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PubMed1994

[Hyperthyroidism: a possible factor of cholestasis associated with hyperemesis gravidarum of prolonged evolution].

We report two cases of hyperemesis gravidarum with hyperthyroidism and jaundice. The cessation of vomiting associated with supportive care was followed by complete recovery in 5 weeks. Hyperthyroidism occurs in 60% of hyperemesis gravidarum, but jaundice is uncommon. The association of jaundice and hyperthyroidism suggests that hyperthyroidism is a possible factor of cholestasis in patients with hyperemesis gravidarum.

Adult↗
PubMedDate not supplied

Hyperthyroidism associated with hyperemesis gravidarum.

Hyperemesis gravidarum is an uncommon presentation of hyperthyroidism in pregnancy which is usually attributable to autoimmune (Graves') disease. While this condition necessitates treatment with antithyroid drugs, a syndrome of transient hyperthyroidism associated with hyperemesis gravidarum that resolves spontaneously is also recognised. Differentiation between these two conditions may prove problematic in practice. We report two cases of hyperthyroidism associated with severe hyperemesis gravidarum. Intractable hyperemesis continued in one patient despite normalisation of circulating free thyroid hormone concentrations with carbimazole. Neither patient exhibited clinical or immunological features of autoimmune thyroid disease, suggesting in retrospect that they had the syndrome of transient hyperthyroxinaemia associated with hyperemesis gravidarum rather than Graves' disease. The role of antithyroid drugs in the treatment of self-limiting transient hyperthyroidism associated with hyperemesis gravidarum requires clarification.

Adult↗
PubMed1994

[Determination of hepatocyte adrenergic alpha 1 receptor and study on actions of nourishing yin and replenishing qi drugs in experimental hyperthyroid rats].

In this study, hyperthyroid rat models (group 1) were established by daily intramuscular injections of thyroxine for 7 days. Group 2 were hyperthyroid rats receiving at the same time Nourishing Yin and Replenishing Qi drugs (Ophiopogonis japonis, Pseudostellariae heterophylla and Rehmannia glutinosa). Normal rats served as controls. Group 1 and group 2 rats showed manifestations of hyperthyroidism, higher rectal temperature, increased O2 consumption, as well as significantly higher serum TT3 and TT4 levels. Receptor proteins of liver cell membrane were prepared. Receptor binding assay was performed using 3H-prazosin (adrenergic alpha 1 receptor antagonist) as radioligand, maximal binding capacity (Bmax) and dissociation constant (Kd) were calculated from Scatchard curve. It was found Bmax (fmol/mg protein) in model groups were lower than that of the control group, but the differences were not statistically significant. Kd (nM) in group 1 was significantly lower than that of control group (2.32 +/- 1.09 vs 5.42 +/- 2.54, P < 0.05), indicating that receptor affinity was increased in hyperthyroid rats. Kd in group 2 (3.11 +/- 1.48) was intermediate between that in group 1 and controls, suggesting that these Chinese herbal medicine might have an effect in lowering receptor affinity and the peripheral conversion of T4 to T3.

Animals↗
PubMed1993

[Impaired carbohydrate tolerance in patients with hyperthyroidism--evaluation of some influencing factors].

Relation between the appearance of impaired carbohydrate tolerance and such factors as the duration of hyperthyroidism, age of patients, blood serum concentrations of thyroxine, triiodothyronine and free fatty acids, as well as insulin secretion both basal and stimulated by oral and "intravenous glucose administration was studied in 62 patients with untreated hyperthyroidism. Control group consisted of 24 healthy subjects having performed oral and intravenous glucose tolerance tests. Among the studied factors, high blood serum concentrations of thyroxine and triiodothyronine, elevated concentration of free fatty acids and defective insulin secretion influenced the appearance of impaired glucose tolerance in patients with hyperthyroidism. No relation was found, however, between the impaired glucose tolerance and the duration of hyperthyroidism or the age of patients.

Adult↗
PubMed1993

Altered platelet indices in dogs with hypothyroidism and cats with hyperthyroidism.

Changes in platelet indices (platelet count and platelet size) and PCV associated with thyroid disease were studied in 7 dogs with hypothyroidism and 21 cats with hyperthyroidism that were admitted to the veterinary teaching hospital. Compared with control (euthyroid) dogs, dogs with hypothyroidism had higher platelet count (P = 0.003), smaller platelet size (P = 0.01), and lower PCV (P = 0.02). Comparison of the group of hyperthyroid cats with a group of similarly aged, clinically normal cats with normal thyroxine values indicated that the group of hyperthyroid cats had significantly (P = 0.03) higher mean platelet size than did control cats, but differences were not found in mean platelet count or PCV. Results of this investigation indicate that the changes in platelet size reported in human beings with thyroid endocrinopathies also are found in animals so-affected. Although the pathogenesis of platelet abnormalities in animals with thyroid derangement is unclear and likely is multifactorial, the observed relation between platelet and erythrocyte production in this group of dogs is consistent with reports of an inverse relation between thrombocytopoiesis and erythropoiesis in iatrogenically hyperthyroid mice and in mice exposed to hypoxia.

Animals↗
PubMed1994

[Cardiopulmonary stress in hyperthyroidism].

Spiroergometry might be applicable to detect alterations of cardiopulmonary functions related to hyperthyroidism. Thus, cardiac and respiratory changes as well as work capacity in hyperthroid female patients were to be assessed with the help of the Cardiopulmonal Exercise Test System. Twelve female hyperthyroid patients with Graves' disease of whom all were controlled in euthyroidism, were examined. Eighteen euthyroid female patients in whom intracardiac catheter examination ruled out cardiopulmonary disease served as controls. The anaerobic threshold was determined by means of the V-slope method. An echocardiography was performed in all patients. Ergometry was performed in a semisupine position using a continuous ramp protocol of 20 watt/min. A markedly reduced work capacity, and a high heart rate in rest and exercise were found. In the ratio heart rate/oxygen uptake a lower rise (p = 0.001) due to a decreased growth in the heart rate was noticed. Regarding the pulmonary system a decreased tidal volume in hyperthyroidism (p = 0.021), and a higher breathing frequency (p = 0.003) were recognized, as well as an impaired oxygen consumption, in comparison with the euthyroid state. Also, echocardiographically an increased cardiac index (p = 0.008) and a markedly reduced stroke volume (p = 0.005) in comparison to the control group were observed. Heart rate, work capacity, oxygen uptake, and the ratio heart rate to oxygen uptake were normalized in euthyroidism. With the help of the CPX-System noninvasive measure of marked cardiopulmonary changes in hyperthyroidism are possible, especially the lower growth of the heart rate in exercise, which might be the limiting factor of work capacity.

Adult↗
PubMed1993

Specific activities of seminal vesicular phosphomonoesterases and Mg2+-,Ca2+- and Na+/K(+)-adenosine triphosphatases in hypo- and hyperthyroid albino rats.

Hypothyroidism (surgical thyroidectomy) inhibited the activities of acid phosphatase and Mg(2+)-ATPase in seminal vesicular tissue and fluid and that of Ca(2+)- and Na+/K(+)-ATPases in fluid alone, and T4 supplementation restored normalcy in all, except acid phosphatase. Hyperthyroidism (T4 25 micrograms/100g body weight/day for 60 days, im) enhanced the activities of alkaline phosphatase and ATPases in seminal vesicular tissue and fluid, and decreased acid phosphatase activity in tissue alone. Withdrawal of T4 treatment from hyperthyroid rats (after 30 days) augmented the activity of ATPases in tissue and impaired the same in fluid, while phosphomonoesterases remained at hyperthyroid level. The results suggest specific responses of various seminal vesicular phosphatases to altered thyroid hormone status. Modification in the specific threshold of androgen/estrogen action on different phosphatases in seminal vesicles appears to be the plausible mechanism underlying these changes in hypo- and hyperthyroid conditions.

Adenosine Triphosphatases↗
PubMed1976

Serum levels of thyrotropin, prolactin, growth hormone, triiodothyronine and thyroxine after oral administration of thyrotropin releasing hormone in hypothyroid and hyperthyroid patients.

After peroral administration of TRH there were found elevated responses of TSH and HPr in hypothyroidism but not in hyperthyroidism. While the basal levels of TSH were elevated in hypothyroidism and depressed in hyperthyroidism, no such difference has been found in the case of basal levels of HPr. After TRH stimulation the levels of HGH decreased especially in hyperthyroidism; in patients with acromegaly serum HGH level increased after TRH. Serum T4 increased only in euthyroid persons after 2 and especially 24 hours, but not in hyperthyroidism or hypothyroidism. Mean values of serum T3 were elevated after TRH in all three groups, but the difference was significant only in euthyroid subjects. FT4I was increased in euthyroid person after TRH stimulation.

Acromegaly↗
PubMed1993

The effects of hyperthyroidism on MIBG uptakes in the human heart--preliminary report.

Twelve cases of hyperthyroidism with cardiac manifestations (4 males, 8 females, ages: 20 to 70 years) and 12 normal controls of euthyroidism (6 males, 6 females, ages: 27 to 70 years) were included in our study. Each case accepted an I.V. injection of I-131 MIBG (I.R.E., Belgium) with 0.5mCi/1.7m2 of body surface area. The 24 and 48 hr imagings of the anterior chest, including total heart and lungs, were used to estimate cardiac sympathetic nerve innervation by the following formula: H/L = (the mean counts of pixels in the regions of interest (ROI) over the heart)/(the mean counts of pixels in the ROI over the lungs). The results showed that the 24 and 48 hr H/L values in euthyroidism were a little higher than those in hyperthyroidism, but the differences were not significant by a Wilcoxon rank sum test. The correlation between H/L and 24 hr I-131 thyroid uptake in patients with hyperthyroidism were also evaluated and the results showed no significant correlation between the H/L and uptake. In conclusion, we consider that the clinical manifestations concerning the heart in hyperthyroidism may not totally depend on the effects of increased cardiac sympathetic nerve innervation.

3-Iodobenzylguanidine↗
PubMed1993

[Prevention of iodine-induced hyperthyroidism after coronary angiography].

Coronary angiography (CA) is followed by an iodine load of 15 to 20 mg for the thyroid and may be the cause of iodine-induced hyperthyroidism. 60 consecutive patients hospitalized for CA without any thyroid history were examined and 56 had thyroid diseases with normal thyroid function. 33 patients still showed a significant decrease of 20 min Technetium uptake (TcU) and an increase of urine iodine excretion because of iodine excess 12 weeks after CA. 3 patients developed latent hyperthyroidism. 27 patients received medication of 1 g natrium-perchlorate and 60 mg methimazole 24 hours before and on the day of CA. These patients showed normal TcU and urine iodine excretion 4 and 12 weeks after CA. 1 out of these 27 patients developed overt hyperthyroidism but had PTCA without premedication 2 weeks after CA. Since Iodine excess leads to iodine-induced hyperthyroidism even in euthyroids a prophylaxis with perchlorate and methimazole is generally recommended in patients with CA.

Adult↗
PubMed1993

[Immunogenic hyperthyroidism following radioiodine ablation of a focal autonomy].

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.

Aged↗
PubMed1993

Use of breath hydrogen measurement to evaluate orocecal transit time in cats before and after treatment for hyperthyroidism.

Orocecal transit time was evaluated in 13 cats diagnosed with hyperthyroidism. Transit was determined by measuring the change in breath hydrogen and methane concentrations following oral administration of a nonabsorbable carbohydrate (lactulose). Transit times before and three to four weeks after treatment of the hyperthyroidism with radioactive iodine were compared. There was a significant prolongation of transit time, as determined by a change in hydrogen concentration, following correction of the hyperthyroidism (p = 0.034). Average transit times and standard errors were 27.7 +/- 3.7 minutes before treatment and 56.5 +/- 12.1 minutes after treatment. Methane was not detected in any of the samples. Hyperthyroidism appears to be associated with an accelerated small intestinal transit time in cats.

Animals↗
PubMed1995

[Use and efficacy of radioiodine therapy in the treatment of hyperthyroidism].

Radioiodine (131J) therapy is a method of radical treatment for hyperthyroidism. In our study in the period 1971-1993, we administered radioiodine therapy in 163 patients with hyperthyroidism. We performed a long-term follow-up, from one month, to 21 years after the radioiodine therapy. The cured rate was 83.4%: euthyroid state was found in 43.6% of patients and hypothyroidism appeared in 39.9% of patients. After the radioiodine therapy hyperthyroidism was found in 16.6% of cases. Radioiodine therapy is very efficient, non-invasive, radical treatment of hyperthyroidism, not expensive and easy to administer. It has practically no immediate or long-term complications, except hypothyroidism.

Adult↗
PubMed1996

[Value of thyroidectomy in amiodarone-induced hyperthyroidism. Apropos of 3 cases].

Amiodarone-induced hyperthyroidism in a relatively rare complication of long-term treatment with this molecule. It usually carries a good prognosis with regression being the rule after withdrawal of the drug although lethal forms have been reported. Conventional medical therapy (synthetic antithyroid drugs, steroids, betablockers) used in severe forms, is not always effective. In addition, amiodarone may be essential for the treatment of life-threatening, poorly tolerated arrhythmias, refractory to other forms of treatment. The authors report the cases of three patients treated with amiodarone for malignant arrhythmias who developed severe hyperthyroidism resistant to medical therapy and who were treated by total thyroidectomy. Surgery was followed by rapid resolution of the thyrotoxicosis without significant complications and immediate represcription of amiodarone. Thyroidectomy therefore seems a simple solution for amiodarone-induced hyperthyroidism allowing very rapid resolution of the hyperthyroidism and the possibility of immediate represcription of amiodarone.

Adult↗
PubMed1995

Comparison of the outcome between the calculated dosimetry and the estimated dosimetry of 131I in the treatment of hyperthyroidism.

To compare the outcomes of different methods in prescribing the optimal dose of radioactive iodine (131I) for the treatment of hyperthyroidism, we retrospectively analyzed 52 patients with toxic diffuse goiter. They received single dose of 131I for the treatment of hyperthyroidism. In addition, all of them met the following criteria: 1) symptoms and signs of hyperthyroidism; 2) elevated blood triiodothyronine (T3) and thyroxin (T4) by radioimmunoassay (RIA) method; 3) diffuse goiter with increase of uptake proved by thyroid scintiscan; 4) only one dose of 131I was given during the follow-up period; 5) well-documented thyroid function test in the medical chart during the follow-up period (6 months, 1 year, 2 years and 5 years after 131I therapy). The enrolled patients were divided into estimated and calculated group. The dose of 131I in the calculated group was obtained from the measurement of size and 131I uptake of thyroid gland. The dose of 131I in the estimated group was prescribed according to the size of thyroid gland by physical examination, and the association with cardiac arrhythmia, congestive heart failure, or ischemic heart disease. The mean doses of 131I were 4.8 +/- 1.4 mCi and 7.0 +/- 1.1 mCi in the calculated and estimated group respectively. In this study, there were no significant difference in the incidence of euthyroidism, hyperthyroidism, and hypothyroidism between these two groups in thefollow-up period after 131I therapy. In view of simplicity and time-saving, it is a practical choice to prescribe the dose of 131I therapy for toxic diffuse goiter according to the size of thyroid gland and the associated cardiac condition.

Adult↗
PubMed1996

Four- to twenty-four-hour uptake ratio: an index of rapid iodine-131 turnover in hyperthyroidism.

UNLABELLED: Rapid thyroidal iodine turnover may contribute to 131I therapy failure in patients with hyperthyroidism. The utility of a 4- to 24-hr 131I uptake ratio was evaluated as an index of thyroidal iodide retention in hyperthyroid patients. METHODS: In 433 hyperthyroid patients, the success of 131I therapy was correlated with the following factors: gender, pretreatment with antithyroid drugs, clinical diagnosis, magnitude of early and late thyroidal 131I uptake values, and the 4- to 24-hr 131I uptake ratio. RESULTS: Of the 433 patients, 362 patients (84%) had a successful outcome after a single therapeutic dose of 131I while 71 (16%) did not. Multiple linear regression analysis revealed that the highest statistically significant predictor of outcome was the 4- to 24-hr 131I uptake ratio (p-value < 0.001); all other factors showed a weaker association. An 131I uptake ratio of > 1 was found in 67 (15%) patients. Thirty-two of these 67 patients (48%) failed 131I therapy, whereas those patients with uptake ratios of < 1.0, only 39/366 (11%) failed 131I therapy. CONCLUSION: The 4- to 24-hr 131I thyroidal uptake ratio is a practical substitute for exact determination of the effective half-life. It identifies patients who are likely to have a rapid 131I turnover without the need for extended thyroid uptake measurements. An 131I uptake ratio of > or = 1 was found in 15% of hyperthyroid patients and was associated with a near 50% 131I therapy failure rate.

Adult↗
PubMed1995

[Hyperthyroidism as a cause of chronic anemia].

Hyperthyroidism like cause of anemia is rare, normally in this pathology there is a increase of the erythropoiesis secondary to the cellular hypoxia causes by the increase of the basal metabolism. We have revised the histories of diagnostical hyperthyroidism in our center, which presented anemia, we found four cases which presented anemia. All of them were women with associated heart disease. It is believe that this anemia is related with the patients age and the evolution time of the hyperthyroidism. We concluded after the bone marrow studies that the anemia of hyperthyroidism is a anemia of chronic disease with light reactive plasmocytosis.

Aged↗
PubMed1996

Alkaline phosphatase bone isoenzyme and osteocalcin in the serum of hyperthyroid cats.

The effect of hyperthyroidism on serum markers for increased bone metabolism and turnover was evaluated in 36 cats with elevated serum levels of thyroxine and alkaline phosphatase. Serum was analyzed for total and ionized calcium and phosphorous. Alkaline phosphatase isoenzymes were separated by agarose gel electrophoresis and osteocalcin was measured by radioimmunoassay. Values for hyperthyroid cats were compared with those for healthy cats. Alkaline phosphatase bone isoenzyme was markedly increased in all 36 hyperthyroid cats. Osteocalcin was increased in 44% of the cats. There was no correlation among the magnitude of increase in alkaline phosphatase bone isoenzyme, osteocalcin, and serum thyroxine concentrations. Increased serum phosphorus was found in 35% of the cats. Total calcium was within the reference range in all cats, while 50% of the cats had reduced levels of serum ionized calcium. We conclude that hyperthyroid cats do have altered bone metabolism, although it is usually clinically insignificant.

Alkaline Phosphatase↗