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PubMed2003

Efficacy and safety of once versus twice daily administration of methimazole in cats with hyperthyroidism.

OBJECTIVE: To determine whether once daily administration of methimazole was as effective and safe as twice daily administration in cats with hyperthyroidism. DESIGN: Randomized, nonblinded, clinical trial. ANIMALS: 40 cats with newly diagnosed hyperthyroidism. PROCEDURE: Cats were randomly assigned to receive 5 mg of methimazole, PO, once daily (n = 25) or 2.5 mg of methimazole, PO, twice daily (15). A complete physical examination, including measurement of body weight; CBC; serum biochemical analyses, including measurement of serum thyroxine concentration; and urinalysis were performed, and blood pressure was measured before and 2 and 4 weeks after initiation of treatment. RESULTS: Serum thyroxine concentration was significantly higher in cats given methimazole once daily, compared with cats given methimazole twice daily, 2 weeks (3.7 vs 2.0 micro +/- g/dL) and 4 weeks (3.2 vs 1.7 microg/dL) after initiation of treatment. In addition, the proportion of cats that were euthyroid after 2 weeks of treatment was lower for cats receiving methimazole once daily (54%) than for cats receiving methimazole twice daily (87%). Percentages of cats with adverse effects (primarily gastrointestinal tract upset and facial pruritus) were not significantly different between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that once daily administration of methimazole was not as effective as twice daily administration in cats with hyperthyroidism and cannot be recommended for routine use.

Administration, Oral↗
PubMed2005

Association of the risk of development of hypothyroidism after iodine 131 treatment with the pretreatment pattern of sodium pertechnetate Tc 99m uptake in the thyroid gland in cats with hyperthyroidism: 165 cases (1990-2002).

OBJECTIVE: To assess whether the risk of development of hypothyroidism after treatment with iodine 131 (131I) was associated with the pattern of sodium pertechnetate Tc 99m activity in the thyroid gland detected via scintigraphy before treatment in cats with hyperthyroidism. DESIGN: Retrospective study. ANIMALS: 165 cats. PROCEDURE: Medical records of cats with hyperthyroidism that had been treated with 131I (from 1990 to 2002) and had undergone scintigraphy of the thyroid gland before treatment were reviewed; data regarding signalment, scintigraphic findings (classified as unilateral, bilateral-asymmetric, bilateral-symmetric, or multifocal patterns), serum total thyroxine (T4) concentrations before treatment and prior to hospital discharge, and 131I treatment were collected. A questionnaire was sent to each referring veterinarian to obtain additional data including whether the cats subsequently developed hypothyroidism (defined as serum total T4 concentration less than the lower reference limit > or = 3 months after treatment). RESULTS: 50 of 165 (30.3%) 131I-treated cats developed hypothyroidism. Hypothyroidism developed in 39 of 109 cats with bilateral, 10 of 50 cats with unilateral, and 1 of 6 cats with multifocal scintigraphic patterns of their thyroid glands. Cats with a bilateral scintigraphic pattern were approximately 2 times as likely to develop hypothyroidism after 131I treatment than were cats with a unilateral scintigraphic pattern (hazard ratio, 2.1; 95% confidence interval, 1.04 to 4.2). CONCLUSIONS AND CLINICAL RELEVANCE: Cats with hyperthyroidism that have a bilateral scintigraphic pattern in the thyroid gland before 131I treatment appear to have a significantly higher risk of subsequently developing hypothyroidism, compared with cats with a unilateral scintigraphic pattern.

Animals↗
PubMed2006

Survival times for cats with hyperthyroidism treated with iodine 131, methimazole, or both: 167 cases (1996-2003).

OBJECTIVE: To compare survival times for cats with hyperthyroidism treated with iodine 131, methimazole, or both and identify factors associated with survival time. DESIGN: Retrospective case series. ANIMALS: 167 cats. PROCEDURE: Medical records of cats in which hyperthyroidism had been confirmed on the basis of high serum thyroxine concentration, results of thyroid scintigraphy, or both were reviewed. RESULTS: 55 (33%) cats were treated with 131I alone, 65 (39%) were treated with methimazole followed by 131I, and 47 (28%) were treated with methimazole alone. Twenty-four of 166 (14%) cats had preexisting renal disease, and 115 (69%) had preexisting hepatic disease. Age was positively correlated (r = 0.4) with survival time, with older cats more likely to live longer. Cats with preexisting renal disease had significantly shorter survival times than did cats without preexisting renal disease. When cats with preexisting renal disease were excluded, median survival time for cats treated with methimazole alone (2.0 years; interquartile range [IQR], 1 to 3.9 years) was significantly shorter than median survival time for cats treated with 131I alone (4.0 years; IQR, 3.0 to 4.8 years) or methimazole followed by 131I (5.3 years; IQR, 2.2 to 6.5 years). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that age, preexisting renal disease, and treatment type were associated with survival time in cats undergoing medical treatment of hyperthyroidism.

Age Factors↗
PubMedDate not supplied

Hyperthyroidism complicating asthma treatment.

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

Aged↗
PubMed1999

Effects of induced hypothyroidism or hyperthyroidism on growth and reproductive performance of Brahman heifers.

Prepubertal Brahman heifers (BW = 302 +/- 7.5 kg, body condition score [BCS] = 5.4 +/- .2, age = 498 +/- 3.4 d: SEM) were used to study the effects of thyroid function on growth and reproduction. Seven heifers were controls (C). Seven heifers were induced to become hypothyroid by ingestion of 4 mg/kg BW of 6-n-propyl-2-thiouracil (PTU). Seven heifers were induced to become hyperthyroid (T) by daily s.c. injections of triiodothyronine (T3, 1 mg/d). Treatments were administered for 84 d followed by an 84 d posttreatment period. Blood samples were obtained twice weekly via tail venipuncture for analysis of T3, thyroxine, and progesterone. The BW, BCS, and rectal temperature (RT) were recorded weekly. Estrus was monitored twice daily with the aid of a fertile bull equipped with a chin ball marker. Hyperthyroidism and hypothyroidism were successfully induced in T- and PTU- treated heifers, respectively. During the treatment period, PTU heifers gained the most BW and BCS (72.4 +/- 5.4 kg; .93 +/- .15 units), C heifers were intermediate (41.7 +/- 5.4 kg; .43 +/- .15 units), and T heifers gained the least (13.3 +/- 5.4 kg; -.36 +/- .15 units; P < .05). The RT also decreased (P < .05) in PTU heifers (-1.9 +/- .2 degrees C) compared with C (-1.2 +/- .2 degrees C) or T heifers (-.8 +/- .2 degrees C). No heifers exhibited estrus during the treatment period. During the posttreatment period, T heifers gained the most BW and BCS (93.9 +/- 6.1 kg; 1.14 +/- .13 units), C heifers were intermediate (67.0 +/- 6.1 kg; .86 +/-. 13 units), and PTU heifers gained the least (22.2 +/- 6.1 kg; -.14 +/- .13 units; P < .05). The reversal in BW and BCS gains during the posttreatment period corresponded to periods of transient hypo- and hyperthyroidism in T and PTU heifers, respectively. Age and BW at puberty and pregnancy were similar among all treatment groups. The BCS for T heifers was lower (5.7 +/- .2 units; P < .05) at puberty and pregnancy than for PTU heifers (6.6 +/- .2 units). Induction of hypothyroidism resulted in significant increases in BW and BCS during the treatment period, but these increases were not sufficient to dramatically affect reproductive performance of Brahman heifers.

Animals↗
PubMed1989

Cerebral embolism and hyperthyroidism.

Three different cases of cerebral embolism occurring in combination with hyperthyroidism are reported. Case 1; a healthy 37-year-old woman presented with sudden onset of left hemiparesis and left sided hypoesthesia of all modalities. Embolism in area of the right middle cerebral artery was confirmed by angiography and CT scan. Laboratory examination revealed hyperthyroidism and anemia. Antithyroid treatment brought about euthyroid function while slight hemiparesis remained present. Case 2; a 79-year-old woman who suffered from hypertension for one year had sudden onset of disorientation and left hemiparesis. Electrocardiogram showed atrial fibrillation. The CT scan indicated infarction in the right anterior and middle cerebral artery. The patient was diagnosed as having masked hyperthyroidism. Although antithyroid medication reduced it to euthyroid condition, the patient is now bedridden with hemiparesis. Case 3; a 45-year-old man who had partial thyroidectomy for Basedow's disease and had been treated with antithyroid and antiarrhythmic therapy for 10 years. Suddenly, he was in coma with dilated right pupil and left hemiplegia. Atrial fibrillation and hypothyroid function were observed. CT scan indicated hemorrhagic infarction in the territory of the middle cerebral artery with transtentorial herniation. He died on the 59th day of hospitalization following an episode of bronchopneumonia. On the basis of the cases presented here as well as on the basis of those described in the literature it appears that thyrotoxic patients with atrial fibrillation exhibit high incidence of cerebral embolism, and prophylactic anticoagulant therapy may be recommended.

Adult↗
PubMed2000

Hyperthyroidism and asthma.

Two patients presented with new onset of thyrotoxicosis and they then developed episodic wheezing a few months afterward. The asthmatic attacks improved when the patients were rendered in a euthyroid state with treatment. The present paper discusses the relationship between two diseases, hyperthyroidism and asthma, and the underlying factors potentially contributing to their conditions. The present findings suggest that asthma may develop in a susceptible individual with hyperthyroidism and it is possible that the reactive oxygen species may be a contributory factor in exacerbating wheezing in our hyperthyroid patients.

Adult↗
PubMed1991

Influence of antithyroidal therapy on asthma symptoms in the patients with both bronchial asthma and hyperthyroidism.

To investigate the possible influences of hyperthyroidism on the pathophysiology of bronchial asthma, we clinically observed the effect of antihyperthyroidal therapy on asthmatic symptoms in 7 patients who shared both disorders. In five cases, asthma symptoms were affected by the therapy. Asthma symptoms improved after normalization of thyroid function in two cases, but worsened after therapy for hyperthyroidism in three cases. There was no apparent correlation between the pathophysiology of the two diseases after therapy in the two other cases. These results showed that thyrotoxicosis does not uniformly affect the pathophysiology of asthma and emphasizes the need to follow asthmatic patients closely following treatment for hyperthyroidism.

Adult↗
PubMed1992

Airway response to inhaled fenoterol in hyperthyroid patients before and after treatment.

Bronchodilatory response to inhaled fenoterol was studied in 15 hyperthyroid patients before and after successful treatment with antithyroid drugs. Baseline forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were lower than the predicted values in 12 and 11 patients, respectively. Improved values were seen after treatment for hyperthyroidism although statistical significance was not reached. Even if some improvement occurred in PEFR (a rise by 0.24-0.48 L/s) and FVC (increase of 73-78 ml) in the hyperthyroid state in response to fenoterol inhalation after various time intervals, the increase in different parameters of lung function was significantly more after the patients achieved euthyroid state (increases in FVC by 290-165 ml; in FEV1 by 333-193 ml; in peak expiratory flow (PEFR) by 0.75-0.52 L/s and in forced expiratory flow (FEF50%) by 0.55-0.31 L/s). In the euthyroid state the mean absolute improvements from the baseline values were significantly higher (< 0.05-0.001). These observations indicate that bronchodilatory response is impaired in the presence of excess thyroid hormones and improves after euthyroid state is achieved.

Administration, Inhalation↗
PubMed1975

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

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

Adult↗
PubMed1993

Elevated plasma levels of VWF:Ag in hyperthyroidism are mediated through beta-adrenergic receptors.

Thyroid dysfunction influences the levels of Von Willebrand factor (VWF:Ag). Plasma VWF:Ag levels in 35 hyperthyroid patients were significantly elevated, which had a positive correlation with both T3 (Triiodothyronine) and T4 (Thyroxine) levels. A follow-up study of seven hyperthyroid patients undergoing anti-thyroid therapy showed that the elevated VWF:Ag levels returned to normal range with the normalization of thyroid function. On the other hand, after administration of 160 mg/day of propranolol, a specific blocker of beta-adrenergic receptors, to five hyperthyroid patients for twenty-eight days, plasma VWF:Ag levels returned to normal range, while T3, T4 levels remained high without significant alteration. These results demonstrated that the elevation of plasma VWF:Ag by thyroid hormone is mediated through beta-adrenergic receptors, which may be useful to further understand the physiological and pathological roles of thyroid hormone in the regulation of VWF:Ag levels.

Adult↗
PubMed1989

Tyrosine content, influx and accumulation rate, and catecholamine biosynthesis measured in vivo, in the central nervous system and in peripheral organs of the young rat. Influence of neonatal hypo- and hyperthyroidism.

The influence of neonatal hypo- and hyperthyroidism on different aspects of tyrosine metabolism in the hypothalamus, striatum, brainstem, adrenal glands, heart and brown adipose tissue (BAT) were studied in 14-day old rats. The synthesis rate of catecholamines (CA) was also determined in vivo after the injection of labelled tyrosine. Hypothyroidism increases tyrosinaemia and endogenous tyrosine concentration in the hypothalamus and BAT. Hyperthyroidism decreases tyrosinaemia and endogenous tyrosine levels in the striatum, adrenals and heart. The accumulation rate of tyrosine determined 30 min after an intravenous injection of the labelled amino acid has been determined in the organs, together with the influx of the amino acid, determined within 20s. Hypothyroidism increases tyrosine accumulation rate in all the organs studied, and tyrosine clearance is decreased in the striatum and brainstem; together with an increased tyrosinaemia, this leads to a normal influx. The influx of tyrosine is increased in the hypothalamus. Hyperthyroidism decreases tyrosine accumulation rate in all the organs except the adrenals. These results indicate that the thyroid status of the young rat can influence tyrosine uptake mechanisms, without modifying an organ's tyrosine content. The fact that hypothyroidism increases tyrosine influx in the hypothalamus without modifying it in the brainstem and striatum reflects an heterogeneous reactivity to the lack of thyroid hormones in different brain structures. Neonatal hypothyroidism decreases the CA synthesis rate in the striatum, the heart and the interscapular brown adipose tissue, while synthesis was enhanced in the brainstem and the adrenals. It is likely that these variations in CA synthesis are due to thyroid hormone modulation of tyrosine hydroxylase activity, the enzyme which catalyses the rate limiting step in CA biosynthesis.

Adipose Tissue, Brown↗
PubMed1998

Is it hyperthyroidism? You can't always tell from the clinical picture.

Hyperthyroidism usually causes a typical clinical syndrome in younger patients, but in some cases it presents with only minimal or atypical symptoms. This is especially true in older patients, who may have none of the typical signs, such as goiter. Differentiation between a euthyroid hyperthyroxinemic state and hyperthyroidism is crucial to avoid unnecessary treatment of persons with a normally functioning thyroid gland. In addition, distinguishing between causes of hyperthyroidism is important, because the treatments may be completely different. For example, in subacute thyroiditis, supportive care and observation are usually the only treatments needed, whereas in Graves' disease or toxic multinodular goiter, more definitive therapy is required.

Adult↗
PubMed2003

Experience in the use of radioactive iodine therapy for hyperthyroidism in Nigerian patients. A study of twenty-two patients.

This is a descriptive and follow-up study of the efficacy of radioiodine (131I) in the treatment of hyperthyroidism in Nigerian patients, and is aimed at creating awareness about the therapy amongst medical practitioners in the West African sub-region. Twenty-two patients (13 female, 9 males) were seen with clinical and biochemical features of thyrotoxicosis, and were treated with 131I between 1991 and 1999. The age range was 31 to 60 years, with a mean age of 44.2 +/- 1.8 years. The indications for 131I therapy were diverse and included its use as a first-line treatment for Graves' disease, thyrotoxic heart disease, recurrent thyrotoxicosis and failed antithyroid drug therapy. An incremental fixed-dose regimen was used in successive years, for different batches of patients. The duration of follow-up ranged from two months to nine years with a mean duration of 3.6 +/- 0.5 years. Three patients achieved euthyroidism, two patients needed a re-treatment with 131I because of persistent Hyperthyroidism. Nine patients developed hypothyroidism between two to 30 months of receiving 131I therapy. While seven other patients defaulted soon after the treatment and one patient who also had type 1 diabetes mellitus suffered a sudden death after two months. In conclusion, our experience revealed similar outcomes as have been reported by other workers. Radioactive iodine was found to be a safe and an effective treatment for hyperthyroidism in Nigerian patients, but a high rate of default precludes adequate long-term follow-up.

Adult↗
PubMed2004

Critical illness myopathy associated with hyperthyroidism.

A 51-year-old woman was admitted to the intensive care unit for exacerbation of chronic obstructive pulmonary disease. She received antibiotics, neuromuscular blocking agents, and steroids. After 8 days in the intensive care unit, she was noted to be severely weak, her serum creatine kinase had risen to 1,692 U/L (normal, 20-220 U/L), and a muscle biopsy was consistent with critical illness myopathy. As a result of evaluating for resting tachycardia, the patient was found to be hyperthyroid. Her weakness rapidly improved within 1 month after treatment of her hyperthyroidism with iodine-131 and methimazole. The metabolic alterations associated with hyperthyroidism may enhance the risk of developing critical illness myopathy after the administration of antibiotics, neuromuscular blocking agents, and steroids in the intensive care unit.

Critical Illness↗
PubMedDate not supplied

[Pharmacokinetics of beta blockers in hyperthyroidism. Therapeutic relevance].

Hyperthyroidism is associated with alterations in pharmacokinetic parameters such as absorption, distribution, metabolism and elimination. Beta-blockers are used in particular in the treatment of hyperthyroidism and are also subject to pharmacokinetic changes occurring during this pathology. The magnitude of these variations is examined when beta-blockers are used for clinical manifestations of hyperthyroidism or during thyroid surgery. Clinical means used to assess the accuracy of therapeutic drug monitoring are also described.

Adrenergic beta-Antagonists↗
PubMed1999

[Hyperthyroidism and acute renal failure in partial bladder mole].

We report on a 31-year-old II gravida I para treated because of a hydatidiform mole, hyperthyroidism and acute renal failure in the 16th week of pregnancy. The pathomechanism of trophoblast-induced hyperthyroidism will be discussed. To our knowledge this is the first report on acute renal failure in association with trophoblast-induced hyperthyroidism.

Abortion, Eugenic↗
PubMed1998

[Hyperthyroidism and pregnancy].

DESIGN: The aim of our study was to describe a course of pregnancy, delivery and puerperal time in women hospitalized in our Clinic during their pregnancies because of hyperthyroidism. MATERIALS AND METHODS: Sixteen case reports (thirteen pregnant women) were retrospectively analysed. Our study embrace data from the recent ten years. RESULTS: In all cases pregnancies, deliveries and puerperal time proceeded without any serious complications. Infants were delivered in good condition and no congenital defects were reported. CONCLUSIONS: 1. A proper treatment of hyperthyroidism in a pregnant woman determines the correct course of pregnancy, delivery and puerperal time. 2. We have not found any congenital defects, hypotrophy cases and infants' death reports in our material. 3. Hyperthyroidism in pregnancy does not determine cesarean section as a way of delivery.

Female↗