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PubMed2006

Left ventricular mass in patients with hyperthyroidism.

BACKGROUND: The mechanisms of increased left ventricular mass (LVM) in hyperthyroidism are complex. The aim was to determine the effects of hyperthyroidism and thyreostatic therapy on LVM regarding its interrelationship with factors responsible for the heart's hemodynamic workload. MATERIAL/METHODS: The study included 51 hyperthyroid subjects and 30 healthy controls. Left heart ventricle parameters evaluated using standard ultrasonocardiography were: left ventricular volume (end-systolic and end-diastolic), left ventricle posterior wall thickness at systole (LVPWs) and diastole (LVPWd) with the respective interventricular septal thicknesses (IVSs, IVSd), LVM, stroke volume (SV), cardiac output (CO), output-pressure index (OPI), and total peripheral resistance (TPR). Systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), and body mass index (BMI) were investigated. Measurements were repeated after two weeks of thiamazole treatment and after attaining euthyreosis. RESULTS: Compared with controls, the hyperthyroid subjects had significant thickening of LVPWd, LVPWs, and IVSs, increased LVM, augmented SV, CO, OPI, SBP, and HR, but reduced TPR and DBP. Hyperthyroid treatment did not normalize LVM. LVM showed positive correlations with SV, CO, OPI, SBP, BMI, and serum triiodothyronine concentration and negative correlation with TPR. In multivariate regression analysis, LVM correlated with SBP, SV, and BMI (R=0.64, p<0.001). CONCLUSIONS: 1) In hyperthyroid patients, LVM is increased, mainly due to its eccentric remodeling, probably caused by volume overload; the increased LVM does not seem to be reversible despite attainment of euthyreosis. 2) The increased LVM is probably related to the heart's hemodynamic workload and reflects adaptive changes.

Adult↗
PubMedDate not supplied

[Parathyroid function in hyperthyroidism: implications for bone metabolism and effect of the treatment].

PURPOSE: using bone densitometry, to evaluate bone loss of hyperthyroidism patients, and to study the possible contribution of parathyroid hormone (PTH) in the genesis of this osteopenia. TYPE: prospective study of patients with hyperthyroidism before and after treatment. PLACE: Division of Endocrinology, Escola Paulista de Medicina. São Paulo, SP. PATIENTS: 14 outpatients with clinical and laboratory diagnosis of toxic diffuse goiter (Basedow-Graves disease). Six of these patients were studied again after treatment, with at least 6 months of clinical and laboratory euthyroidism. METHOD: bone mineral content of the lumbar vertebral bodies was evaluated by dual-photon bone densitometry. Parathyroid hormone secretion was studied with an amino-terminal specific assay after EDTA-induced hypocalcemia; results were compared to those obtained from a group of 10 normal controls. RESULTS: there was a significant increase in bone mineral density after treatment (1.300 +/- 0.079 g/cm2) as compared to the pre-treatment condition (1.229 +/- 0.091 g/cm2, p less than 0.001). Decrement rate of serum calcium during EDTA infusion was significantly lower (p less than 0.001) in hyperthyroid (-0.698 x 10(-3) +/- 0.12 x 10(-5)) than in normal control individuals (-1.486 x 10(-3) +/- 9.33 x 10(-5)), and went back to normal after treatment. EDTA-induced calcium lowering was sufficient to induce a PTH plateau of maximum response. Maximum PTH response in hyperthyroidism patients (2.34 +/- 0.45pmol) was significantly lower (p less than 0.001) than that observed in normal controls (7.51 +/- 0.40), PTH response was normal after six months of euthyroidism. CONCLUSIONS: bone mineral density showed a significant increment in treated patients, suggesting that these patients had suffered some degree of bone loss during the course of thyrotoxicosis. The lower PTH secretory reserve found in untreated hyperthyroid patients suggests that hyperthyroid state-induced bone loss may be a consequence of a direct action of thyroid hormones. This conditions was reverted after 6 months of euthyroidism.

Adolescent↗
PubMed1990

[Results of radioiodine therapy of manifest hyperthyroidism and autonomous struma with euthyroidism].

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 hyperthyroidism (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 significantly more frequent if the basal TSH level was greater than or equal to 0.5 muIE/ml before therapy. The goiter size was reduced independent of the basal TSH level. In this group protection by thyroxine could avoid posttreatment hypothyroidism without impairing the reduction of goiter. 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 TSHh 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 as compared to the other groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Bone changes in hyperthyroidism--a preliminary study.

Thyrotoxicosis may cause osteopenia and lead to increased risk of fractures. From July 1988 to March 1989, 88 hyperthyroid patients and 65 age, sex matched normal controls were enrolled for lumbar spine bone mineral density (BMD) study. Significantly lower BMD values can be found in premenopausal hyperthyroid women (1.233 gm/cm2 vs 1.317 gm/cm2, p less than p less than 0.05). In the group of thyrotoxicosis, no linear correlation can be found between BMD and the degree of hyperthyroidism (N = 84, r = 0.01 and N = 74, r = 0.054 as comparing BMD to T4 and T3, respectively). After treatment with antithyroid drugs (ATD) for 3 months, BMD did not change significantly (1.258 gm/cm2 vs 1.242 gm/cm2, p = 0.02) in the hyperthyroid patients. Therefore, premenopausal hyperthyroid women have lower BMD than premenopausal euthyroid women. The treatment of hyperthyroidism after 3 months' course did not increase lumbar spine BMD.

Adult↗
PubMedDate not supplied

Plasma glucose, insulin, proinsulin, C-peptide and glucagon before and after a carbohydrate-rich meal in hyperthyroid patients.

The function of the pancreatic B- and A- cell during a carbohydrate-rich meal was investigated in hyperthyroid patients, since these patients frequently present an altered handling of glucose. In basal conditions the plasma levels of glucose, immunoreactive insulin (IRI), C-peptide (CPR), proinsulin were higher in hyperthyroid patients than in normal subjects, whereas plasma glucagon was similar in the two groups. Hyperthyroid patients had high post-breakfast incremental areas of glucose and IRI and those of CPR and glucagon were normal. In post-breakfast plasma, the hyperthyroid patients had high proinsulin and normal insulin levels. The molar ratio between CPR and IRI was low throughout the test in the hyperthyroid group. In conclusion, in the hyperthyroid group the plasma levels of proinsulin were high and those of glucagon were normal; in response to the standard breakfast the levels of insulin and C-peptide were normal. These findings do not explain the altered glucose handling present in these patients.

Adult↗
PubMed1986

Problems of anticoagulation with warfarin in hyperthyroidism.

From clinical observation it would appear that hyperthyroid patients are particularly sensitive to the anticoagulant effects of warfarin. A study was made of clotting factors prothrombin (II), VII, procoagulant VIII (VIIIC), IX and X and of prothrombin ratio (PTR) and partial thromboplastin time with kaolin (PTT-K). These parameters and warfarin levels were measured before and following a single dose of warfarin given to five patients when hyperthyroid and again when euthyroid. Hyperthyroidism was associated with lower activity of factor II and a shorter PTT-K. Warfarin produced a greater fall in factors II and VII and a greater increase in PTR and PTT-K in the hyperthyroid state than in the euthyroid state. The enhanced response to warfarin in hyperthyroidism was, however, relatively greater for the PTR than for the PTT-K. In order to produce adequate protection against intravascular thrombosis by a suitable prolongation of the PTT-K, it may be necessary in hyperthyroid patients to extend the PTR beyond the normal therapeutic range.

Aged↗
PubMedDate not supplied

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

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.

Adult↗
PubMed1983

Regulation of ketonaemia in hyperthyroidism: study of the role of free fatty acids.

We have indirectly assessed the role of free fatty acids (FFA) and of hepatic ketogenesis in the regulation of ketone body levels in euthyroid and hyperthyroid subjects. All studies were performed under controlled dietary conditions (35 and 45 kcal/kg body weight/day respectively for euthyroid and hyperthyroid subjects). In the post-absorptive state hyperthyroid patients had normal, glucagon levels and, in spite of increased insulinemia (p less than 0.02), elevated concentrations of blood glucose (p less than 0.01), glycerol (p less than 0.001) and ketone bodies (p less than 0.05). In the face of this hyperketonaemia, there was no significant increase of plasma FFA, suggesting possible increased hepatic conversion of FFA to ketone bodies. However, when FFA were acutely raised to high levels, the induced rise of ketone bodies was similar in hyperthyroid and euthyroid subjects. Oral propranolol administration to hyperthyroid patients in the post-absorptive state decreased the concentrations of glycerol (p less than 0.05) and ketone bodies (p less than 0.05) without altering insulin concentrations. Ketone bodies fell without any significant decrease of FFA suggesting a possible direct effect of propranolol administration on hepatic ketogenesis. However, the ketone body response to raised FFA levels was unaffected by propranolol. We have evidence in hyperthyroid patients of increased lipolysis and ketogenesis in spite of increased daily caloric intake. These results suggest that these metabolic abnormalities are not merely due to relative starvation. We have tentative evidence for modification of the intra-hepatic conversion of FFA to ketone bodies in the post-absorptive state but no supporting evidence when FFA levels were experimentally raised.

Adult↗
PubMed1984

Hypertropic cardiomyopathy and hyperthyroidism in the cat.

In a 21/2-year period, hypertrophic cardiomyopathy was found at necropsy of 23 cats that died (13 cats) or were euthanatized (10) because of problems associated with hyperthyroidism. Of these, 4 (17%) also had evidence of cardiac failure (pulmonary edema or pleural effusion). The mean body weight of the cats with hyperthyroidism and hypertrophic cardiomyopathy was significantly less (P less than 0.001) than that of clinically normal cats and cats with primary cardiomyopathy (congestive or restrictive) or excessive moderator band cardiomyopathy. In addition, the ratio of heart weight to body weight was significantly greater (P less than 0.001) in the 23 hyperthyroid cats than in the normal cats and cats with primary cardiomyopathy. Twenty (87%) of the cats had symmetric hypertrophy of the ventricular septum and left ventricular free wall, whereas the remaining 3 cats had disproportionate thickening of the ventricular septum, compared with the free wall, similar to what is found in cats with asymmetric hypertrophic cardiomyopathy. Histologic cardiac abnormalities included large, hyperchromatic nuclei, interstitial fibrosis, endocardial fibroplasia, fibrosis of the atrioventricular node, and marked disorganization of cardiac muscle cells. The study showed that hypertrophic cardiomyopathy develops in most hyperthyroid cats, some of which also develop congestive heart failure. Although the signs of heart disease in primary myocardial disease and thyrotoxic disease are similar, the characteristic signalment and clinical signs of hyperthyroidism should lead one to suspect the association of hypertrophic cardiomyopathy with the hyperthyroidism.

Animals↗
PubMed1984

Thirty-five cases of transient hyperthyroidism.

Over a 7-year period transient hyperthyroidism was diagnosed in 35 patients seen in a consulting practice in a community hospital. The patients were followed up for an average of 15 months. Initially all of them had biochemical evidence of hyperthyroidism but a very low 24-hour uptake of radioiodine. The hyperthyroid phase was short, and there were no relapses. Seventeen patients subsequently became hypothyroid; this phase, too, was almost always transient. The clinical course of the disease in the 11 women who became hyperthyroid within 6 months after giving birth was similar to that experienced by the other patients, but of the 11 who had increased titres of antimicrosomal antibodies a significantly greater proportion (73%) showed at least transient evidence of hypothyroidism; 1 patient remained frankly hypothyroid for a year. Transient hyperthyroidism can be distinguished from Graves' disease only if the uptake of radioiodine is measured. It is important to make this distinction, as transient hyperthyroidism can be managed safely and symptomatically with beta-blockers alone. The propensity of this disease for the postpartum period and the high proportion of patients with antithyroid antibodies suggest an autoimmune cause.

Adult↗
PubMed1981

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

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.

Adenoma↗
PubMed1994

Beta-adrenoceptor antagonism and the hyperthyroid rat heart.

beta-Adrenoceptor antagonists such as propranolol and atenolol ameliorate the symptoms of human hyperthyroidism. We wished to define whether the cardiac changes of hyperthyroidism are attenuated by treatment with the beta-adrenoceptor antagonist atenolol. Rats were treated with triiodothyronine (T3) [1 mg/kg/day subcutaneously (s.c.) for 14 days] together with oral atenolol (100 mg/day on days 8-14); physiological parameters, inotropic and chronotropic responses in isolated cardiac tissues to compounds that increase intracellular cyclic AMP, and ventricular beta 1- and beta 2-adrenoceptors were measured. Administration of T3 produced marked hyperthyroidism, leading to increased metabolism, cardiac hypertrophy, tachycardia, hypertension, marked decrease in or loss of positive inotropic responses to calcium chloride, norepinephrine (NE), forskolin, and theophylline and increased ventricular beta 1- and beta 2-adrenoceptor density. Atenolol treatment of hyperthyroid rats attenuated the increases in heart rate (HR), rectal temperature, and O2 consumption but did not alter cardiac hypertrophy, hypertension, decreased positive inotropic responses or increased beta-adrenoceptor density. We conclude that beta-adrenoceptor antagonists produce only limited changes in hyperthyroidism-induced cardiovascular responses; furthermore, beta-adrenoceptor antagonists are unlikely to attenuate the cardiovascular risk factors of hyperthyroidism.

Adrenergic beta-Antagonists↗
PubMed1994

[Circulating levels of CoQ10 in hypo- and hyperthyroidism].

Coenzyme Q10 (CoQ10) plays an essential physiologic role in oxidative phosphorylation and its plasma and tissue concentration has been evaluated in various pathologic conditions, both endocrine and non endocrine; among the latter particularly in cardiac failure. Plasma CoQ10 determination has been reported in the literature an a useful diagnostic tool in differential diagnosis of thyroid diseases. In the present study we have evaluated CoQ10 circulating levels both in hypo- and hyperthyroidism. For this purpose plasma CoQ10, fT3-fT4 and TSH concentrations have been determined (HPLC, RIA and IRMA respectively) in a group of hypothyroid patients, hyperthyroid and control subjects. No patient was harbouring cardiovascular, metabolic or systemic disease. CoQ10 has resulted 0.97 +/- 0.46 mcg/ml in the hypothyroid group, 0.51 +/- 0.35 in hyperthyroid and 0.73 +/- 0.16 in control group, with a significative difference between first and second group only; more, the prevalence of high levels has appeared greater in hypo- towards hyperthyroid patients and that of low levels in the latter greater than in the former. Finally an inverse relation of CoQ10 with fT3 and tT3, but not with fT4 and tT4, has been shown. In conclusion, plasma CoQ10 levels have not given in this study a sharp distinction between euthyroidism on a side and hypo- and hyperthyroidism on the other, but necessity of longitudinal studies after therapy is outlined, both to know time of normalization of plasma concentrations and to verify the opportunity of exogenous administration of CoQ10 in hyperthyroid patients with risk factors for heart failure.

Adult↗
PubMed1994

[Anti-microsomal, anti-thyroglobulin antibodies and thyroid stimulants in hyperthyroid subjects. Analysis of 315 patients followed-up for 3 years at a single medical center].

The objective of the study was to evaluate the significance of the determination of antithyroid antibodies in hyperthyroid patients. Two-hundred-fifteen untreated Graves' hyperthyroid patients (active toxic diffuse goiter-TDG), 54 Plummer's hyperthyroid patients (focal hyperthyroidism) and 46 subjects with other forms of hyperthyroidism were studied. Serum levels of T4, T3, TSH, TSH receptor antibody (TRAb), microsomal antibody (TMAb), and thyroglobulin antibody (TGAb) were evaluated before starting treatment, at regular intervals during therapy, and during the follow-up period after therapy was withdrawn. The antibodies were positive in all patients with active and non-active TGD but positive in only two patients (3.7%) with focal hyperthyroidism. During the treatment interval, TRAb, TMAb and TGAb serum levels fell with a nadir in the 7th month of therapy. In particular, TRAb fell to normal levels in all patients who had basal levels less than 500 U/l (97.7% of the cases) while TMAb and TGAb remained positive. Relapses, following the completion of therapy, occurred in 20.4% after one year and in 33% after two years. Relapses were always linked to a new increase in TRAb. In conclusion, TRAb can be useful in the determination of early disease and in diagnosing remission. It did not appear useful as a prognostic indicator for relapse in individual patients.

Adult↗
PubMed1996

Hyperthyroidism in elderly hospitalised patients. Clinical features and treatment outcomes.

OBJECTIVE: To review the clinical features and response to treatment of hyperthyroidism in elderly hospitalised patients. PARTICIPANTS AND SETTING: Sixty patients over the age of 70: 41 admitted to a geriatric hospital and 19 to an acute-care hospital, 1990-1993. METHODS: Thyroid function tests were performed routinely in the geriatric hospital but only on demand at the acute-care hospital. Hyperthyroidism was defined as elevation of plasma free thyroxine (FT4) or total tri-iodothyronine (T3) level and suppression of thyroid-stimulating hormone (TSH) level. Seventy-seven per cent of patients were seen personally; in the remainder details were obtained from their hospital records. Outcome was assessed by clinical and biochemical improvement. RESULTS: Clinical features - Fifty-two women and eight men with hyperthyroidism were identified. Their average age was 80.2 years (range, 70-101; median, 80.0). The most common clinical features were weight loss (83%) and atrial fibrillation (60%); 58% were agitated and 15% apathetic. Fifty-two per cent had cognitive impairment with either dementia or confusion. The diagnosis was not initially suspected in 62%. Thyroid antibodies were absent in 35/40 and an isotope scan showed a nodular thyroid in 27/29. Contrast radiography with iodine-containing media had been performed within the preceding six months in 23% of patients. Treatment and outcome - Forty-seven patients were treated with antithyroid drugs in standard doses and 21 received radioactive iodine. In 35 adequately assessed patients, including 21 with dementia, clinical improvement and normal results of thyroid function tests were achieved, but five patients died with uncontrolled hyperthyroidism. CONCLUSIONS: Hyperthyroidism in the elderly is usually due to autonomous thyroid nodules, and in about 20% of hospitalised patients may follow a contrast radiography procedure. The more common clinical features of hyperthyroidism occur frequently as unrelated symptoms in the elderly so that the diagnosis is often not apparent, particularly in the presence of cognitive impairment. As the response to standard biochemical treatment is rewarding, screening of the elderly with thyroid function tests should be done routinely.

Age Distribution↗
PubMed1996

[Risk of hyperthyroidism in examinations with contrast media].

Investigations with contrast media inevitably lead to the patient being exposed to large amounts of iodine. Under certain preconditions this gentails danger for the patient by causing either iodine-induced hyperthyroidism, which is difficult to treat, or even a thyrotoxic crisis. Patients with normal thyroid function and size have only minute changes of thyroid hormones and TSH within the normal range and are not at risk. Patients with unknown hyperthyroidism--independent of the etiological form--and patients with functional autonomy are at risk of exacerbation of pre-existing hyperthyroidism or development of iodine-induced hyperthyroidism. This development depends on two factors: a) the volume of autonomous tissue and b) the quantity of iodine exposure. Besides contrast media, other sources of iodine excess are possible, such as iodine-containing disinfectants, secretolytic agents, antiarrhythmics like amiodarone, eye drops and ointments, geriatrics, skin ointments, toothpaste etc. The development of hyperthyroidism can be prevented by combined treatment with antithyroid drugs and perchlorate in the case of preexisting hyperthyroidism or the urgent clinical suspicion of thyrotoxicosis or with perchlorate alone, when the patients is euthyroid and does not have a large nodular goitre.

Contrast Media↗
PubMed1976

[Dose-response relationship in radioiodine therapy of hyperthyroidism].

For the analysis of the dose-response relationship during radioiodine therapy, the effective dose was calculated based on measurements in 1171 patients in the course of treatment. Early results of the radioiodine therapy of these cases were checked up from six to nine months afterwards. The probability of incidence of a residual hyperthyroidism or of the induction of hypothyroidism respectively, in dependence on dosage, is represented by a dose-response curve. The dose-response curve for residual hyperthyreoses shows an exponential shape, whereas the curve of induced hypothyroidism is sigmoidally shaped. The results of experimental biophysics concerning dose-response curves allow the statement that there is no reactivity of the thyroid gland in cases of residual hyperthyroidism, whereas distinct compensation mechanisms are counteracting the induction of hypothyroidism. Thus, the conception of fractionated radioiodine therapy is supported by the shape of dose-response curves. The fractionation of the dose leads to accumulated inactivation effects on the hyperthyroidism, while the compensational mechanisms against hypothyroidism are strengthening by intermittent recovery and the rate of induced hypothyroidism is decreasing. The favorable effect of multiple treatment on the number of induced hypothyreoses could be verified by our own material. During the radioiodine therapy of hyperthyroidism, a defined interrelation is found between the effective dose, the thyroid mass and the effect of the dose. A formula of the isoeffective dose in dependence of the thyroid mass is derived analogically to percutaneous radiation therapy. The deviation of the effective dose from the dose previously calculated is represented as a distribution function. The mean value of this distribution function can be regarded as an expectation of the effective dose. Hence, a previous calculation of the dose is considered useful also in future. The isoeffective dose is proposed to be chosen in dependence on the thyroid mass according to a fifty-per-cent-probability of residual hyperthyroidism. Relative to the intensity of residual hyperthyroidism, a second treatment considering the same standards should be performed after four to nine months. The number of reiterated treatments needed depends on individual radiation sensitivity resulting from biological factors.

Dose-Response Relationship, Radiation↗
PubMed1997

Hyperthyroid goitre treated surgically.

The aim of the study was the comparative analysis of the degree of intensity of male and female hyperthyroidism treated surgically in the years 1990 to 1996. In this period 295 females and 42 males underwent operation for hyperthyroid goitre. Female predominance was noted in hyperthyroidism (ratio 7:1), in Graves' disease (7.4:1) and in toxic nodular goitre (6.3:1). The clinical findings in pre- and postoperative patients, including laboratory, visual diagnosis, and intra- and postoperative complications were evaluated. In the preoperative period, the incidence of the thyreocardiac syndrome was greater in the male. Male hyperthyroidic goitres were more frequently located retrosternally and caused trachea compression. No significant sexual differences were found in routine laboratory tests. Operations for hyperthyroidic male goitres usually caused more intraoperative problems and were connected with greater blood loss. Estimation of cardio-vascular parameters in the early postoperative period showed higher intensification of hyperkinetic circulation and higher mean body temperature in men. Signs of psychosis developed postoperatively in two men. The analysis of patients with hyperthyroidic goitre treated surgically revealed more severe course of male thyreotoxicosis in the perioperative period.

Adult↗