrasound, Khulna during the period from July 1994 to June 2004. All the patients had clinical signs and symptoms of hyperthyroidism as well as elevated triiodothyronine (T 3 ), thyroxine (T 4 ) and suppressed thyroid stimulating hormone (TSH). T 3 , T 4 and TSH were done in all cases. Radionuclide scan and ultrasound of thyroid gland, radioactive iodine uptake (RAIU), thyroid microsomal antibody (TMAb) and fine needle aspiration cytology (FNAC) was done in selected cases. We assessed all patients prior to radioiodine therapy. Elderly patients and all those with cardiac complications and severe hyperthyroidism were pretreated with a short course of antithyroid drug in full dosages until they were clinically and biochemically euthyroid. Ninety five patients were on antithyroid medication (Neomercazole) prior to radioiodine therapy. Antithyroid medication were stopped 3 days before radioiodine therapy and restarted 3 days later and continued for 1 to 2 months depending on patient's symptoms. The rest of the patients received either no treatment or beta-blocker prior to radioiodine therapy. Menstrual history was taken in female patients and pregnancy was excluded by ultrasonography in doubtful cases before administering radioiodine. The likely consequences of the treatment were fully explained to the patients and attendants, the usual precautions for radiation protection of the public and the necessity of the follow-up were discussed and verbal consent was taken before administering radioiodine

  20. 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 stud...... design, characteristics of participants, or confounders. In order to test whether hyperthyroidism influences mortality, we performed a critical review and statistical meta-analysis....

  1. 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.

  2. Recurrent Graves' hyperthyroidism after prolonged radioiodine-induced hypothyroidism.

    Science.gov (United States)

    Salman, Fariha; Oktaei, Hooman; Solomon, Solomon; Nyenwe, Ebenezer

    2017-07-01

    Radioactive iodine (RAI) is the most cost effective therapy for Graves' disease (GD). Patients with GD who have become hypothyroid after therapeutic RAI, rarely develop recurrence of disease. Herein we describe a case of recurrence of thyrotoxicosis after 2 years of hypothyroidism. We present the clinical features, laboratory findings, imaging and management of an unusual case of recurrent hyperthyroidism. A 48-year-old male presented to the emergency room with a 2-day history of palpitation, chest discomfort and 30 pounds of weight loss. Examination was remarkable for rapid and irregular pulse, diffuse thyromegaly and brisk deep tendon reflexes but no eye changes or tremors. Laboratory tests showed thyroid-stimulating hormone (TSH) of 20 (1.8-4.7 pg/ml), total thyroxine >800 (80-200 ng/dl). Electrocardiogram showed atrial fibrillation with rapid ventricular response. RAI uptake and scan showed a homogenous gland with 54% uptake in 6 h and 45% in 24 h. He was treated with propranolol and propylthiouracil with some clinical improvement. He subsequently underwent RAI therapy and developed hypothyroidism after 8 weeks. Hypothyroidism was treated with levothyroxine. At 2 years after RAI ablation, he again developed symptoms of hyperthyroidism and had suppressed TSH. The levothyroxine dose was stopped, 3 weeks after discontinuing levothyroxine, he remained hyperthyroid with TSH of 0.008 and FT4 of 1.62 and FT3 of 4.8. RAI uptake demonstrated 17% uptake at 24 h. Recurrent hyperthyroidism in GD is uncommon after development of post-ablative hypothyroidism. Our case illustrates the need for continued surveillance.

  3. Ocena efektywności podziału subwencji oświatowej dla gmin

    Directory of Open Access Journals (Sweden)

    Jan Herczyński

    2016-06-01

    Full Text Available Celem przedstawionych analiz jest ocena dopasowania podziału pomiędzy gminy części oświatowej subwencji ogólnej do kosztów dostarczania usług edukacyjnych. W artykule zarysowano problematykę związaną z podziałem subwencji oświatowej pomiędzy gminy, opisano wagi stosowane w algorytmie podziału subwencji oświatowej, skoncentrowano się na zmianach wprowadzonych do algorytmu w 2015 r. i omówiono konsekwencje wynikające ze stosowania wag wiejskich, które mają stosunkowo duży wpływ na podział środków. W ostatniej części wprowadzono miarę nieefektywności algorytmu podziału części oświatowej subwencji ogólnej i zastosowano ją do oceny podziału środków subwencyjnych pomiędzy gminy. Miara ta pozwala m.in. ilościowo ocenić efekt zmian wprowadzonych do algorytmu w 2015 r. Zaproponowano możliwe korekty wag algorytmu pozwalające na redukcję nieefektywności i zjawiska tzw. przewrotnej motywacji organów prowadzących szkoły. W podsumowaniu przedstawiono główne wnioski wynikające z analiz.

  4. Graves hyperthyroidism 131I treatment the clinical curative effect of observation

    International Nuclear Information System (INIS)

    Duan Yongqiang; Wang Zuobing; Yu Hui; Wang Jing; Li Xiaoqin; Chen Yuanhao; Wu Jiquan

    2012-01-01

    Objective: to study the clinical treatment of 131 I Graves hyperthyroidism curative effect. Methods: the clinical data of Graves hyperthyroidism patients were retrospectively analyzed. Results: 258 cases of patients with hyperthyroidism Graves. 131 I treatment 1∼2 times after healed 200 cases, improvement of 38 patients, a low, 10 cases were invalid 10 cases failure; the total effective 96.12%. 1 year after treatment 131 I thyroid quality by before treatment 43.6 + 20.9 grams shrinks to 1.98 + 18.5 grams (p 131 I before treatment with prominent eyes 68 cases (26.4%) 131 I after treatment, the prominent eyes healed 24 cases (34.8%), improvement 30 patients (43.5%), invalid in 12 cases (17.4%), aggravating in 2 cases (2.9%), efficient for 79.7%. Concurrent hyperthyroidism 131 I before treatment in patients with 31 patients (heart), after the treatment of 131 I 12.0% in 25 patients recovered, 6 patients get better, efficient 100%. After the treatment of 131 I temporary armor low in 25 patients (9.7%) , permanent armour low 27 cases (10.5%). After the treatment of 131 I 15 cases have been reduced to a sex WBC (5.8%), 8 cases of liver function mild damage (3.1%), 13 cases itchy skin (1 case), cholesterol by 5.0% compared appear suspected hyperthyroidism crises (0.4%). 258 patients with thyroid type micronodular 41 cases, treatment cured after 131 I in 25 patients (61.0%), improvement in 16 (39.0%), laseris 100%, Diffuse 217 example, cure 175 cases (80.6%), improvement 22 patients (10%), a low 10 (4.6%), invalid 10 (4.6%), laseris 95.4 percent. Conclusion: 131 I treatment Graves hyperthyroidism is simple, safe, effective, and can be used as the preferred treatment method outperforms that of anti-thyroid drugs. (authors)

  5. [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.

  6. Maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of human chorionic gonadotropin: a case report.

    Science.gov (United States)

    Bakas, P; Tzouma, C; Creatsa, M; Boutas, I; Hassiakos, D

    2016-01-01

    To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. All signs of hyperthyroidism resolved and the results of thyroid function tests returned to normal without any medication after embryo meiosis. De novo maternal hyperthyroidism may develop during pregnancy as a result of pathological stimulation of the thyroid gland from the high levels of hCG hormone that can be seen in multiple pregnancies. The risk of hyperthyroidism is related to the number of fetuses. Reversibility of symptomatology can be seen after fetal reduction of multiple pregnancies.

  7. 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.

  8. Thyroid cancer following 131I therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Watanabe, Iwao

    1980-01-01

    A women aged 37 who had thyroid cancer after 131 I therapy for hyperthyroidism was reported. She had received various conservative therapies and surgical treatments for hyperthyroidism for 10 years before 131 I therapy. Similar cases were picked out from many reports, and their clinical characteristics were discussed. The incidence of thyroid cancer after 131 I therapy, age and sex of patients, dosage of 131 I, histological changes after the irradiation of 131 I, sites of thyroid cancer, and the relationship between 131 I therapy and the occurrence time of thyroid cancer were also considered. (Tsunoda, M.)

  9. Changes of cardiac function in hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Morishita, Takeshi; Kawamura, Yasuaki; Yamazaki, Junichi; Okuzumi, Ichio; Muto, Toshinori; Wakakura, Manabu; Okamoto, Kiyoshi; Irie, Minoru; Inoue, Kazuko.

    1988-01-01

    Changes of cardiac parameters in patients with 21 hyperthyroidisms and 11 primary hypothyroidisms were studied administered by methimazole or 1-thyroxine using radionuclide method. In hyperthyroidisms, cardiac parameter (CI, EF, PEP/LVET, PEP) normalized 4 - 6 week delayed compared with hormonal level (T 3 , T 4 ) recovery period. On the other hand, in hypothyroidism PEP/LVET delayed about 2 weeks compared with hormonal level, however, other cardiac parameters were maintained within normal level, relatively. Correlation between T 3 and LVET was significant statistically (r = -0.59, p 3 and PEP was significant (r = -0.60, p < 0.01) in hypothyroidisms, respectively. (author)

  10. Osteoporotic cytokines and bone metabolism on rats with induced hyperthyroidism; changes as a result of reversal to euthyroidism.

    Science.gov (United States)

    Simsek, Gönül; Karter, Yesari; Aydin, Seval; Uzun, Hafize

    2003-12-31

    Hyperthyroidism is characterized by increased bone turnover and resorptive activity. Raised levels of serum osteoporotic cytokines, such as interleukin (IL) -1beta, IL-6 and tumor necrosis factor (TNF)-alpha have been demonstrated previously in hyperthyroidism. These elevations are controversial and it is difficult to differentiate the contribution of thyroid hormones to the elevation of cytokines from that of the autoimmune inflammation in Graves' disease (GD) and follicular cell damage in thyroiditis. Therefore, we investigated the effect of thyroid hormones on serum IL-1beta, IL-6, TNF-alpha levels and bone metabolism on L-thyroxine induced hyperthyroid rats and changes in cytokine levels and bone metabolism on the same rats after reversal to euthyroidism. Rats were treated with L-thyroxine for 5 weeks (0.4 mg/ 100 g food). Plasma T3, T4, TSH and serum IL-1beta, IL-6, TNFalpha, Calcium (Ca), phosphorous (P), parathyroid hormone (PTH), alkaline phosphatase (ALP), bone alkaline phosphatase (B-ALP) levels were measured and differential leucocyte counts were made initially, at the 5th week of the experiment (hyperthyroid state) and 5 weeks after quitting the administration of L-thyroxine (euthyroid state). Significant rises in serum IL-1beta, IL-6 and TNFalpha were noted in hyperthyroidism (P hyperthyroid state while there was no correlation in euthyroid states. Ca and P levels did not differ significantly while PTH levels declined significantly in the hyperthyroid state (P hyperthyroidism (P hyperthyroid state (P metabolism in hyperthyroidism might be mediated by cytokines and the increased bone turnover in hyperthyroidism failed to decrease despite euthyroidism.

  11. 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.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

    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

  13. 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.

  14. Hypothyroidism and hyperthyroidism in the elderly.

    Science.gov (United States)

    Mintzer, M J

    1992-04-01

    Thyroid disease in the elderly can be easily overlooked. Symptoms too often are explained away as normal processes of aging. Development of unstable illness, especially cardiac disease, is a frequent mode of presentation. One symptom or one clinical feature of thyroid disease in the elderly may be overwhelming in its presentation, as in apathetic hyperthyroidism, thyroid myopathy, depression and dementia. Physical examination of the thyroid gland can be helpful but in a high percentage of older patients the gland is normal to palpation. The treatment of hypothyroidism is straightforward. Only myxedema coma requires large doses of levothyroxine parenterally; all other forms of hypothyroidism are treated with oral levothyroxine. The dose is started very low and increased gradually over months. The euthyroid state is achieved gradually and safely. Hyperthyroidism can be treated by several modalities. In the unstable elderly patient, antithyroid medication can quickly produce a euthyroid state. When the patient is stable, further decisions can be made regarding definitive therapy. Radioactive iodine therapy is well-tolerated and effective. On occasion, a second course of therapy is needed to suppress hyperthyroidism. Close follow-up of all patients ever having received this therapy is needed to identify the development of hypothyroidism. Surgical thyroid ablation may be necessary in patients who fail to respond to radioactive iodine therapy. Abnormalities associated with unresolved thyromegaly, dysphagia, or tracheal compression may require surgical intervention. If suspicion exists that the gland is cancerous, surgical intervention is warranted.

  15. Effect of propranolol on heart rate variability in hyperthyroidism.

    Science.gov (United States)

    Tankeu, Aurel T; Azabji-Kenfack, Marcel; Nganou, Chris-Nadège; Ngassam, Eliane; Kuate-Mfeukeu, Liliane; Mba, Camille; Dehayem, Mesmin Y; Mbanya, Jean-Claude; Sobngwi, Eugene

    2018-02-22

    We aimed to determine the effect of propanolol on heart rate variability (HRV) in hyperthyroidism before antithyroid treatment. This was a before and after study, on ten patients presenting overt hyperthyroidism naïve to treatment. In each patient, a resting electrocardiogram was done followed by estimation of cardiac autonomic dysfunction during five maneuvers (Ewing battery tests). Long term HRV measurement was done using 24 h ambulatory electrocardiographic recording. This automatically provided estimation of HRV using SDNN and RMSSD index, LF, HF, and HF/LF ratio. After baseline investigations, 40 mg of propanolol was given twice a day for 3 days and same parameters were measured after 72 h of treatment. Our patients were aged 40 ± 10 years. Propanolol significantly reduced RR and HR interval (669 ms vs 763 ms and 91 vs 79 bpm; p hyperthyroidism. Trial registration NCT03393728 "Retrospectively registered".

  16. Ophthalmological evolution in hyperthyroid patients treated with radioactive iodine

    International Nuclear Information System (INIS)

    Marrero Rodriguez, Maria Teresa; Rodriguez Gonzalez, Julio Cesar; Alavez Martin, Ernesto

    2005-01-01

    This study was aimed at analyzing the ophthalmological evolution in hyperthyroid patients treated with radioactive iodine. 100 patients (88 females and 12 males) from the thyroid department of the National Institute of Endocrinology with clinical and biochemical diagnosis of hyperthyroidism and with a mean age of 40 + - 10 years old, were studied. These patients underwent a treatment with radioactive iodine at a dose of 80 m Ci/g of thyroid tissue. A bilateral ophthalmometry was performed to each patient before the treatment and 12 months after it. Mean ophthalmometry of the right eye was 14.51 + - 2.86 mm before the treatment and 13.92 + - 2.83 mm after the treatment, whereas for the left eye it was 14.98 + - 2.91 mm and 14.27 + - 2.83 mm , respectively. Taking into account the results of the ophthalmometry, we concluded that the use of radioactive iodine in the treatment of hyperthyroid patients had no negative results on the ophthalmological evolution of the studied patients

  17. Hyperthyroidism: Presenting as Isolated Tricuspid Regurgitation and Right Heart Failure

    OpenAIRE

    Whitner, Tanya E.; Hudson, Christopher J.; Smith, Timothy D.; Littmann, Laszlo

    2005-01-01

    Although hyperthyroidism has many signs and symptoms, right heart failure can occasionally be the main presenting symptom. We describe the case of a previously healthy 42-year-old woman whose chief complaint was progressive bilateral lower extremity edema. The echocardiogram revealed right atrial dilatation and moderate-to-severe tricuspid regurgitation. Results of laboratory studies were consistent with hyperthyroidism. Thyroid ablation resulted in permanent resolution of symptoms and resolu...

  18. 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.

  19. Subclinical Hyperthyroidism and the Risk of Coronary Heart Disease and Mortality

    Science.gov (United States)

    Collet, Tinh-Hai; Gussekloo, Jacobijn; Bauer, Douglas C.; den Elzen, Wendy P. J.; Cappola, Anne R.; Balmer, Philippe; Iervasi, Giorgio; Åsvold, Bjørn O.; Sgarbi, José A.; Völzke, Henry; Gencer, Bariş; Maciel, Rui M. B.; Molinaro, Sabrina; Bremner, Alexandra; Luben, Robert N.; Maisonneuve, Patrick; Cornuz, Jacques; Newman, Anne B.; Khaw, Kay-Tee; Westendorp, Rudi G. J.; Franklyn, Jayne A.; Vittinghoff, Eric; Walsh, John P.; Rodondi, Nicolas

    2013-01-01

    Background Data from prospective cohort studies regarding the association between subclinical hyperthyroidism and cardiovascular outcomes are conflicting. We aimed to assess the risks of total and coronary heart disease (CHD) mortality, CHD events, and atrial fibrillation (AF) associated with endogenous subclinical hyperthyroidism among all available large prospective cohorts. Methods Individual data on 52 674 participants were pooled from 10 cohorts. Coronary heart disease events were analyzed in 22 437 participants from 6 cohorts with available data, and incident AF was analyzed in 8711 participants from 5 cohorts. Euthyroidism was defined as thyrotropin level between 0.45 and 4.49 mIU/L and endogenous subclinical hyperthyroidism as thyrotropin level lower than 0.45 mIU/L with normal free thyroxine levels, after excluding those receiving thyroid-altering medications. Results Of 52 674 participants, 2188 (4.2%) had subclinical hyperthyroidism. During follow-up, 8527 participants died (including 1896 from CHD), 3653 of 22 437 had CHD events, and 785 of 8711 developed AF. In age-and sex-adjusted analyses, subclinical hyperthyroidism was associated with increased total mortality (hazard ratio [HR], 1.24, 95% CI, 1.06–1.46), CHD mortality (HR, 1.29; 95% CI, 1.02–1.62), CHD events (HR, 1.21; 95% CI, 0.99–1.46), and AF (HR, 1.68; 95% CI, 1.16–2.43). Risks did not differ significantly by age, sex, or preexisting cardiovascular disease and were similar after further adjustment for cardiovascular risk factors, with attributable risk of 14.5% for total mortality to 41.5% for AF in those with subclinical hyperthyroidism. Risks for CHD mortality and AF (but not other outcomes) were higher for thyrotropin level lower than 0.10 mIU/L compared with thyrotropin level between 0.10 and 0.44 mIU/L (for both, P value for trend, ≤.03). Conclusion Endogenous subclinical hyperthyroidism is associated with increased risks of total, CHD mortality, and incident AF, with highest

  20. The clinical significance of the early presence hyperthyroidism from into hyperthyroidism by thyroid antibody due to the radioiodine treatment

    International Nuclear Information System (INIS)

    Liang Huaju; Ma Yuqin; Xu Yaoling; Liu Junqing; Zhang Huafang

    2008-01-01

    Objective: To observe the levels of TMAb, TGAb, TRAb in the serum of patients with hyperthyroidism before the treatment of radioiodine ( 131 I) and investigate the clinical significance of the early hypothyroidism after 131 I treatment. Methods: According to the levels of thyroid auto-antibodies, 622 patients with hyperthyroidism were divided into four groups: group A 54 cases with negative TMAb, TGAb and TRAb, group B 176 cases with nagative TMAb and TGAb and positive TRAb, group C 78 caese with positive TMAb, TGAb and negative TRAb, Group D, 314 cases with positive TMAb TGAb and TRAb. The rate of early hypothyroidism were observed regularly after 1 3 1 I therapy in each group. Results: The rates of early hypothyroidism were 11.11% in group A, 13.64% in group B, 26.92% in group C and 23.57% in group D, Both the rates in group A and group B are lower than those in group C and group D (P 0.05). Conclusion: The levels of TMAb, TGAb in are serum in an important influencing factor on the rate of the early hypothyroidism after 131 I therapy for patients with hyperthyroidism, while the level of TRAb is of no importance. (authors)

  1. Radioiodine therapy for hyperthyroidism

    International Nuclear Information System (INIS)

    Barrenechea, E.C.A.

    1996-01-01

    The introduction of I-131 in 1946 for the treatment of hyperthyroidism marked a historic event. It ushered in the era of radionuclides in medicine and led to the birth of nuclear medicine. Today I-131 has become one of the most commonly used agents for the treatment of hyperthyroidism. Ninety percent (90%) of its effect is due to beta radiation and 10% is due to gamma radiation. The mechanism of action is production of radiation thyroiditis (3-10 days) and chronic gland atrophy (over a period of 3 years). To achieve the necessary dosage levels, four considerations are needed: maximum amount of I-131 taken by the thyroid gland, size of tissue to be irradiated, effective half life of the isotope in the thyroid and relative sensitivity of the thyroid to I-131. There are two kinds of dosing - the preferred dose where 160 μCi/gram of tissue of given (15-20μCi) or the usual dose 80 μCi/gram - (2 to 15 mCi). In giving these dosages, four basic approaches are utilized and two major principles are applied. However, precision in the calculation of I-131 dose makes very little difference in the outcome in any individual patients. The inherent sensitivity of the thyroid to radiation seems to vary widely for unknown reasons. The success in treatment is high with incidence of cure as follows: 70-86% in single dose; 10-20% using 2 doses and less than 5% required 3 doses or more. Adjunctive therapy in the forms of antithyroid drugs, beta blocker and steroids may be needed. There are short and long term complications where hypothyroidism is the most important complication. Long term follow-up is advocated by FT4 and TSH determinations. There is an unknown risk of malignancy and genetic damage. Finally, I-131 has been a choice of treatment for hyperthyroidism with some considerations in the U.S.A., Europe, and Asia. It is rapidly effective, predictable and inexpensive. Several studies on the experience will be discussed. (author)

  2. Radioimmunoassay for thyroid hormones determination on rats progeny with hypothyroidism and hyperthyroidism

    International Nuclear Information System (INIS)

    Silveira, Maria F.G.; Danda, Karina P.N.; Luna, Taciana F.; Souza, Grace M.; Catanho, Maria T.J.A.; Bernardo-Filho, Mario; Moura, Egberto G.

    2002-01-01

    The onset of fetal thyroid function occurs about 17-18 days after conception in the rat. The maternal hypothyroidism or hyperthyroidism which occur during gestation provokes alteration, the hormonal modification in the newborn rats was analyzed. The hypothyroidism was induced in normal dams, which were being treated for 7 days with methimazole (in the of 0,03 % in drinking water) before mating. The hyperthyroidism was induced in normal dams, which were being treated for 2 days with T 4 (2μg per 100 g body wt/day) before mating. It was seen that the rat which was born from hypothyroid or hyperthyroid dams suffered alteration on its T 4 levels concerning the days 10,20,30 and 60 after birth. The administration of methimazole or thyroxine affects the fetal thyroid gland function, causing alteration of both T 4 levels, even after the birth, indicating that the maternal hypothyroidism or hyperthyroidism influence on the post-natal life of the rat. (author)

  3. Transient hyperthyroidism after surgery for secondary hyperparathyroidism: a common problem

    Science.gov (United States)

    2011-01-01

    Background Postoperative hyperthyroidism occurs in approximately one third of patients following parathyroidectomy due to primary hyperparathyroidism (PHP), but has only rarely been described in secondary hyperparathyroidism (SHP). The frequency, course, and laboratory markers of postoperative hyperthyroidism in SHP remain unknown. Our purpose was to evaluate the frequency and the clinical course of postoperative hypcrthyroidism following surgery of SHP and to determine the diagnostic value of thyroglobulin in this setting. Material and Methods A total of 40 patients undergoing parathyroidectomy because of SHP were included in this study. Thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fl4), and thyroglobulin (Tg) were determined one day before and on day 1, 3, 5, 10, and 40 after surgery. At each of these visits patients were clinically evaluated for signs or symptoms of hyperthyroidism. Results Biochemical evidence of hyperthyroidism was evident in 77% of patients postoperatively despite of preoperatively normal serum levels. TSH dropped from 1.18 ± 0.06mU/L to 0.15 ± 0.07mU/L (p = 0.0015). Free triiodothyronine (fT3) and fT4 levels increased from 2.86 ± 0.02ng/L and 10.32 ± 0.13ng/L, respectively, to their maximum of 4.83 ± 0.17ng/L and 19.35 ± 0.58ng/L, respectively. Thyroglobulin levels rose from 3.8 ± 0.8ng/mL to 111.8 ± 45.3ng/mL (p hyperthyroidism is frequent after parathyroidectomy for SHP with Tg being a suitable marker. Awareness of this self-limiting disorder is important to avoid inappropriate and potentially harmful treatment. PMID:21813380

  4. Transient hyperthyroidism after surgery for secondary hyperparathyroidism: a common problem

    Directory of Open Access Journals (Sweden)

    Rudofsky G

    2011-08-01

    Full Text Available Abstract Background Postoperative hyperthyroidism occurs in approximately one third of patients following parathyroidectomy due to primary hyperparathyroidism (PHP, but has only rarely been described in secondary hyperparathyroidism (SHP. The frequency, course, and laboratory markers of postoperative hyperthyroidism in SHP remain unknown. Our purpose was to evaluate the frequency and the clinical course of postoperative hypcrthyroidism following surgery of SHP and to determine the diagnostic value of thyroglobulin in this setting. Material and Methods A total of 40 patients undergoing parathyroidectomy because of SHP were included in this study. Thyroid stimulating hormone (TSH, free triiodothyronine (fT3, free thyroxine (fl4, and thyroglobulin (Tg were determined one day before and on day 1, 3, 5, 10, and 40 after surgery. At each of these visits patients were clinically evaluated for signs or symptoms of hyperthyroidism. Results Biochemical evidence of hyperthyroidism was evident in 77% of patients postoperatively despite of preoperatively normal serum levels. TSH dropped from 1.18 ± 0.06mU/L to 0.15 ± 0.07mU/L (p = 0.0015. Free triiodothyronine (fT3 and fT4 levels increased from 2.86 ± 0.02ng/L and 10.32 ± 0.13ng/L, respectively, to their maximum of 4.83 ± 0.17ng/L and 19.35 ± 0.58ng/L, respectively. Thyroglobulin levels rose from 3.8 ± 0.8ng/mL to 111.8 ± 45.3ng/mL (p Conclusion Transient hyperthyroidism is frequent after parathyroidectomy for SHP with Tg being a suitable marker. Awareness of this self-limiting disorder is important to avoid inappropriate and potentially harmful treatment.

  5. Transient hyperthyroidism after surgery for secondary hyperparathyroidism: a common problem.

    Science.gov (United States)

    Rudofsky, Gottfried; Tsioga, M; Reismann, P; Leowardi, C; Kopf, S; Grafe, I A; Nawroth, P P; Isermann, B

    2011-08-08

    Postoperative hyperthyroidism occurs in approximately one third of patients following parathyroidectomy due to primary hyperparathyroidism (PHP), but has only rarely been described in secondary hyperparathyroidism (SHP). The frequency, course, and laboratory markers of postoperative hyperthyroidism in SHP remain unknown. Our purpose was to evaluate the frequency and the clinical course of postoperative hyperthyroidism following surgery of SHP and to determine the diagnostic value of thyroglobulin in this setting. A total of 40 patients undergoing parathyroidectomy because of SHP were included in this study. Thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroglobulin (Tg) were determined one day before and on day 1, 3, 5, 10, and 40 after surgery. At each of these visits patients were clinically evaluated for signs or symptoms of hyperthyroidism. Biochemical evidence of hyperthyroidism was evident in 77% of patients postoperatively despite of preoperatively normal serum levels. TSH dropped from 1.18 ± 0.06mU/L to 0.15 ± 0.07mU/L (p = 0.0015). Free triiodothyronine (fT3) and fT4 levels increased from 2.86 ± 0.02ng/L and 10.32 ± 0.13ng/L, respectively, to their maximum of 4.83 ± 0.17ng/L and 19.35 ± 0.58ng/L, respectively. Thyroglobulin levels rose from 3.8 ± 0.8ng/mL to 111.8 ± 45.3ng/mL (phyperthyroidism is frequent after parathyroidectomy for SHP with Tg being a suitable marker. Awareness of this self-limiting disorder is important to avoid inappropriate and potentially harmful treatment.

  6. Energy Metabolism in the Bone is Associated with Histomorphometric Changes in Rats with Hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Zhuoqing Hu

    2018-04-01

    Full Text Available Background/Aims: In this study we assessed histomorphometric changes induced by thyroxine (T4 in 3-month-old hyperthyroid male rats and examined whether the potential mechanism of these changes is related to bone changes. Methods: Rats were classified as either hyperthyroid following administration of 250 µg/kg/day freshly prepared T4 by gavage for 2 months or euthyroid following administration of vehicle alone (n = 8 per group. We measured bone mineral density (BMD, bone biomechanical properties, and bone histomorphometric changes. Levels of serum indicators were also measured, and three right femurs from the two groups were selected for proteomic investigation. Results: Compared with the control rats, hyperthyroid rats showed a reduction in the fifth lumbar vertebral BMD as well as in the entire femoral BMD (p = 0.033 and 0.026, respectively. Histomorphometric analysis of the proximal tibial metaphysis showed that the percentage of the trabecular area, trabecular number, and percentage of the cortical bone area in the hyperthyroid rats significantly decreased compared with those of the control rats. Conversely, bone formation rate (per unit of bone surface and bone volume, percentage of the osteoclast perimeter, trabecular separation, and endosteal mineral apposition rate in the hyperthyroid rats significantly increased compared with the control rats (all p < 0.05. Except for stiffness (p = 0.24, all bone biomechanical properties of the femur showed a significant decreasing trend in the hyperthyroid rats versus the control rats (all p < 0.05. Serum levels of osteocalcin, alkaline phosphatase, terminal telopeptides of type β collagen, and tartrate-resistant acid phosphatase were higher in the hyperthyroid rats than in the control rats (all p < 0.05. Using isobaric tags for relative and absolute quantification (iTRAQ, the expression levels of 1,310 proteins were found to be significantly different between the hyperthyroid and control rats (711

  7. [Aneurysm of the ascending aorta, hyperthyroidism and pregnancy. Case report].

    Science.gov (United States)

    Zavala-Barrios, Berenice; García-Castanedo, Carla; Viruez-Soto, José Antonio; Briones-Garduño, Jesús Carlos; Coronel-Cruz, Fausto

    2015-10-01

    Aortic aneurysms are a rare condition in childhood and youth, etiology, evolution, natural progression and prognosis in pregnancy unknown. Hyperthyroidism occurs when there is a synthesis and/or excessive secretion of thyroid hormones during pregnancy poses difficulty for diagnosis. The new monitoring hemodynamics in pregnancy by transthoracic bioimpedance is a feasible alternative, noninvasive and real-time hemodynamic monitoring pregnant women. Primiparity 18, is referred to present tachycardia, hyperthyroidism is diagnosed and drug treatment is initiated with antithyroid from week 14.1 echocardiogram reports bivalve aortic aneurysm in the sinus of Valsalva is performed. He was determined to continue the same under strict hemodynamic and fetal monitoring. Pregnancy concludes at the end obtained through the abdomen, at 40.4 weeks, with male product, weight 2250 g, Apgar 9/9, with growth restriction type I. The mother and baby were discharged simultaneously without complications. The hyperdynamic state of pregnant patients in hyperthyroidism and aneurysms is complex and potentially complicable is why the hemodynamic patient monitoring is essential to detect changes in it that endanger the life of the binomial to this condition. Heart disease and hyperthyroidism, in this case, consistent with a fetal complications level is described as intrauterine growth restriction, however narrow and multidisciplinary monitoring and timely interventions binomial lead to satisfactory results in this case.

  8. Urinary deoxypyridinoline (DPD), serum bone glia protein (BGP) and bone metabolism change in hyperthyroidism

    International Nuclear Information System (INIS)

    Zeng Yun; Ding Jianzhong; Xiang Hong

    2002-01-01

    Objective: To study the effect of thyroid function on bone metabolism. Methods: Urinary DPD, Serum FT 3 , FT 4 and BGP levels were determined with chemiluminescence assay and RIA in 41 patients with hyperthyroidism and 47 healthy controls. Results: Urinary DPD and serum FT 3 , FT 4 , BGP levels were significantly higher in patients with hyperthyroidism than those in healthy controls (p < 0.01). Conclusion: The data showed that hyperthyroidism was correlated with bone metabolism

  9. A comparison of 20 or 40 mg per day of carbimazole in the initial treatment of hyperthyroidism.

    Science.gov (United States)

    Page, S R; Sheard, C E; Herbert, M; Hopton, M; Jeffcoate, W J

    1996-11-01

    The optimal dosage regimen for carbimazole (CBZ) in the treatment of hyperthyroidism remains uncertain, despite clinical use of the drug for approximately fifty years. We have compared the early clinical and biochemical responses to 20 or 40 mg/day of CBZ given as initial treatment for hyperthyroidism. Prospective open multicentre trial. Sixty-three patients presenting with hyperthyroidism. Serum total and free thyroid hormones, serum TSH and SHBG were measured at baseline and at 4 and 10 weeks after start of therapy. Weight, pulse and a symptom questionnaire were also monitored at 6 and 12 weeks. Patients randomized to a starting dose of 40 mg/day CBZ had lower total (98 +/- 10 vs 158 +/- 11 nmol/l, P symptom score) and SHBG concentrations were similar. Drug-related hypothyroidism was less likely to occur at 4 and 10 weeks in those patient who initially received 20 mg CBZ/day, but this dose was less effective at controlling hyperthyroidism in those with more severe hyperthyroidism with baseline TT4 > 260 nmol/l. In treating hyperthyroidism, 20 mg/day carbimazole is effective, convenient and has a lower risk than 40 mg/day of iatrogenic hypothyroidism in patients with mild or moderate hyperthyroidism. Higher doses are required for those with severe hyperthyroidism.

  10. Circulating Levels of Orexin-A, Nesfatin-1, Agouti-Related Peptide, and Neuropeptide Y in Patients with Hyperthyroidism.

    Science.gov (United States)

    Tohma, Yusuf; Akturk, Mujde; Altinova, Alev; Yassibas, Emine; Cerit, Ethem Turgay; Gulbahar, Ozlem; Arslan, Metin; Sanlier, Nevin; Toruner, Fusun

    2015-07-01

    There is insufficient information about the appetite-related hormones orexin-A, nesfatin-1, agouti-related peptide (AgRP), and neuropeptide Y (NPY) in hyperthyroidism. The aim of the present study was to investigate the effects of hyperthyroidism on the basal metabolic rate (BMR) and energy intake, orexin-A, nesfatin-1, AgRP, NPY, and leptin levels in the circulation, and their relationship with each other and on appetite. In this prospective study, patients were evaluated in hyperthyroid and euthyroid states in comparison with healthy subjects. Twenty-one patients with overt hyperthyroidism and 33 healthy controls were included in the study. Daily energy intake in the hyperthyroid state was found to be higher than that in the euthyroid state patient group (p=0.039). BMR was higher in hyperthyroid patients than the control group (p=0.018). Orexin-A was lower and nesfatin-1 was higher in hyperthyroid patients compared to the controls (phyperthyroid and euthyroid states and controls (p>0.05). Orexin-A correlated negatively with nesfatin-1 (p=0.042), BMR (p=0.013), free triiodothyronine (fT3; phyperthyroidism" was the main factor affecting orexin-A (phyperthyroidism, the orexin-A and nesfatin-1 levels are markedly affected by hyperthyroidism.

  11. 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.

  12. 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

  13. Evaluation of oxidative status with exhaled breath 8-isoprostane levels in patients with hyperthyroidism.

    Science.gov (United States)

    Bastug, Emrah; Tasliyurt, Turker; Kutluturk, Faruk; Sahin, Safak; Yilmaz, Ayse; Sivgin, Hakan; Yelken, Berna Murat; Ozturk, Banu; Yilmaz, Abdulkerim; Sahin, Semsettin

    2013-12-01

    Studies conducted so far on the effect of hyperthyroidism on oxidative stress (OS) have employed blood and urine samples. Exhaled Breath Condensate (EBC) is a non-invasive technique used to take sample from lungs to determine many biological indications. The aim of the present study was determine the possibility of using 8- isoprostane levels in EBC as an indicator of OS in hyperthyroid patients. The present study was performed on 42 patients with hyperthyroidism and 42 healthy control subjects. Hyperthyroid patients included patients with newly diagnosed Graves' disease, toxic multinodular goiter and toxic adenoma. Exhaled breath condensates were collected from patients in each group using a condensing device. 8- isoprostane levels as an indicator of OS in EBC were detected via immunoassay method. Hyperthyroid patients and control groups had 8-isoprostane levels of 6.08±6.31 and 1.56±0.88 pg/ml, respectively. The difference between patient and control groups was statistically significant (phyperthyroid patients, eleven had Graves', 21 multinodular goiter, and 10 toxic adenoma diagnosis. There were no significant differences among patients of different diagnoses for 8-isoprostane levels (p=0.541). No significant correlations were found between 8-isoprostane and free thyroxine (fT4) or thyroid stimulating hormone (TSH) levels. In the present study, 8-isoprostane levels in EBC of hyperthyroid patients were found to be significantly higher than that in healthy control group. This study is important in that it is the first to evaluate the effects on respiratory system of elevated OS of hyperthyroidism in EBC.

  14. Coexistence of adult-onset Still's disease and autoimmune hyperthyroidism in a patient who responded to corticosteroids and β-blocker.

    Science.gov (United States)

    Chen, Hsiao-Shuang; Yu, Kuang-Hui; Ho, Huei-Huang

    2010-12-01

    The pathogenesis of adult-onset Still's disease (AOSD), which is currently thought to be an autoimmune disorder, may share similarities with autoimmune hyperthyroidism. This report describes a middle-aged woman in whom hyperthyroidism and Still's disease developed concurrently. During the course of her illness, the hyperthyroidism was observed to be aggravated whenever her AOSD was in the active stage. After her AOSD activity was controlled, her hyperthyroidism improved clinically. The extent of activation of her hyperthyroidism was observed in parallel to the extent of activation of her AOSD. Furthermore, the patient developed neutropenia after receiving either propylthiouracil (PTU) or methimazole, both of which are standard accepted medications for treatment of hyperthyroidism. Immune mechanisms contributed to PTU induced neutropenia have been proposed, and hyperthyroid patients treated with standard antithyroid agents should be monitored for blood cell counts especially for AOSD patients. Corticosteroid may effect Graves' disease activity, and steroids may play a role in the treatment of hyperthyroidism if a patient had drug allergies to antithyroid agents.

  15. Subclinical hyperthyroidism is a risk factor for poor functional outcome after ischemic stroke.

    Science.gov (United States)

    Wollenweber, Frank Arne; Zietemann, Vera; Gschwendtner, Andreas; Opherk, Christian; Dichgans, Martin

    2013-05-01

    Subclinical hyperthyroidism is associated with adverse cardiovascular events, including stroke and atrial fibrillation. However, its impact on functional outcome after stroke remains unexplored. A total of 165 consecutively recruited patients admitted for ischemic stroke were included in this observational prospective study. Blood samples were taken in the morning within 3 days after symptom onset, and patients were divided into the following 3 groups: subclinical hyperthyroidism (0.1hyperthyroidism, and 23 patients (13.9%) had subclinical hypothyroidism. Patients with subclinical hyperthyroidism had a substantially increased risk of functional disability 3 months after stroke compared with subjects with euthyroid state (odds ratio, 2.63; 95% confidence interval, 1.02-6.82, adjusted for age, sex, smoking status, and time of blood sampling). The association remained significant, when including the baseline NIHSS, TIA, serum CRP, atrial fibrillation, body mass index, and total cholesterol as additional variables (odds ratio, 3.95; 95% confidence interval, 1.25-12.47), and was confirmed by the secondary outcome (Barthel Index: odds ratio, 9.12; 95% confidence interval, 2.08-39.89). Subclinical hyperthyroidism is a risk factor for poor outcome 3 months after ischemic stroke.

  16. The role of hyperthyroidism as the predisposing factor for superior sagittal sinus thrombosis.

    Science.gov (United States)

    Hwang, Jong-Uk; Kwon, Ki-Young; Hur, Jin-Woo; Lee, Jong-Won; Lee, Hyun-Koo

    2012-09-01

    Superior sagittal sinus thrombosis (SSST) is an uncommon cause of stroke, whose symptoms and clinical course are highly variable. It is frequently associated with a variety of hypercoagulable states. Coagulation abnormalities are commonly seen in patients with hyperthyroidism. To the best of our knowledge, there are few reports on the association between hyperthyroidism and cerebral venous thrombosis. We report on a 31-year-old male patient with a six-year history of hyperthyroidism who developed seizure and mental deterioration. Findings on brain computed tomography (CT) showed multiple hemorrhages in the subcortical area of both middle frontal gyrus and cerebral digital subtraction angiography (DSA) showed irregular intra-luminal filling defects of the superior sagittal sinus. These findings were consistent with hemorrhagic transformation of SSST. Findings on clinical laboratory tests were consistent with hyperthyroidism. In addition, our patient also showed high activity of factors IX and XI. The patient received treatment with oral anticoagulant and prophylthiouracil. His symptoms showed complete improvement. A follow-up cerebral angiography four weeks after treatment showed a recanalization of the SSS. In conclusion, findings of our case indicate that hypercoagulability may contribute to development of SSST in a patient with hyperthyroidism.

  17. Selected markers of endothelial dysfunction in patients with subclinical and overt hyperthyroidism

    International Nuclear Information System (INIS)

    Modzelewska, A.; Szelachowska, M.; Zonenberg, A.; Abdelrazek, S.; Nikolajuk, A.; Gorska, M.

    2006-01-01

    Introduction: There are many factors causing endothelial dysfunction. The aim was to observe chosen markers of endothelial function in patients with subclinical and overt hyperthyroidism. Material and methods: We studied 97 patients with hyperthyroidism: 51 with subclinical (44 F/7 M; mean age 49.3 ± 15.9 y) and 46 patients with overt (39 F/7 M, mean age 50.4 ± 13.2 y). The control comprised of 39 healthy volunteers (26 F/13 M, mean age 47.5 ± 11.8 y). Concentration of TSH, FT3, FT4 were measured by MEIA, TPO Ab, TG Ab, E-selectin, interleukin 6, VCAM-1, ICAM-1 by ELISA. Results: The goiter was found in 71 persons 63F/8M, mean age 49.9 ± 15.3 y, (42-subclinical, 29-overt). Morbus Graves--Basedow was diagnosed in 26 persons, 20 F/6 M, mean age 49.5 ± 12.8 y (9-subclinical, 17-overt). There were no significant differences serum concentration of E-selectin, IL-6, ICAM-1 in patients with subclinical and overt hyperthyroidism compared to the control. Statistically significant differences were shown between concentration of IL-6 in patients with Graves-Basedow compared with the control (p < 0.05). Significance of VCAM-1 values were found in the patients with subclinical and overt hyperthyroidism compared to the control (p < 0.001; p < 0.001, respectively). Conclusions: Among persons with overt and subclinical hyperthyroidism occurs endothelial dysfunction which doesn't depends on exciting cause of thyrotoxicosis but on degree of hyperthyroidism. Elevated concentrations of endothelial markers may confirm that persons with thyroid disorders are extremely exposed to the occurrence of the cardiovascular diseases. (author)

  18. Dietary omega 6 fatty acids and the effects of hyperthyroidism in mice.

    Science.gov (United States)

    Deshpande, N; Hulbert, A J

    1995-03-01

    The influence of the type of dietary fat on the effects of thyroid hormones was investigated in mice. Hyperthyroidism was achieved by providing thyroid hormones (T3 and T4) in the drinking water. Both hyperthyroid and euthyroid mice (Mus musculus) were fed isoenergetic diets containing 18% (w/w) total lipid but differing in fatty acid composition. Diets were either low in the polyunsaturated linoleic acid (18:2, omega 6) and high in saturated fatty acids (SFAs) or low in saturated fats and high in the polyunsaturated fatty acid (PUFA), linoleic acid. Treatments were maintained for 21-22 days. Plasma thyroid hormone levels, standard metabolic rate (SMR), changes in body mass, specific activities of malic enzyme (ME), Na-K-ATPase and glycerolphosphate dehydrogenase (GPDH) of the liver were measured. Fatty acid composition of the liver phospholipids was also determined. Levels of T3 (15-17 nM) and T4 (250-255 nM) were significantly higher in the respective hyperthyroid groups. There was no significant influence of the diet on hormone levels. Hyperthyroidism increased the SMR 37-44% above the euthyroid levels. A significant body weight loss of 14-18% was observed in hyperthyroid mice on the PUFA diet but not in those on the SFA diet. PUFA diet significantly reduced the activity of ME but had no effect on Na-K-ATPase or GPDH activity. Activities of Na-K-ATPase and GPDH were significantly elevated in all hyperthyroid groups. Mice on T4 and PUFA diet showed a highly significant 399% increase in GPDH activity above the euthyroid level.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Results of radioiodine treatment in various types of hyperthyroidism

    International Nuclear Information System (INIS)

    Donner, C.S.

    1988-01-01

    During an investigation period starting early in 1982 and ending in the middle of 1985 a total of 360 patients were treated with iodine-131 for hyperthyroidism of different origins. The case reports of 337 of these patients were reviewed for the purposes of this study. The patients were divided into three groups. In this cohort, the healing rates achieved with one single treatment were 84.4% for autonomic adenomas, 50.8% for hyperthyroidism of other than immunologic origins and 22.7% for Basedow's disease. After a series of up to four treatments the healing rates were seen to be increased to 93% for autonomous adenomas, 84% for nonimmunogenic hyperthyroidism and 80% for Basedow's disease. The results thus achieved appeared to be unrelated to the patients' sex or previous surgical interventions for disorders of the thyroid. The findings show that therapeutic regimes calculated individually on the basis of a formula should be approached with some caution. Thus, doses lower than 100 Gy are hardly advisable for patients showing diffuse hyperthyroidism. It would also appear wise in autonomous adenomas to reduce the dose from 400 to 200 Gy. Likewise, the use of doses above 15 mCi should be restricted to special cases. A dose-effect relationship could not be detected in patients suffering from Basedow's disease. It seems recommendable here to use low initial doses so as to permit less radiosensitive patients to be healed by repeat treatment with a higher dose. (orig./MG) [de

  20. 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. Conflict of interest:None declared. PMID:23154161

  1. 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.

  2. TSH-induced hyperthyroidism caused by a pituitary tumor.

    Science.gov (United States)

    Beck-Peccoz, Paolo; Persani, Luca

    2006-09-01

    A 45-year-old man presented with frontal headache and visual disturbances to our clinic. For the previous 5 years, he had been receiving treatment for long-lasting mild hyperthyroidism with antithyroid therapy, but therapy had not been carefully followed. During the last 2 years he had also complained of erectile dysfunction and loss of libido. On physical examination, he had a small goiter, normal skin, no Graves' ophthalmopathy, normal BMI, and reduced testis volume and pubic hair. Serum levels of free T3 and T4, serum prolactin, testosterone, serum gonadotropins, insulin-like growth factor 1, adrenocorticotropic hormone, and cortisol were measured. MRI scan, TSH-releasing hormone test, and T3 suppression test were carried out. Levels of pituitary glycoprotein hormone alpha-subunit and sex-hormone-binding protein were also measured. Hyperthyroidism caused by a mixed pituitary adenoma that secretes prolactin and TSH. Trans-sphenoidal resection of the pituitary tumor. After surgery, T3 suppression test failed to completely suppress TSH secretion, which suggested a persistence of residual adenomatous cells. Hyperthyroidism and hypogonadism recurred after 5 years, therefore, treatment with lanreotide was initiated, and resulted in complete resolution of signs and symptoms of the disease.

  3. Oxidative muscular injury and its relevance to hyperthyroidism.

    Science.gov (United States)

    Asayama, K; Kato, K

    1990-01-01

    In experimental hyperthyroidism, acceleration of lipid peroxidation occurs in heart and slow-oxidative muscles, suggesting the contribution of reactive oxygen species to the muscular injury caused by thyroid hormones. This article reviews various models of oxidative muscular injury and considers the relevance of the accompanying metabolic derangements to thyrotoxic myopathy and cardiomyopathy, which are the major complications of hyperthyroidism. The muscular injury models in which reactive oxygen species are supposed to play a role are ischemia/reperfusion syndrome, exercise-induced myopathy, heart and skeletal muscle diseases related to the nutritional deficiency of selenium and vitamin E and related disorders, and genetic muscular dystrophies. These models provide evidence that mitochondrial function and the glutathione-dependent antioxidant system are important for the maintenance of the structural and functional integrity of muscular tissues. Thyroid hormones have a profound effect on mitochondrial oxidative activity, synthesis and degradation of proteins and vitamin E, the sensitivity of the tissues to catecholamine, the differentiation of muscle fibers, and the levels of antioxidant enzymes. The large volume of circumstantial evidence presented here indicates that hyperthyroid muscular tissues undergo several biochemical changes that predispose them to free radical-mediated injury.

  4. Practical management of hyperthyroidism

    International Nuclear Information System (INIS)

    Houston, M.S.; Hay, I.D.

    1990-01-01

    There are several causes of hyperthyroidism, and correct diagnosis is essential for management. Graves' disease is most commonly managed with radioactive iodine therapy ( 131 I), antithyroid drugs or surgery. Toxic adenomas (single or multiple) may be treated with 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

  5. 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)

  6. 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.

  7. Current status of radioiodine (131I) treatment of hyperthyroidism

    International Nuclear Information System (INIS)

    Becker, D.V.; Hurley, J.R.

    1982-01-01

    Radioiodine appears to be increasingly selected as the primary form of therapy for most hyperthyroid adults. Some controversy exists concerning the use of I-131 in children and adolescents as well as in some patients with toxic nodular goiter. The technical aspects of radioiodine administration reviewed in this chapter include the biologic basis of I-131 use, dose strategies, measurement and evaluation of radioiodine parameters, and I-125 treatment of hyperthyroidism. The management of patients before and after I-131 treatment is discussed as well as posttreatment hypothyroidism and complications of radioiodine treatment

  8. Effects of hyperthyroidism and hypothyroidism on glutamine metabolism by skeletal muscle of the rat.

    OpenAIRE

    Parry-Billings, M; Dimitriadis, G D; Leighton, B; Bond, J; Bevan, S J; Opara, E; Newsholme, E A

    1990-01-01

    1. The effects of hyperthyroidism and hypothyroidism on the concentrations of glutamine and other amino acids in the muscle and plasma and on the rates of glutamine and alanine release from incubated isolated stripped soleus muscle of the rat were investigated. 2. Hyperthyroidism decreased the concentration of glutamine in soleus muscle but was without effect on that in the gastrocnemius muscle or in the plasma. Hyperthyroidism also increased markedly the rate of release of glutamine from the...

  9. Antiarrhythmic effect of tamoxifen on the vulnerability induced by hyperthyroidism to heart ischemia/reperfusion damage.

    Science.gov (United States)

    Pavón, Natalia; Hernández-Esquivel, Luz; Buelna-Chontal, Mabel; Chávez, Edmundo

    2014-09-01

    Hyperthyroidism, known to have deleterious effects on heart function, and is associated with an enhanced metabolic state, implying an increased production of reactive oxygen species. Tamoxifen is a selective antagonist of estrogen receptors. These receptors make the hyperthyroid heart more susceptible to ischemia/reperfusion. Tamoxifen is also well-known as an antioxidant. The aim of the present study was to explore the possible protective effect of tamoxifen on heart function in hyperthyroid rats. Rats were injected daily with 3,5,3'-triiodothyronine at 2mg/kg body weight during 5 days to induce hyperthyroidism. One group was treated with 10mg/kg tamoxifen and another was not. The protective effect of the drug on heart rhythm was analyzed after 5 min of coronary occlusion followed by 5 min reperfusion. In hyperthyroid rats not treated with tamoxifen, ECG tracings showed post-reperfusion arrhythmias, and heart mitochondria isolated from the ventricular free wall lost the ability to accumulate and retain matrix Ca(2+) and to form a high electric gradient. Both of these adverse effects were avoided with tamoxifen treatment. Hyperthyroidism-induced oxidative stress caused inhibition of cis-aconitase and disruption of mitochondrial DNA, effects which were also avoided by tamoxifen treatment. The current results support the idea that tamoxifen inhibits the hypersensitivity of hyperthyroid rat myocardium to reperfusion damage, probably because its antioxidant activity inhibits the mitochondrial permeability transition. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Radioactive iodine therapy in cats with hyperthyroidism

    International Nuclear Information System (INIS)

    Turrel, J.M.; Feldman, E.C.; Hays, M.; Hornof, W.J.

    1984-01-01

    Eleven cats with hyperthyroidism were treated with radioactive iodine ( 131 I). Previous unsuccessful treatments for hyperthyroidism included hemithyroidectomy (2 cats) and an antithyroid drug (7 cats). Two cats had no prior treatment. Thyroid scans, using technetium 99m, showed enlargement and increased radionuclide accumulation in 1 thyroid lobe in 5 cats and in both lobes in 6 cats. Serum thyroxine concentrations were high and ranged from 4.7 to 18 micrograms/dl. Radioactive iodine tracer studies were used to determine peak radioactive iodine uptake (RAIU) and effective and biological half-lives. Activity of 131 I administered was calculated from peak RAIU, effective half-life, and estimated thyroid gland weight. Activity of 131 I administered ranged from 1.0 to 5.9 mCi. The treatment goal was to deliver 20,000 rad to hyperactive thyroid tissue. However, retrospective calculations based on peak RAIU and effective half-life obtained during the treatment period showed that radiation doses actually ranged from 7,100 to 64,900 rad. Complete ablation of the hyperfunctioning thyroid tissue and a return to euthyroidism were seen in 7 cats. Partial responses were seen in 2 cats, and 2 cats became hypothyroid. It was concluded that 131 I ablation of thyroid tumors was a reasonable alternative in the treatment of hyperthyroidism in cats. The optimal method of dosimetry remains to be determined

  11. 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.

  12. The dynamic changes of brain natriuretic peptide level in patients with hyperthyroid heart disease after 131I therapy

    International Nuclear Information System (INIS)

    Su Yingrui; Zha Jinshun; Zhou Jingxiong; Lin Xiahong; Xu Chaoxiang; Wang Yaoguo; Du Xinqing

    2012-01-01

    Objective: To investigate the application value of urine brain natriuretic peptide (BNP) level in 131 I treatment of hyperthyroid heart disease. Methods: One hundred and eleven hyperthyroidism patients who received 131 I therapy were divided into two groups, hyperthyroidism group (51 cases) and hyperthyroid heart disease group (60 cases), and 30 healthy subjects as control. Sixty patients in the hyperthyroid heart disease group all received ultrasonic cardiogram. The hyperthyroid heart disease group was divided into two subgroups according to New York Heart Association (NYHA) functional classification (hyperthyroid heart disease A subgroup and hyperthyroid heart disease B subgroup). The urine and serum BNP level and serum free triiodothyronine (FT 3 ), free thyroxine (FT 4 ) level were measured through chemiluminescence before and after therapy. Results: The urine and serum BNP level before 131 I therapy of the hyperthyroid heart disease group were significantly higher than those of hyperthyroidism group (serum: t=8.98 and 9.52, both P<0.01; urine: t=10.83 and 12.73, both P<0.01) and the control group (serum: t=8.97 and 9.52, both P<0.01; urine: t=9.21 and 5.64, both P<0.01). The urine and serum BNP level before and 6, 12 months after 131 I therapy of the hyperthyroid heart disease A subgroup were significantly higher than those of hyperthyroid heart disease B subgroup (serum: t=5.98, 5.87 and 6.35, all P<0.01; serum: t=4.33, 4.09 and 5.02, all P<0.01). The urine level of BNP was gradually increased with the severity of cardiac insufficiency and it was positively correlated with the serum level of BNP (r=0.829, P<0.01), the NYHA functional classification (r=0.751, P<0.01) and the serum level of FT 3 and FT 4 (FT 3 : r=0.635, P<0.01; FT 4 : r=0.672, P<0.01). Conclusions: The urine BNP level of hyperthyroid heart disease patient increased with the severity of cardiac insufficiency. The urine BNP level could accurately reflect cardiac function of hyperthyroid heart

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

    OpenAIRE

    Angelis, Dimitrios; Kubicky, Rita Ann; Zubrow, Alan B.

    2015-01-01

    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 hyperthyroi...

  14. 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.

  15. Follicular carcinoma of the thyroid with hyperthyroidism. A case report.

    Science.gov (United States)

    Sharma, Prashant; Kumar, Neeta; Gupta, Ruchika; Jain, Shyama

    2004-01-01

    Follicular carcinoma of the thyroid in association with hyperthyroidism is rare. The malignant lesion may remain occult for a long time. Certain clinical and cytologic features may be helpful in raising the alarm. An elderly male with a history of occupational exposure to X rays, long-standing toxic multinodular goiter and clinical hyperthyroidism presented with a rapidly enlarging mass in the neck. Cytologic smears showed a prominent microfollicular pattern, scanty colloid, anisonucleosis and nuclear overlapping. The noteworthy feature was the presence of marginal vacuoles. The cytologic diagnosis of follicular neoplasm with highly suggestive malignancy was made. Subsequently, multiple pulmonary nodules provided radiologic evidence of possible metastatic spread. This case report demonstrates the rare association of follicular carcinoma of the thyroid with hyperthyroidism and analyzes certain high-risk clinical and cytologic features to be considered in the follow-up of long-standing hyperfunctioning multinodular goiter.

  16. A stepwise approach to the evaluation and treatment of subclinical hyperthyroidism.

    Science.gov (United States)

    Mai, Vinh Q; Burch, Henry B

    2012-01-01

    To review a stepwise approach to the evaluation and treatment of subclinical hyperthyroidism. English-language articles regarding clinical management of subclinical hyperthyroidism published between 2007 and 2012 were reviewed. Subclinical hyperthyroidism is encountered on a daily basis in clinical practice. When evaluating patients with a suppressed serum thyrotropin value, it is important to exclude other potential etiologies such as overt triiodothyronine toxicosis, drug effect, nonthyroidal illness, and central hypothyroidism. In younger patients with mild thyrotropin suppression, it is acceptable to perform testing again in 3 to 6 months to assess for persistence before performing further diagnostic testing. In older patients or patients with thyrotropin values less than 0.1 mIU/L, diagnostic testing should proceed without delay. Persistence of thyrotropin suppression is more typical of nodular thyroid autonomy, whereas thyroiditis and mild Graves disease frequently resolve spontaneously. The clinical consequences of subclinical hyperthyroidism, such as atrial dysrhythmia, accelerated bone loss, increased fracture rate, and higher rates of cardiovascular mortality, are dependent on age and severity. The decision to treat subclinical hyperthyroidism is directly tied to an assessment of the potential for clinical consequences in untreated disease. Definitive therapy is generally selected for patients with nodular autonomous function, whereas antithyroid drug therapy is more appropriate for mild, persistent Graves disease. The presented stepwise approach to the care of patients presenting with an isolated suppression of serum thyrotropin focuses on the differential diagnosis, a prediction of the likelihood of persistence, an assessment of potential risks posed to the patient, and, finally, a personalized choice of therapy.

  17. Results of radioiodine therapy of manifest hyperthyroidism and autonomous euthyroid goiter

    International Nuclear Information System (INIS)

    Berding, G.; Schicha, H.

    1990-01-01

    In 200 patients follow-up examinations were performed up to one year after radioiodine therapy (RITh) with individual dose calculation. The mean applied dose was significantly lower in patients with immunogenic hyperhyroidism (Graves' disease) as compared to patients with non-immunogenic hyperthyroidism (disseminated/multifocal autonomy, HYDA). In Graves' disease the rate of recurrent hyperthyroidism was significantly higher and that of posttreatment hypothyroidism lower. Considering the high recurrence rate in Graves' disease a higher dose, e.g. 150 Gy, seems to be appropriate. In patients with HYDA who received antithyroid drugs during RITh, recurrence of hyperthyroidism appeared slightly more, and posttreatment hypothyroidism slightly less, frequent. The efficiency of RITh was not significantly reduced by additional treatment with antithyroid drugs. Posttreatment hypothyroidism in patients with euthyroid goiter and disseminated/multifocal autonomy (EUDA) occurred significnatly more frequent if the basal TSH level was ≥ 0.5 μIE/ml before therapy. The goiter size was reduced independent of the basal TSH level. In HYDA patients after thyroid surgery recurrence appeared less, and in those with EUDA posttreatment hypothyroidism significantly more, frequent. A lower dose seems to be suitable in patients who underwent thyroid surgery before. In patients with focal autonomy after RITh no recurrence of hyperthyroidism was observed. In 9% a suppressed basal TSH level indicating persistent autonomy was seen. Posttreatment hypothyroidism in focal autonomy appeared only in patients without manifest hyperthyroidism before RITh and was significantly more frequent in this group. In patients with focal autonomy who developed hypothyroidism the dose calculation was based on a significantly higher volume of the adenoma. (orig./MG) [de

  18. 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.

  19. Increase in incidence of hyperthyroidism predominantly occurs in young people after iodine fortification of salt in Denmark.

    Science.gov (United States)

    Bülow Pedersen, Inge; Laurberg, Peter; Knudsen, Nils; Jørgensen, Torben; Perrild, Hans; Ovesen, Lars; Rasmussen, Lone Banke

    2006-10-01

    To prevent goiter and nodular hyperthyroidism, iodine fortification (IF) of salt was introduced in Denmark in 1998. We prospectively registered all new cases of overt hyperthyroidism in two areas of Denmark before and for the first 6 yr after iodine fortification. We used 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) during the early (2001-2002) period of mandatory IF; and 4) during the late (2003-2004) period with mandatory IF. The overall incidence rate of hyperthyroidism increased [baseline, 102.8/100,000/year; voluntary IF, 122.8; early mandatory IF, 140.7; late mandatory IF, 138.7 (P for trend Hyperthyroidism increased in both sexes (P hyperthyroidism. Contrary to current concepts, many of the new cases were observed in young subjects, and are presumably of autoimmune origin. Furthermore, monitoring is expected to show a decrease in the number of elderly subjects suffering from nodular hyperthyroidism.

  20. Polymyositis associated with hypothyroidism or hyperthyroidism: two cases and review of the literature.

    Science.gov (United States)

    Wang, Han; Li, Hong; Kai, Cui; Deng, Juelin

    2011-04-01

    Studies confirming a possible relationship of polymyositis within thyroid dysfunction, either hypothyroidism or hyperthyroidism, are hardly available. To define the association, identify clinical, laboratory, electromyographic, and pathologic features in polymyositis (PM) patients with hypothyroidism or hyperthyroidism, we conducted a MEDLINE and Chinese biomedicine database search to identify relevant literature published in the past 25 years. Seventeen cases were included. All patients were female (10 hypothyroidism patients, seven hyperthyroidism patients). The mean (SD) age of PM, hypothyroidism, and hyperthyroidism at diagnosis was 54.8 (16.7), 55.5 (16.5), and 32.7 years (10.2), respectively. PM diagnosis can precede or parallel hypothyroidism while PM may occur following the diagnosis of hyperthyroidism. The most common comorbidities were malignant tumors in these disorders, including thymoma, colon cancer, and thyroid cancer. Muscle weakness was described in 100% of patients. Other common manifestations included muscles' atrophy and pain, deep tendon reflexes, polyarthralgia, and dysphagia. Most patients had markedly elevated creatine kinase and the presence of anti-Sjogren's syndrome A (SSA) antibodies was also found in two cases. Malignancy associated with PM may more frequently occur in hypothyroidism than in hyperthyroidism. The abnormalities on electromyography and biopsy did not differ from those findings of PM. Therapy consisting of corticosteroids, thyroid hormone, or anti-thyroid drugs was administrated; however, poor prognosis seemed to be associated with malignant tumors as well as older age and the presence of anti-SSA antibodies. It is reasonable to suggest that those patients should be routinely evaluated for thyroid function, especially in older female and patients suffering from cancers.

  1. 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...

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

    Science.gov (United States)

    Dadan, Jacek; Zbucki, Robert L; Sawicki, Bogusław; Winnicka, Maria M

    2008-01-01

    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.

  3. 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.

  4. Strategic planning of treatment for hyperthyroid disease

    International Nuclear Information System (INIS)

    Hoeffer, R.

    1994-01-01

    Strategic planning of treatment of hyperthyroid disease must correspond to the pathophysiological mechanism of elevation of thyroid hormone serum concentration, i.e. excess stimulation, autonomous thyroid function, destruction induced hyperthyoroxinemia. In cases of excess stimulation one should go to extremes to save the essentially 'normal' thyroid gland and life-long antithyroid drug treatment confronts with total ablation of the thyroid gland in non remitting disease. Size and quantity of regions of autonomously functioning follicles/cells will be the determinant of therapeutic strategy in cases of autonomous thyroid function. Selective surgery confronts with radioiodine treatment aiming at 'restitutio ad integrum'. In destruction induced hyperthyroxinemia antiintlammatory and symptomatic measures may help to bridge the time to the return of normal hormone concentrations. Based on these considerations a detailed therapeutic strategy for hyperthyroid disease can be designed. (author)

  5. Sclerostin and bone metabolism markers in hyperthyroidism before treatment and interrelations between them.

    Science.gov (United States)

    Sarıtekin, İlker; Açıkgöz, Şerefden; Bayraktaroğlu, Taner; Kuzu, Fatih; Can, Murat; Güven, Berrak; Mungan, Görkem; Büyükuysal, Çağatay; Sarıkaya, Selda

    2017-01-01

    Sclerostin, which is a glycoprotein produced by osteocytes, reduces the formation of bones by inhibiting the Wnt signal pathway. Thyroid hormones are related with Wnt signal pathway and it has been reported that increased thyroid hormones in hyperthyroidism fasten epiphysis maturation in childhood, and increase the risk of bone fractures by stimulating the bone loss in adults. The aim of this study was to examine the sclerostin serum levels, the relation between sclerostin and thyroid hormones as well as the biochemical markers of the bone metabolism in patients with hyperthyroidism (including multinodular goiter and Graves' disease), whose treatments have not started yet. No difference was found in the serum sclerostin levels between the hyperthyroidism group (n=24) and the control group (n=24) (p=0.452). The serum osteocalcin levels and 24-hour urinary phosphorus excretion were found to be higher in the hyperthyroid group than in the control group (p0.05). Therefore, we consider that a long-term study that covers the pre-post treatment stages of hyperthyroidism, including both the destruction and construction of the skeleton would be more enlightening. Moreover, the assessment of the synthesis of sclerostin in the bone tissue and in the serum level might show differences.

  6. [Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease].

    Science.gov (United States)

    Zhang, M Z; Li, B X; Zhao, R; Guan, D W; Zhang, G H; Wu, X; Zhu, B L; Li, R B

    2017-10-01

    To analyse the cases of sudden death due to hyperthyroid heart disease, and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases. Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine, China Medical University. The general information (gender and age), clinical manifestations, medical history, anatomical and histopathological findings, biochemical parameters and cause of death were analysed retrospectively. Most of the 6 patients had definite history of hyperthyroidism, and they all showed certain degrees of symptoms of cardiovascular disease; had obvious incentive factors of death; histopathological examination of thyroid conformed to the performances of diffuse toxic goiter; with increase of cardiac weight, dilatation of cardiac chambers, myocardial hypertrophy and focal necrosis; postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease. The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy, histopathological examination, postmortem toxicology tests. The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary. Copyright© by the Editorial Department of Journal of Forensic Medicine

  7. Unmasking Hyperthyroidism in the Elderly: How to distinguish hyperthyroidism from conditions that mimic the symptoms

    OpenAIRE

    Gordon, Michael; Isenberg, Yoel; Bain, Jerald

    1992-01-01

    Hyperthyroidism in the elderly can mimic symptoms suggestive of aging or concomitant illnesses. The disease can cause serious problems and disabilities in older individuals. A strong sense of suspicion, the appropriate use of screening tests, and, when indicated, more definitive investigations usually results in the accurate diagnosis of a condition for which there is effective treatment.

  8. Hyperthyroidism in cats: what's causing this epidemic of thyroid disease and can we prevent it?

    Science.gov (United States)

    Peterson, Mark

    2012-11-01

    Since first being reported in the late 1970s, there has been a dramatic increase in the prevalence of hyperthyroidism in cats. It is now recognized worldwide as the most common feline endocrine disorder. Hyperthyroidism is an important cause of morbidity in cats older than 10 years of age. It is estimated that over 10% of all senior cats will develop the disorder. Despite its frequency, the underlying cause(s) of this common disease is/are not known, and no one has suggested a means to prevent the disorder. Because of the multiple risk factors that have been described for feline hyperthyroidism, 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 in an additive or synergistic manner, may first lead to euthyroid goiter and then to autonomous adenomatous hyperplasia, thyroid adenoma and hyperthyroidism. This review draws on published research studies to summarize the available evidence about the risk factors for feline hyperthyroidism. Based on the known goitrogens that may be present in the cat's food, drinking water or environment, it proposes measures that cat owners can implement that might prevent, or reduce the prevalence of, thyroid tumors and hyperthyroidism in their cats.

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

    OpenAIRE

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

    2014-01-01

    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 no...

  10. [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.

  11. Thyroglobulin for hyperthyroidism and thyroid carcinoma

    International Nuclear Information System (INIS)

    Sijperda, A.

    1984-01-01

    This thesis describes the metabolism and the estimation of thyroglobulin in the circulation. The relations between the thyroglobulin and calcitonin level in the circulation of patients suffering from hyperthyroidism after treatment with radioactive iodine are discussed. The thyroglobulin level of patients suffering from thyroid carcinoma are considered

  12. Hyperthyroidism due to struma ovarii: Diagnostic pitfalls and preventing thyroid storm

    OpenAIRE

    Koichi Nagai; Hiroshi Yoshida; Kayo Katayama; Yumi Ishidera; Yuka Oi; Noriko Ando; Hiroyuki Shigeta

    2017-01-01

    We report struma ovarii in a case that had hyperthyroidism and was treated with laparoscopic tumor resection. A 40-year-old Japanese woman presented with tachycardia, finger tremor, and weight loss. Although blood examination showed hyperthyroidism, test results for thyroid stimulating hormone receptor antibody and thyroid stimulating antibody were negative, and thyroid scintigraphy showed no abnormal findings. Because she was diagnosed with an ovarian tumor, and whole-body scintigraphy showe...

  13. Global epidemiology of hyperthyroidism and hypothyroidism.

    Science.gov (United States)

    Taylor, Peter N; Albrecht, Diana; Scholz, Anna; Gutierrez-Buey, Gala; Lazarus, John H; Dayan, Colin M; Okosieme, Onyebuchi E

    2018-05-01

    Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. Hypothyroidism and hyperthyroidism are common conditions with potentially devastating health consequences that affect all populations worldwide. Iodine nutrition is a key determinant of thyroid disease risk; however, other factors, such as ageing, smoking status, genetic susceptibility, ethnicity, endocrine disruptors and the advent of novel therapeutics, including immune checkpoint inhibitors, also influence thyroid disease epidemiology. In the developed world, the prevalence of undiagnosed thyroid disease is likely falling owing to widespread thyroid function testing and relatively low thresholds for treatment initiation. However, continued vigilance against iodine deficiency remains essential in developed countries, particularly in Europe. In this report, we review the global incidence and prevalence of hyperthyroidism and hypothyroidism, highlighting geographical differences and the effect of environmental factors, such as iodine supplementation, on these data. We also highlight the pressing need for detailed epidemiological surveys of thyroid dysfunction and iodine status in developing countries.

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

    Science.gov (United States)

    Zhang, Wei; Song, Lingheng; Yin, Xuntao; Zhang, Jiuquan; Liu, Chen; Wang, Jian; Zhou, Daiquan; Chen, Bing; Lii, Haitao

    2014-01-01

    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). 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. 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. 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. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. 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.

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

    International Nuclear Information System (INIS)

    Zhang, Wei; Song, Lingheng; Yin, Xuntao; Zhang, Jiuquan; Liu, Chen; Wang, Jian; Zhou, Daiquan; Chen, Bing; Lii, Haitao

    2014-01-01

    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

  17. Struma Ovarii in Pregnancy: An Uncommon Cause of Hyperthyroidism.

    Science.gov (United States)

    Merza, Zayd; White, Duncan; Khanem, Noor

    2015-08-01

    A 28-year-old woman presented with weight loss and tiredness. Investigations revealed hyperthyroidism. She was commenced on treatment and later became pregnant. Her thyroid levels remained raised, and she later underwent an elective cesarean delivery and ovarian cystectomy. Only a partial cystectomy was achieved, and histopathology examination revealed struma ovarii. An isotope uptake scan ((123)I) including her pelvis revealed low uptake in the thyroid gland and an area of high uptake in her pelvis. The cyst was subsequently removed, and within days, her thyroid hormone levels dropped. This case illustrates the importance of considering uncommon causes of hyperthyroidism.

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

    International Nuclear Information System (INIS)

    Barat, J.L.; Wicker, P.; Manley, W.

    1985-01-01

    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

  19. 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.

  20. Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism.

    Science.gov (United States)

    Miao, Q; Zhang, S; Guan, Y H; Ye, H Y; Zhang, Z Y; Zhang, Q Y; Xue, R D; Zeng, M F; Zuo, C T; Li, Y M

    2011-01-01

    Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy. Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized. Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri. The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy.