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PubMed1979

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

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.

Adult↗
PubMed2004

Iron supplementation in experimental hyperthyroidism: effects on oxidative stress in skeletal muscle tissue.

This study was designed to investigate the effects of iron supplementation on the parameters of oxidative stress in the skeletal muscle tissue of hyperthyroidism induced rats. Hyperthyroidism was found to cause an increase in thiobarbituric acid-reactive substances (TBARS) and copper zinc superoxide dismutase (Cu, Zn SOD) activity, but decreases in the glutathione-peroxidase (GSH Px) activity and glutathione (GSH). Iron supplementation caused an increase in TBARS and a decrease in GSH. Iron supplementation in hyperthyroid rats attenuated the hyperthyroid state, but lowered the plasma ferritin level, which is considered an indicator of thyroid hormone action. Iron supplementation caused no additional increase in the TBARS in hyperthyroid rats, ameliorated the decrease in GSH content and abolished the induction of Cu, Zn SOD. Our findings suggested no increase, but a decrease, in the risk of oxidative stress in iron supplemented hyperthyroid rats. Whether supplementation of iron would have similar effects in humans should be further investigated in clinical studies.

Animals↗
PubMed1994

Treatment of hyperthyroid disease.

PURPOSE: To evaluate treatments for hyperthyroid disease. DATA SOURCES: Selected studies published during the last 20 years addressing the diagnosis, causes, and treatment of hyperthyroid disease. STUDY SELECTION: Studies were chosen based on their usefulness in addressing specific points in the treatment of hyperthyroid disease. DATA EXTRACTION: Various treatment principles extracted from the references form the basis for the conclusions and recommendations made here. RESULTS: Hyperthyroid disease is a common endocrine disease. Although Graves disease is the most common cause of thyrotoxicosis, other primary and secondary causes exist. With classic signs and symptoms accompanied by confirmatory laboratory measures of thyroid hyperfunction, the diagnosis can be established firmly. Radioiodine is the preferred method to treat Graves disease; however, recent data concerning treatment with a combination of propylthiouracil and thyroxine require further evaluation to establish its efficacy. Radioiodine is also the preferred treatment for the other forms of hyperthyroid disease; however, patient-specific considerations in both may require patient-tailored therapies. CONCLUSIONS: Hyperthyroid disease can be treated definitively for most patients. Palliative therapy with beta-adrenergic blockade is useful in some patients. Further studies are needed to determine whether more recently described treatments have improved efficacy and whether therapy directed specifically at the underlying immunologic cause of Graves disease can be used successfully.

Graves Disease↗
PubMed2000

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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Adult↗
PubMed2000

[Radioiodine treatment of hyperthyroidism using a simplified dosimetric approach. Clinical results].

PURPOSE: To evaluate the clinical effectiveness of a simplified dosimetric approach to the iodine-131 treatment of hyperthyroidism due to Graves' disease or uninodular and multinodular toxic goiter. MATERIAL AND METHODS: We enrolled 189 patients with biochemically confirmed hyperthyroidism and performed thyroid ultrasonography and scintigraphy obtaining the diagnosis of Graves' disease in 43 patients, uninodular toxic goiter in 57 patients and multinodular toxic goiter in 89 patients. In 28 patients we found cold thyroid nodules and performed fine-needle aspiration with negative cytology for thyroid malignancy in all cases. Antithyroid drugs were stopped 5 days till radioiodine administration and, if necessary, restored 15 days after the treatment. Radioiodine uptake test was performed in all patients and therapeutic activity calculated to obtain a minimal activity of 185 MBq in the thyroid 24 hours after administration. The minimal activity was adjusted based on clinical, biochemical and imaging data to obtain a maximal activity of 370 MBq after 24 hours. RESULTS: Biochemical and clinical tests were scheduled at 3 and 12 months posttreatment and thyroxine treatment was started when hypothyroidism occurred. In Graves' disease patients a mean activity of 370 MBq (distribution 259-555 MBq) was administered. Three months after treatment and at least 15 days after methimazole discontinuation 32 of 43 (74%) patients were hypothyroid, 5 of 43 (11%) euthyroid and 6 of 43 (15%) hyperthyroid. Three of the latter were immediately submitted to a new radioiodine administration while 32 hypothyroid patients received thyroxine treatment. One year after the radioiodine treatment no patient had hyperthyroidism; 38 of 43 (89%) were on a replacement treatment while 5 (11%) remained euthyroid. In uni- and multinodular toxic goiter a mean activity of 444 MBq (distribution 259-555 MBq) was administered. Three months posttreatment 134 of 146 (92%) patients were euthyroid and 12 of 146 (8%) patients hyperthyroid. Two patients were immediately submitted to a new radioiodine administration. One year posttreatment 142 of 146 (97%) patients were euthyroid while only 4 of 146 (3%) patients showed TSH levels above the normal range. Only 2 of them required thyroxine treatment. CONCLUSIONS: The simplified dosimetric method illustrated in our paper is very effective in clinical practice because it permits to avoid resorting to sophisticated but also imprecise quantitative methods. Hypothyroidism should not be considered as a major collateral effect of radioiodine treatment, particularly in Graves' disease. In fact, the pathogenesis of the disease requires an ablative treatment with both surgery and radioidine treatment and the control of hyperthyroidism and the prevention of relapse are the major clinical targets. Vice versa, hypothyroidism was very uncommon in uni- and multinodular toxic goiter when our dosimetric approach was applied.

Adolescent↗
PubMed2000

[The role of the autonomic nervous system on malfunction of gastric motor and myoelectric activity in patients with hyperthyroidism].

The aim of this study was to determine both the type of gastric mioelectric and emptying disorders in correlation to degree of severity of hyperthyroidism (clinical and thyroid hormones' blood levels) and ANS function estimated in HRV analysis. The study was performed on a group of 50 patients (35 with multinodular toxic goitre and 15 with Graves' disease, 45 females and 5 males, mean age 39.6 years, mean BMI 23.72) with newly diagnosed and so far untreated hyperthyroidism. The control group were 50 healthy volunteers age-, sex-, and BMI-matched to the studied group. Patients were studied twice, within newly diagnosed thyreotoxicosis and after treatment (Metizol) and reaching stable euthyroid state. The study consisted of: a) percutaneous EGG analysis (Synectics): 30 minutes before and after a test meal (ENRICH Liquid 250 ml), b) HRV analysis (ECG POSTER 2002): 10 minutes at rest and during deep breathing test, c) ultrasound measurement of gastric emptying by Bolondi method. Statistical analysis of collected data was performed. In hyperthyroid patients significant both preprandial and postprandial dysrhythmia (33.01% of bradygastria and 16.49% of tachygastria) was found. In some patients decrease of amplitude of EGG signal was marked as a result of antral hypomotility with coexisting significantly prolonged gastric emptying (110 min). Among severe hyperthyroid patients both the antral food distribution (antrum 35% bigger than in a control group) and impaired proximal stomach relaxation were evident. The degree of gastric mioelectric activity and emptying disorders was proportional to the degree of both severity of clinical manifestation of hyperthyroidism in Zgliczynski scale (from I degree to III degrees) and free thyroid hormones' blood levels (positive correlation). In HRV analysis at rest in hyperthyroid patients comparing to a control group the decrease of both the heart rate variability and a total power was found particularly in HF component resulting in relative sympathetic activation. In HRV analysis during deep breathing test the decrease of heart rate variability was present mostly in LF component. It indicates on reduction of vagal regulation (and vagal excitability) of sinus node and gastric pacemaker function. Coexistence of the increase and decrease of a gastric basic electrical rhythm with delay of gastric emptying indicates on a complex mechanism of their formation. Both neurogenic regulation dysfunction and primary miogenic autoregulation disorders as a result of tyreotoxicosis seem to be the possible causes. All the found changes were functional and disappeared after reaching the stable euthyroid state within 3 months of pharmacological treatment.

Adult↗
PubMedDate not supplied

Changes of plasma arginine-vasopressin level in patients with hyperthyroidism during treatment.

BACKGROUND: Hyperthyroidism is associated with several kinds of changes in the circulatory system, including alterations in blood volume. Arginine-vasopressin (AVP) is known to be one of the major factors regulating plasma volume. The present study was designed to evaluate the plasma AVP level in patients with hyperthyroidism during treatment. MATERIAL AND METHODS: AVP was measured under basal conditions and after stimulation with a low-sodium diet and upright position. Seventy-four patients with hyperthyroidism and 37 controls were investigated. Measurements were taken before treatment, two weeks after pharmacological treatment, and after attaining euthyroid status. The following indices were determined: AVP, total and free thyroxin and triiodothyronine, thyrotropin, sodium, potassium, hematocrit, arterial blood pressure, cardiac index, and total peripheral resistance index. Plasma osmolality and changes in plasma volume were calculated indirectly. RESULTS: Plasma AVP was higher in patients with hyperthyroidism before treatment. After normalization of thyroid status, the AVP level was similar to that of the controls. The application of a low-sodium diet and upright position resulted in a greater decrease in plasma volume than the controls. AVP correlated with thyroxin level and plasma osmolality in patients with hyperthyroidism. CONCLUSION: Enhanced AVP level in patients with hyperthyroidism is suggested to be the result of alterations in plasma volume and is relatively independent of changes in plasma osmolality.

Adolescent↗
PubMed2001

The systolic function of the left ventricle of the heart in patients with hyperthyroidism during therapy.

Hyperthyroidism is associated with enhanced systolic function. The present study was designed to evaluate systolic cardiac function in patients with hyperthyroidism during a short-term and a long-term pharmacotherapy. The diagnostic value of various indices of the left ventricle function was analysed. Fifty-one hyperthyroid patients were investigated before initiation of the treatment, after 14 days of therapy with thiamazol (mean dose 54 mg/24 hr), a short-term treatment and after attainment of normal thyroid function, a long-term treatment (mean period 9 months). Control values were obtained from 30 healthy individuals. All investigated subjects were aged 18-50 yr. The following indices were determined with ultrasonocardiographic method: preejection period (PEP), left ventricle ejection time (LVET), preejection period index (PEPI) and left ventricle ejection time index (LVETI), index PEP/LVET, left ventricle shortening fraction (LVSF), left ventricle ejection fraction (LVEF), mean velocity of the circumferential fiber shortening (mVcf), contractility index (CIx), stroke volume (SV), cardiac index (CI), output-pressure index (OPI) and end-systolic wall stress (ESWS). Additionally, total peripheral resistance index (TPRI) and double product (DP) were calculated. In patients with untreated hyperthyroidism, a significant shortening of PEP, PEPI, LVET and low PEP/LVET index and TPRI as well as increased LVSF, LVEF, mVcf, CIx, CI, OPI and DP were shown. There was no changes in LVETI, SV and ESWS. A short-term treatment resulted in changes in PEP, PEPI, LVET, mVcf, CI and OPI in direction of normal values. After a long-term treatment all altered indices were normal with an exception of OPI, CI and DP. It is concluded that enhanced systolic function of the heart in patients with hyperthyroidism becomes normal after pharmacological control of the thyroid gland. Some changes are seen after a short-term treatment with thiamazol. The indices which reverse early are PEP, PEPI, LVET, mVcf and CI. Changes in ejection function of the left ventricle in patients with hyperthyroidism are resulted from increased heart rate and were found to be related to total peripheral vascular resistance.

Adult↗
PubMed2002

Subclinical hyperthyroidism: controversies in management.

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. The thyroid-stimulating hormone value is typically measured in a third-generation assay capable of detecting approximately 0.01 microU per mL (0.01 mU per L). Subclinical hyperthyroidism may be a distinct clinical entity, related only in part to Graves' disease or multinodular goiter. Persons with subclinical hyperthyroidism usually do not present with the specific signs or symptoms associated with overt hyperthyroidism. A detailed clinical history should be obtained, a physical examination performed and thyroid function tests conducted as part of an assessment of patients for subclinical hyperthyroidism and to evaluate the possible deleterious effects of excess thyroid hormone on end organs (e.g., heart, bone). A reasonable treatment option for many patients is a therapeutic trial of low-dose antithyroid agents for approximately six to 12 months in an effort to induce a remission. Further research regarding the etiology, natural history, pathophysiology, and treatment of subclinical hyperthyroidism is warranted.

Algorithms↗
PubMed2002

[Is hyperthyroidism often present in patients with thyroid differentiated carcinoma?].

The coexistence of thyroid cancer and hyperthyroidism is confirmed by many authors. It appears that the frequency of both disease can be greater as a result of lack of proper and penetrating biopsy diagnosis and of qualification to surgery treatment patients with hyperfunctional goiter and Graves disease, especially coexisting with nodes. The aim of our study was estimation of occurrence of hyperthyroidism in the patients with thyroid differentiated cancer. We examined group of 217 patients with diagnosed thyroid differentiated cancer, 20 patients (9.1%) of them were earlier hyperthyroidism diagnosed. 17 of them were hyperfunctional nodular goiter diagnosed and three as Graves disease, confirmed by presence of anti-TSH receptor antibodies (TRAK). Before thyroidectomy ultrasonography showed nodular goiter in 17 patients and hypoechogenic goiter with nodules in 3 patients. After thyroidectomy at the hyperthyroid patients in 16 papillary thyroid cancer and in 4 follicular thyroid cancers were diagnosed. The frequency of coexistence of cancer and hyperthyroidism in our material amounted for 9.1%. The results of our observation do not diverge from facts given in world literature and is point out the need for precise analysis of patients with hyperthyroidism and of proper qualification to surgery treatments changes suspected to be malignant process.

Adolescent↗
PubMed2002

[Treatment of hyperthyroidism caused by Graves' disease or toxic multinodular goitre by radioiodine: over 80% cure retrospectively after one calculated dose].

OBJECTIVE: Assessment of the results of radioiodine therapy for hyperthyroidism one year after treatment. DESIGN: Retrospective study of patient reports and a literature search. METHOD: Data were collected from 159 patients with Graves' disease or toxic multinodular goitre who had been treated with a calculated dose of radioiodine (131I) during a four-year period (1994-1998) at the Bronovo Hospital, The Hague, the Netherlands. Percentages of hypothyroidism, euthyroidism and hyperthyroidism one year after the treatment were compared with results from the literature. RESULTS: Of the patients treated for Graves' disease 42% were hypothyroid, 38% were euthyroid and 20% were hyperthyroid one year after radioiodine therapy. For patients with toxic multinodular goitre the figures were 10%, 78% and 12% respectively. These results were comparable with those found in the literature. Two factors influenced the outcome of therapy in patients with Graves' disease: patients with persistent hyperthyroidism were on average younger and low thyroid weight increased the chance of hypothyroidism. Whether the hyperthyroidism was permanent or transient could only be established in less than half of all patients with hormone substitution after treatment, as the substitution had already been started in the first six months. CONCLUSION: One calculated dose of radioiodine can effectively cure hyperthyroidism in over 80% of the patients. It is recommended that an effort is made to discontinue radioiodine treatment after one year so as to exclude transient hypothyroidism and unjustified hormone substitution.

Adolescent↗
PubMed1992

Cyclic AMP infusion and blood sugar, serum insulin and serum nonesterified fatty acid responses to glucose in recent experimental hyperthyroid dogs.

Recent experimental hyperthyroid (REH) dogs exhibit poor "in vivo" insulin responses to glucose probably due to a failure somewhere in cAMP-adenylate cyclase system. The actions of exogenous cAMP on these responses and on the regulation of blood sugar (BS) and serum nonesterified fatty acids (NEFA) during glucose infusion tests (GIT) in REH and normal dogs were studied here. Hyperthyroidism was induced by 1-thyroxine administration (100 micrograms/kg body wt./die, 10 days). GIT consisted of i.v. glucose-priming followed by glucose i.v. continuous infusion (60 min). cAMP (0, 33 or 66 mg/kg body wt./min) was infused alone (30 min) and then overlapped to gluco-se infusion (60 min). Peripheral veins were used for infusions and blood sample withdrawal. BS, serum inmunoreactive insulin (IRI) and serum NEFA concentrations, basally and throughout the test, were measured. Basally, there was neither action nor interaction of hyperthyroidism and exogenous cAMP on these variables. During the GIT, the BS levels remained unaffected by hyperthyroidism; cAMP increased them, but failed to interact with hyperthyroidism. cAMP noninfused normal dogs responded to hyperglycemia with hyperinsulinemia, whereas REH dogs noninfused the nucleotide did not. cAMP administration at a high dose promoted their response in normal and REH dogs, particularly in the former; in the latter, the response was still lower than in cAMP noninfused normal controls. Although recent hyperthyroidism increased serum NEFA basal level, it exerted neither action nor interaction with the infused cAMP on serum NEFA during GIT. Results are discussed on the basis that the abolished insulin secretion "in vivo" characterizing the REH dogs, related to beta-adrenergic deficiency, can be for the most part restored by exogenous cAMP administration, despite which some glucose and triglyceride metabolism impairments are developed.

Animals↗
PubMed2004

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

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.

Adult↗
PubMedDate not supplied

[Hyperthyroidism in the elderly].

UNLABELLED: Hyperthyroidism in elderly patients is not to be under-evaluated, since it is characterized in such age range by particular clinical and prognostic features. Based upon literature survey and their clinical experience, the authors discuss in the present paper clinical, diagnostic and therapeutic problems of hyperthyroidism in geriatric patients. MATERIAL AND METHOD: In the period between 1978-2003 out of 1804 patients surgically treated for thyroid disease (non neoplastic in 1470 pts.), 180 subjects presented hyperthyroidism (17%). 36 were in geriatric age-range (mean age 76 yr.; 29 females and 7 males). 26 presented a Multinodular Toxic Goiter (72.2%), whereas 9 patients complained of Plummer Adenoma (25%); only 1 patient showed Basedow disease (2.7%). RESULTS: As far as ASA classification, there were 7 ASA I, 27 ASA II and 2 ASA III. Compression of digestive tract and/or respiratory airway represented a surgical indication in 15 patients (41.6%). 12 (33.4%) were operated due to predominant cardiac symptoms (tachycardia, atrial fibrillation). The remaining 9 patients (25%) were treated for the concomitance of atypical symptoms of hyperthyroidism. We performed 15 total thyroidectomy, 7 "near totally", 8 sub-total, 6 hemithyroidectomy in case of Plummer adenoma. Postoperative mortality was nihil; p.o. morbidity was 5.5% for medical conditions (pneumonia) and surgery-related (1 laryngeal recurrent paralysis and 1 hypoparathyroidism) in 5.5%. Post-operative follow-up, conducted at 6 and 12 months from the operation, showed regression of hyperthyroidism and regression or improvement of all clinical symptoms complained by the patient. CONCLUSION: Surgical treatment seems to be the only immediate and definitive cure for hyperthyroidism. Geriatric age does not seem to be a surgical contraindication.

Aged↗
PubMed2005

Radioactive iodine therapy in Graves' hyperthyroidism: a prospective study from a tertiary referral centre in north India.

BACKGROUND: Radioactive iodine has gained widespread acceptance as the first-line therapy for Graves' hyperthyroidism and is the preferred treatment option in most situations. OBJECTIVE: A prospective study was conducted to look at the therapeutic practice of use of radioactive iodine in the treatment of Graves' hyperthyroidism, to determine whether the expected or desired therapeutic outcome is achieved. SETTINGS: A tertiary referral centre in north India, Delhi that caters to patients with thyroid disorders. METHODS: One hundred and seventy four consecutive subjects with Graves' hyperthyroidism, who were given radioactive iodine were followed up. RESULTS: There were 59 (33.9%) males and 115 (66.1%) females. The mean age was 41.8 +/- 9 years. The dose of radioactive iodine ranged from 2 mCi to 15 mCi and the mean dose administered was 5.2 +/- 1.9 mCi. After one year following radioactive iodine therapy, 29 (16.7%) subjects were euthyroid, 51 (29.3%) were hypothyroid and the remaining 94 (54%) had persisting hyperthyroidism. Those subjects with persisting hyperthyroidism at one year after radioactive iodine had received a significantly lower dose compared to the groups who had achieved cure (either euthyroidism or hypothyroidism). CONCLUSION: The study shows that the current practice of empirical low dose radioactive iodine therapy to avoid hypothyroidism results in majority of patients having persisting hyperthyroidism. There is a need to take a new look at the current practice to increase the cure rate.

Adult↗
PubMed2005

[Effects of maternal hyperthyroidism and antithyroid drug therapy on congenital malformation of newborn infants].

OBJECTIVE: To evaluate the relationship between the incidence of congenital malformations of newborns and maternal hyperthyroidism with antithyroid drug (ATD) therapy during pregnancy. METHODS: The clinical data of 100 cases of pregnant women with hyperthyroidism and their 101 offsprings born in Peking Union Medical College Hospital during 1983-2003 were analyzed retrospectively. According to the maternal thyroid function, and antithyroid drugs taken during the first trimester of pregnancy, subjects were divided into different groups. The incidence of congenital malformations of newborns and risk factors, especially the effects of maternal hyperthyroidism with antithyroid drug therapy were analysed. RESULTS: The prevalence of congenital malformation in infants born to mothers who had hyperthyroidism during pregnancy (6.9%, 7/101) was significantly higher than that of all the infants born in the same hospital during the same period (0.9%, 212/22 765, P < 0.01). The difference of the incidence of malformed infants born to mothers with hyperthyroidism (9.6%, 5/52) or euthyroidism (4.1%, 2/49) during the first trimester was not significant (P > 0.05). The incidence of malformed infants whose mothers received methimazole (MMI; 41.7%, 5/12) was significantly higher than that of mothers treated with propylthiouracil (PTU) (3.6%, 1/28) and without ATDs (1.6%, 1/61), respectively (P < 0.01). The Loglinear model analyses showed that mothers receiving MMI during the first trimester of pregnancy was independent risk factor for the increased incidence of malformation of their infants (L.R. square = 15.668, P = 0.0003). CONCLUSIONS: The risk of congenital malformation in infants whose mothers take MMI during the first trimester may be increased. Therefore, we suggest that MMI should not be used as a choice of drug in treatment of pregnant women with hyperthyroidism.

Antithyroid Agents↗
PubMedDate not supplied

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

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.

Adult↗
PubMedDate not supplied

Oxidative stress markers during a course of hyperthyroidism.

INTRODUCTION: Previous studies have shown the presence of oxidative stress in hyperthyroid patients. The aim of this study was to evaluate the influence of hyperthyroidism on lipid peroxidation, plasma lipoprotein oxidation and antioxidant status. We have estimated the clinical utility of the biochemical parameters analysed as markers of oxidative stress in hyperthyroidism. MATERIAL AND METHODS: Twenty five patients with overt hyperthyroidism because of Graves' disease or toxic multinodular goitre and 20 healthy subjects were included in the study. Lipid peroxidation was evaluated by measurement of peroxides and malondialdehyde with 4-hydroxynonenal (MDA + 4-HNE) concentrations. Autoantibodies against oxidised LDL (anti-oxLDL) were assayed as a marker of lipoprotein oxidation. Changes in the antioxidant defence system were estimated by measurement of total antioxidant status in serum (TAS) and erythrocyte superoxide dismutase activity (SOD). RESULTS: A significant increase in serum concentration of peroxides and MDA + 4-HNE was observed in patients with hyperthyroidism. However, no difference was found in anti-oxLDL concentration and antioxidant status parameters (TAS, SOD) between the control group and the patient group. CONCLUSIONS: Our results indicate an intensification of the oxidative processes caused by an excess of thyroid hormones, which is not accompanied by a response from the antioxidant system. Elevated concentrations of lipid peroxidation products in serum, both peroxides and malondialdehyde with 4-hydroxynonenal, may be useful as markers of oxidative stress during the course of hyperthyroidism.

Adult↗