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PubMed1998

Circadian blood pressure and heart rate profiles in normotensive patients with mild hyperthyroidism.

We investigated the influence of thyroid hormones on the circadian blood pressure (BP) and heart rate (HR) variations in 12 normotensive subjects and 12 normotensive patients with mild hyperthyroidism. BP and HR were monitored every 30 minutes for 48 h, and electrocardiograms (ECGs) were recorded to measure the RR interval of the ECGs. We analyzed the circadian BP and HR variations, HR variability, and the morning rise in BP and HR. There was no significant difference in the average 24 h BP between groups. HR and pulse pressure were higher in the hyperthyroid group than in the control group. Though the circadian BP pattern was similar in both groups, HR decreased at night in the control group, but not in the hyperthyroid group. Spectrum analysis of the RR interval showed no increase in the high-frequency (HF) component at night in patients with hyperthyroidism. The HR did not show a morning rise in the hyperthyroid group. These findings indicate that the circadian rhythm of HR was not preserved in patients with mild hyperthyroidism. The circadian BP rhythm was similar in normotensive subjects and normotensive patients with mild hyperthyroidism, suggesting that it resulted from factors other than thyroid hormone.

Adult↗
PubMed1988

Increased lipid peroxidation in hyperthyroid patients: suppression by propylthiouracil treatment.

Plasma and urinary levels of thiobarbituric acid reactive substances (TBAR) were determined in 24 hyperthyroid patients, 19 hypothyroid subjects, 35 controls, and 17 hyperthyroid patients before and after propylthiouracil (PTU) treatment (400 mg/day for 2-3 months), as indexes of lipid peroxidation. These measurements were carried out together with t-butyl hydroperoxide (t-BHP)-induced oxygen uptake and visible chemiluminescence in erythrocytes as functional tests related to the antioxigenic capacity of cells. Hyperthyroid patients exhibited increased levels of plasma and urinary TBAR compared to controls. Erythrocyte suspensions from hyperthyroid patients showed, compared to controls, higher rates of oxygen consumption with shorter induction periods upon addition of t-BHP, together with 142% and 75% increases in basal and t-BHP-induced chemiluminescence, respectively. Levels of TBAR in untreated hyperthyroid patients in plasma (16.2 +/- 1.3 pmol/mg of protein) and urine (15.9 +/- 1.5 nmol/mg of creatinine) were decreased after PTU treatment (Plasma, 9.5 +/- 0.7, p less than 10(-4); urine, 7.8 +/- 0.9, P less than 10(-5) to values not significantly different from those of the control group (plasma, 10.3 +/- 0.6; urine, 7.9 +/- 0.7). Compared to control, elevated rates of oxygen uptake induced by t-BHP, basal and t-BHP-induced chemiluminescence in erythrocyte suspensions from untreated hyperthyroid patients were reverted to normal by PTU, while decreased induction period (T0) values were enhanced. Determination of these lipid peroxidative parameters in hypothyroid patients revealed no significant changes over control values, excepted t-BHP-induced chemiluminescence in erythrocytes that was diminished. These data indicate that hyperthyroidism is associated with a pro-oxidant condition characterized by an enhancement in circulating and urinary lipid peroxidative indexes, which is suppressed by PTU treatment. It is suggested that this condition might reflect an oxidative stress at cellular level in tissues which are target for thyroid hormone action with a calorigenic response.

Adult↗
PubMedDate not supplied

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

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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 hyperthyroid state per se is eliminated. The current patient illustrates the value of considering hyperthyroidism in the differential diagnosis of diarrhea of unknown cause.

Adrenergic beta-Antagonists↗
PubMed1999

[Effects of chronic subclinical hyperthyroidism from levothyroxine on cardiac morphology and function].

BACKGROUND: Thyroid hormones greatly affect the cardiovascular system. Although the effects of overt hyperthyroidism on the cardiovascular system have been diffusely studied, only in the last years the effects of subclinical hyperthyroidism on the heart have been investigated. Subclinical hyperthyroidism is a symptomatic or asymptomatic condition with an absent response of thyrotropin (TSH) to thyrotropin-releasing hormone in the presence of normal serum levels of thyroid hormones for the general population, though supraoptimal for the individual. The more frequent causes of endogenous subclinical hyperthyroidism are multinodular goiter, toxic, adenoma and Graves's disease, whereas the exogenous causes are induced by levothyroxine (LT4) therapy used to suppress TSH in patients with nontoxic goiter and differentiated thyroid cancer. This paper reports our experience derived from the study of 60 patients with subclinical hyperthyroidism due to TSH-suppressive therapy with LT4 compared to normal subjects. METHODS: Patients (9 males and 51 females, mean age 39 +/- 10 years) were studied by complete Doppler echocardiography, standard and 24 hour ECG Holter monitoring, exercise test with cycloergometer, and radionuclide ventriculography at rest and during fixed workload (75 W). RESULTS: Holter monitoring showed a significant increase in mean 24 hour heart rate (80 +/- 10 vs 70 +/- 9 b/min, p < 0.001) and supraventricular arrhythmias (42 vs 12 patients, p < 0.003). Echocardiography showed an increase in left ventricular mass index (94 +/- 13 vs 80 +/- 18 g/m2, p < 0.001) due to increased septal and posterior wall thickness. At rest, echocardiographic indices of systolic function (fractional shortening and mean corrected velocity of circumferential fiber shortening) were higher in patients than in controls (fractional shortening 40 +/- 6 vs 34 +/- 4%, p < 0.001; mean corrected velocity of circumferential fiber shortening 1.23 +/- 0.17 vs 1.05 +/- 0.14 circ/s, p < 0.001), while the Doppler indices of diastolic function were significantly impaired as documented by the reduced E/A ratio (1.18 +/- 0.3 vs 1.8 +/- 0.5, p < 0.001) and the prolonged isovolumic relaxation time (94 +/- 13 vs 78 +/- 12 ms, p < 0.001). Exercise tolerance was also significantly impaired in patients with subclinical hyperthyroidism: maximal exercise time (6.4 +/- 0.7 vs 9.4 +/- 1.4 min, p < 0.001) and peak workload (81 +/- 11 vs 121 +/- 17 W, p < 0.001) were significantly reduced and radionuclide ventriculography showed a decrease in ejection fraction during exercise (from 62 +/- 7 to 53 +/- 8%, p < 0.002). CONCLUSIONS: Persistent subclinical hyperthyroidism by TSH-suppressive doses of LT4 significantly affects heart morphology and function. Thus, we suggest that a complete suppression of TSH must be recommended only in patients with differentiated thyroid cancer, while in patients with begin thyroid disease it could be sufficient to maintain subnormal TSH levels.

Adult↗
PubMed1999

Effects of vitamin E and vitamin C supplementation on plasma lipid peroxidation and on oxidation of apolipoprotein B-containing lipoproteins in experimental hyperthyroidism.

Increasing numbers of experimental and epidemiological studies suggest the involvement of free radicals in the pathogenesis of various disease entities. Similarly, oxidative processes have been implicated as playing roles in the genesis of hyperthyroidism-induced damage. In this study, we investigated the effects of vitamin E and vitamin C on plasma lipid peroxidation and the susceptibility of apolipoprotein B (apo B)-containing lipoproteins to oxidation in experimental hyperthyroidism. The study animals were initially divided into a control group (Group C) and a hyperthyroid group. The latter was further re-grouped later according to their vitamin supplementation status: Hyperthyroid group without vitamin supplementation (Group H), hyperthyroid group with vitamin E supplementation (Group H+E) and hyperthyroid group with vitamin C supplementation (Group H+C). Malondialdehyde (MDA) level was measured as an indicator of plasma lipid peroxidation. The apo B-containing lipoproteins were separated by precipitation and incubated with copper sulphate. The MDA levels of this non-HDL fraction were measured prior to and after 1, 2 and 3 hours of incubation. Plasma MDA levels showed no significant differences among groups. Whereas MDA levels measured in non-HDL fraction were significantly higher in Group H than Group C. Group H+E and Group H+C had significantly lower MDA levels than Group H in all these measurements. This finding strongly indicates an increased susceptibility of apo B-containing lipoproteins to oxidation in hyperthyroidism, and that vitamin E as well as vitamin C supplementation protect these lipoproteins from copper-induced oxidation.

Animals↗
PubMed1999

[Radioiodine (131I) as the only treatment of hyperthyroidism. Results of 10 years of experience].

This work present the results of the use of 131I, as first line and only, antithyroid treatment, applied to 120 patients suffering from autoimmune hyperthyroidism, compared to 64 patients with toxic goiter and adenoma. The diagnostic weight of the determination of the various antithyroid antibodies was assessed in the identification of autoimmune hyperthyroidism, for which TRAb and TPO Ab are the most significant. The evolution after treatment of a preexisting ophthalmopathy (i.e. Graves'disease) was never found to be alarming and in most cases regularly improved with time. A single case (out of 72) of autoimmune hyperthyroidism with no preexisting sign developed a severe ophthalmopathy after treatment, which was well controlled thereafter. Mean cumulated 131I doses to control hyperthyroidism were 22.8 mCi for toxic goiter, 21.6 mCi for adenoma, 14.1 mCi for autoimmune hyperthyroidism and 16.7 mCi for Graves'disease. Post 131I hypothyroidism was found in 28.2% of toxic goiters, 12.1% of adenomas, 66% of autoimmune hyperthyroidisms and 70% of Graves'disease. No relapse was observed after treatment. A surgical indication was proposed for cases requiring more than two 131I doses to control hyperthyroidism.

Adenoma↗
PubMed1998

[Respiratory muscle function and serum enzymology in hyperthyroidism before and after treatment].

To investigate the effect of hyperthyroidism on respiratory muscle function and its possible mechanism, the thyroid function, serum enzymology, serum potassium, pulmonary function and respiratory muscle function were examined in 60 patients with Grave's disease before treatment and 26 patients among them after treatment, and 20 normal subjects as control. T3, T4, and FT4 increased while FVC and PImax, which reflect the respiratory muscle strength, and Pi/PImax, which reflects the reserve capacity of inspiratory muscle, decreased significantly in the 60 patients with Grave's disease, compared with the ones of normal subjects. The comparison of above measurements in the 26 patients between before- and after-treatment showed that respiratory muscle strength increased obviously along with the improvement of throid function. The serum enzymology, potassium and TSH, however, were not abnormal and not changed after treatment. The thyroid functions in 10 patients with hyperthyroid heart disease were not different, compared with the ones of other 50 patients without hyperthyroid heart disease, but their respiratory muscle strength was significantly lower than the ones of latter. The above results suggested that hyperthyroidism could lead to significant decrease of respiratory muscle strength and its reserve capacity, whereas treatment for hyperthyroidism would improve respiratory muscle function, so the measurement of respiratory muscle function in hyperthyroidism cases might be useful in prediction of hyperthyroid heart disease.

Adult↗
PubMed2000

[A clinical study on coincidence with hyperthyroidism and thyroid carcinoma].

OBJECTIVE: A retrospective study has been carried out to evaluate the prevalence of coincidence with hyperthyroidism and thyroid carcinoma. METHODS: 394 patients underwent surgery for hyperthyroidism and 245 patients suffered from thyroid cancer were chosen for the study in our hospital from January 1983 to June 1998. RESULTS: Thyroid cancer and hyperthyroidism coincided in 12 patients. The incidence of thyroid cancer was 3.0% (12/394) in hyperthyroidism, and the incidence of hyperthyroidism was 4.9% in thyroid cancer. There were 7 female and 5 male, with a diffuse goiter (n = 3), a diffuse goiter with a cold nodule (n = 3), multinodular goiter (n = 6). Among the 12 patients, 7 patients had an occult thyroid cancer with a diameter of 1 cm or less, most of them with papillary carcinoma, less frequently had metastases, 4 patients had thyroid cancer with a diameter of 3 cm or more, and 3 patients had metastases. CONCLUSIONS: The prevalence of coincidence with thyroid cancer and hyperthyroidism is more than that of thyroid cancer in population. Diagnostics for exclusion of thyroid cancer is required carefully even in the presence of hyperthyroidism.

Female↗
PubMed1992

[Cardiac and plasma catecholamine response to dynamic exercise in hyperthyroidism].

To investigate cardiac and sympathoadrenal responses to dynamic exercise, heart rate, systolic blood pressure, serial plasma norepinephrine (NE) and epinephrine (E) concentrations during multistage treadmill exercise were measured in 24 hyperthyroid patients (mean age; 42 +/- 16) and 24 age-sex matched control subjects. Eleven patients were re-examined in the euthyroid state after antithyroid therapy. Exercise duration was shorter in patient with hyperthyroidism. Also, the heart rates and systolic blood pressures at rest and in the early stage of exercise were significantly higher in hyperthyroidism. NE at rest (normal vs hyperthyroid: 124 +/- 10 vs 80 +/- 7 pg/ml, p < 0.01) and NE at peak exercise (475 +/- 38 vs 310 +/- 38 pg/ml, p < 0.01) were lower in hyperthyroidism. E at rest (22 +/- 2 vs 29 +/- 4 pg/ml, n.s.) did not differ, however, E during the first stage of exercise (30 +/- 3 vs 69 +/- 12 pg/ml, p < 0.01) was higher in hyperthyroidism. Re-examination for the euthyroid state revealed the decreases in the heart rates and systolic blood pressures at rest and in the early stage of exercise, and the normalization of the NE and E response. Thus, patients with hyperthyroidism was in the hyperdynamic cardiac state at rest and during dynamic exercise, which was accounted for by decreased sympathetic nervous activity and increased adrenomedullary responses. These modifications of sympathoadrenal response seemed reversible when patients were controlled by antithyroid therapy.

Adolescent↗
PubMedDate not supplied

[Serum activity of angiotensin-converting enzyme and osteocalcin levels in hyperthyroidism].

This study was carried out in order to investigate serum changes of osteocalcin (BGP) and angiotensin converting enzyme (SACE) activity in a group of patients with hyperthyroidism. We studied 20 hyperthyroid patients (F 14, M 6; age mean 37.5 +/- 16.8 years) and 13 control subjects (F 11, M 2; age mean 40.3 +/- 7.5 years). In both patients and controls we measured: FT3, FT4, T3, T4, TSH, BGP, SACE. Finally, in patients with hyperthyroidism a TRH test and functional investigations were also performed. We observed that mean SACE levels were significantly increased in hyperthyroid patients (32.06 +/- 10.3 nmol/ml/min) in respect to control subjects (14.66 +/- 3.88 nmol/ml/min) (p = 2.02 E-6). Similarly serum BGP levels were significantly increased in hyperthyroid patients (5.94 +/- 2.55 ng/ml) than in control subjects (2.89 +/- 1.58 ng/ml) (p = 5.66 E-4). There was a significant linear correlation between SACE and T4 levels (r = 0.48; p < 0.05), between serum BGP and T4 (r = 0.50; p < 0.02) and furthermore between SACE and BGP (r = 0.57; p < 0.01). In conclusion both serum BGP and SACE levels are increased in patients with hyperthyroidism and are directly correlated between than and with indexes of thyroid function; therefore, they may be regarded as peripheral indexes of hyperthyroidism.

Adult↗
PubMed2003

The effect of intraperitoneal melatonin supplementation on the release of thyroid hormones and testosterone in rats with hyperthyroid.

OBJECTIVE: Melatonin has a general inhibitory effect on the reproductive system and thyroid functions. Testosterone secretion increases in parallel to thyroid hormones in hyperthyroidism. The aim of this study was to investigate the effects of melatonin application on total T3, T4 and testosterone in hyperthyroid rats. METHODS: This study was performed on 4 groups each consisted of 6 male Spraque Dawley rats. Control group (G1); sham group (G2); applied 0.5 ml/day of serum physiologic intraperitoneally for 2 weeks, hyperthyroid group (G3); applied 0.3 mg/kg/day thyroxine intraperitoneally for 2 weeks, and hyperthyroid and melatonin supplemented group (G4); applied 0.3 mg/kg/day thyroxine and 3 mg/kg/day melatonin. Blood samples taken by way of decapitation were analysed for total T3, T4 and testosterone by RIA. RESULTS: Serum total T3 and total testosterone levels were the highest in hyperthyroid group (G3), whereas in hyperthyroid and melatonin supplemented group (G4) were the lowest (P<0.001). Total T4 levels were higher in group 3 than group 1, 2 and 4 (P<0.001). CONCLUSION: Results revealed that melatonin supplementation in hyperthyroidism suppress secretion of thyroid hormones and testosterone secretion.

Animals↗
PubMedDate not supplied

Effect of hypoxia and catecholamine stimulation on cardiac performance in the isolated working hyperthyroid rat heart.

The hyperthyroid heart has a greater oxygen demand due to its enhanced contractile state and higher basal metabolic rate. Consequently, it may be more sensitive to conditions of decreased oxygen supply or increased oxygen use. We, therefore, investigated the effect of a restricted oxygen supply (hypoxia) and enhanced oxygen demand (catecholamine stimulation) on cardiac function in the isolated working hyperthyroid heart. Hypoxia was induced by substituting 20% of the oxygen in the perfusate with nitrogen, while catecholamine stimulation was with isoproterenol. Hypoxia caused a 37% drop in cardiac output in the hyperthyroid heart and a 10% decrease in euthyroid hearts. In response to isoproterenol, a dose-dependent increase in heart rate was found in both groups which was greatly augmented in the hyperthyroid hearts by hypoxia. With isoproterenol stimulation under normoxic conditions, euthyroid hearts showed a moderate increase in contractile performance (cardiac output and dP/dtmax), while in hyperthyroid hearts contractile performance declined. Hypoxia exacerbated the decrease in function of the hyperthyroid heart. In conclusion, our results indicate that the hyperthyroid heart is very sensitive to imbalances in the myocardial oxygen supply/demand ratio, especially when demand is increased in the presence of decreased supply.

Animals↗
PubMed1991

Low serum thyrotropin (thyroid-stimulating hormone) in older persons without hyperthyroidism.

We studied a large population (n = 2575) of unselected ambulatory persons older than 60 years to determine the prevalence of a low serum thyroid-stimulating hormone (TSH) level, ie, of less than 0.1 mU/L using a sensitive assay, a level suggestive of hyperthyroidism in younger adults. One hundred one persons (3.9%) had a low serum TSH level. About half of them (51/101) were taking thyroid hormone. Of the remainder, 44 were not hyperthyroid did not become so during up to 4 years of follow-up. Forty-one of the 44 euthyroid persons had a serum thyroxine level of less than 129 nmol/L; repeated testing showed a serum TSH level of more than 0.1 mU/L in the three euthyroid persons with a serum thyroxine level of more than 129 nmol/L. Only six were hyperthyroid or became so during the follow-up period; all had a serum thyroxine level of more than 129 nmol/L. Routine clinical examination was not a sensitive indicator of hyperthyroidism and did not permit discrimination from euthyroidism. A low value of serum TSH alone, while it had high sensitivity and specificity for hyperthyroidism, had a low positive predictive value (12%) for this diagnosis; addition of the thyroxine assay raised the predictive value fivefold to 67%. A low value of serum TSH is far more common in older persons than is hyperthyroidism. Low values in euthyroid persons are accompanied by a clearly normal serum T4 concentration (less than 129 nmol/L) or by a serum TSH level of more than 0.1 mU/L on repeated testing. We recommend measurement of the serum TSH thyroid concentration, using a sensitive assay, as the initial step in testing any older person for possible hyperthyroidism. Measurement of the serum T4 concentration or the free T4 index on the same sample would be needed only in the approximately 2% with a serum TSH level of less than 0.1 mU/L; alternatively, the TSH assay in these could be repeated at a later time.

Aged↗
PubMed1990

[The risk of recurrence following the thyrostatic treatment of immunogenic and nonimmunogenic hyperthyroidism].

Data of 196 patients treated for hyperthyroidism exclusively with antithyroid 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 less than 0.001 and 83%, p less than 0.001, respectively). In patients with primary disease, clinical, biochemical and scintigraphic parameters were tested with respect to their capability of predicting a relapse. For immunogenic hyperthyroidism the highest relapse rates were observed in young patients and in those with large goitres, whereas for non-immunogenic hyperthyroidism they were highest in old patients, in those with nodular goitres and in those without an increased urinary iodine excretion at the time of diagnosing hyperthyroidism.

Adolescent↗
PubMed1990

[Incidence of autonomy and immune hyperthyroidism before and following preventive use of iodized salt in the Berlin-Brandenburg area].

The incidence of hyperthyroidism was observed in the area of Berlin (1.2 million inhabitants) and in a rural district in the geographical region of the "Mark Brandenburg" (48.115 inhabitants) during the period from 1975 und 1989. This area is characterized with a iodine deficiency grade II (WHO). In 1985 an iodine salt supplementation was introduced by law. The period before iodine salt supplementation 1975-1985 was compared to the period after iodine prophylaxis: there was an increase in hyperthyroidism in the Berlin-area by the ratio 1:3.1 and 1:2.8 (1975-83 compared to 1988 and 1989), in the rural district by 1:1.7 (1980-1985 compared to 1986/87). The ratio autonomy (non immunogenic form) to immunogenic etiology was 1:12 (1977-83), and changed to 1:1.45 in 1988 and 1:16.3 in 1989 after iodine supplementation. The sex ratio male:female was 1:10 before, and 1:6.8 after prophylaxis for hyperthyroidism in total, in autonomy the ratio was observed as 1:12 before and 1:7.7 (1988), 1:4.7 (1989) after supplementation, in immunogenic hyperthyroidism 1:10 unchanged in the early and late period of observation. The increase of hyperthyroidism after iodine prophylaxis correlated well with the consumption of thyrostatic drug Thiamazol (Methimazol) for the whole country. The defined daily dose (DDD)/1000 inhabitants/day increased during the observation time from 0.5 (1984), 0.55 (1985), 0.66 (1986), to 1.47 (1987), 1.26 (1988) and 0.81 (1989). The results are compared and discussed with reports from USA, Iceland, Great Britain, Denmark, Italy and Tasmania. During the period of seven years (1980-87) in the rural district a seasonal dependence of onset in hyperthyroidism was observed in spring time between May and June only in immunogenic hyperthyroidism, despite in thyroidal autonomy the disease began throughout the year without a seasonal peak.

Berlin↗
PubMed1989

[Clinical analysis of 36 cases of coexistent hyperthyroidism with idiopathic thrombocytopenic purpura].

36 cases of coexistent hyperthyroidism and idiopathic thrombocytopenic purpura (ITP) were reported. There were 33 cases of overt hyperthyroidism with ITP. After treatment with antithyroid drugs the platelet count returned to normal in 29 and somewhat increased in the remaining four cases. The other three cases had ITP accompanied by hyperthyroidism. In 2 cases the platelet count decreased when they had accompanying hyperthyroidism. When the thyroid function returned to normal after antithyroid treatment, the platelet count returned to normal in one and increased in another. The authors discussed the association between hyperthyroidism and ITP and treatment of coexistent hyperthyroidism and ITP. Probable mechanisms causing thrombocytopenia in hyperthyroidism were discussed also.

Adult↗
PubMed1989

Treatment of hyperthyroidism in community hospital.

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.

Adolescent↗
PubMed1989

Alkaline phosphatase isoenzymes in plasma in hyperthyroidism.

Alkaline phosphatase (ALP; EC 3.1.3.1) isoenzymes were measured in the plasma of 63 untreated hyperthyroid patients (the hyperthyroid group), 58 treated hyperthyroid patients, and 100 blood donors. Total, liver, and bone ALP activities were significantly higher in the hyperthyroid group than in the treated hyperthyroid group or the blood donors. Bone ALP was more frequently and more markedly abnormal than liver ALP. Intestinal ALP did not differ significantly between the groups. The hyperthyroid patient group had significantly higher plasma calcium concentrations and lower serum parathyrin concentrations than those of the treated hyperthyroid group.

Adult↗