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PubMed2006

[Effect of combined therapy of modified kangjia recipe combined with western medicine on hyperthyroidism].

OBJECTIVE: To observe the therapeutic effect of combined therapy of modified Kangjia Recipe (KR) and western medicine propylthiouracil (PTU) on hyperthyroidism and to assess its advantage. METHODS: Ninety patients with hyperthyroidism were divided into the treatment group (TG) and the control group (CG). The 60 patients in TG treated with KR and PTU, and the 30 patients in CG treated with PTU alone. The treatment course of both groups was 3 months. The serum thyroid hormone (TH) level, clinical symptoms and signs, and adverse reaction were observed before and after treatment. RESULTS: The serum TH level, clinical symptoms and signs were significantly improved after treatment in both groups (all P < 0.01). The total effective rate was 93.3% in TG, which was higher than that in CG (83.3%, P < 0.01); and the efficacy in improving palpitation, fidget, aversion to heat, sweating and insomnia was better in the TG than that in the CG respectively (P < 0.05). As for the incidence of adverse reaction, it that was lower in the TG than in the CG. CONCLUSION: KD has good efficacy in treating hyperthyroidism, and the combined treatment of Chinese and Western medicine shows obvious advantages.

Adult↗
PubMed2006

[Aggravation of congestive heart failure after cesarean section in a patient with undiscovered hyperthyroidism].

A 27-year-old woman with toxicity of pregnancy and congestive heart failure underwent an emergency cesarean section. In spite of antihypertensive drugs, blood pressure and heart rate were high preoperatively. She coughed many times and SpO2 was 88%. Circulatory state became stable without antihypertensive drugs under combined spinal-epidural anesthesia and continuous intravenous infusion of propofol intraoperatively. After surgery, blood pressure and heart rate became elevated again and congestive heart failure became worse. She was diagnosed as hyperthyroidism by postoperative laboratory examination. If we had discovered her hyperthyroidism, her symptoms of congestive heart failure would not have become worse. We should be more careful about hyperthyroidism in pregnancy because it is not rare.

Adult↗
PubMed1990

The use of antithyroid drugs in the medical management of feline hyperthyroidism.

Antithyroid drugs are widely used in human medicine for the medical management of Graves' disease. Because patients with Graves' disease may undergo spontaneous remission, antithyroid drugs are preferred for long-term therapy because they do not permanently affect thyroid function. Hyperthyroidism in cats is somewhat different, in that spontaneous remission has not been reported and therefore ablative treatment (surgery or radioiodine) is often preferred. However, antithyroid drugs are essential for preoperative stabilization of cats with hyperthyroidism and often are used for long-term management of certain cases. This chapter will review the various drugs available for the medical management of hyperthyroidism, their mechanisms of action, indications for use, and adverse side effects.

Animals↗
PubMed1991

Use of the triiodothyronine suppression test for diagnosis of hyperthyroidism in ill cats that have serum concentration of iodothyronines within normal range.

Administration of triiodothyronine (liothyronine, 15 micrograms, q 8 h, for 6 treatments) caused marked decrease in serum concentration of thyroxine (T4) and estimates of free T4 (fT4) concentration in clinically normal cats. A prospective clinical study was done to evaluate the use of this suppression test for diagnosis of hyperthyroidism in cats with clinical signs suggestive of the disease, but lacking high serum concentration of iodothyronines. Twenty-three cats were confirmed as hyperthyroid on the basis of histologic changes in the thyroid gland or clinical improvement in response to administration of methimazole. Mean +/- SD serum concentration of T4 (34.3 +/- 12.7 to 31.3 +/- 11.5 nmol/L) and estimate of fT4 concentration (26.6 +/- 6.4 to 25.6 +/- 6.9 pmol/L) did not change after administration of liothyronine to these cats. Twenty-three cats were classified as nonhyperthyroid by histologic confirmation of other disease, abnormal results of other diagnostic tests that strongly supported primary disease other than hyperthyroidism, or spontaneous remission of weight loss without treatment. Mean +/- SD serum concentration of T4 (27.9 +/- 10.3 to 11.7 +/- 6.4 nmol/L) and estimate of fT4 concentration (21.7 +/- 5.4 to 10.4 +/- 4.4 pmol/L) decreased significantly (P less than 0.001) in response to administration of liothyronine. Discriminant analysis was used to identify variables from iodothyronine assays (eg, absolute concentration of T4 or absolute estimate of fT4 concentration, or changes of T4 or fT4 concentration) that provided the best diagnostic sensitivity and specificity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Surgical treatment of hyperthyroidism (therapeutic and nosologic considerations from a personal experience of 2,395 cases)].

A retrospective analysis of the author's surgical experience (2,395 operations) demonstrates that the surgical treatment of hyperthyroid is nowadays simple and benign without mortality and with a very low morbidity. This dramatic improvement can be explained by the combination of a better medical preparation, and a meticulous surgical technic in the hands of an experimented team. The long term results are excellent with no recurrence of hyperthyroid. In about 30% of patients is observed a residual hypothyroid, which is milder, less evolutive and easier to manage than hypothyroid following radio-iodine therapy. Surgery thus appears in most cases to be the best solution, when the impossibility or failure of a medical treatment leads to consider a more radical approach. A classification of hyperthyroid lesions is proposed which seemed more suitable for the establishment of a rational surgical strategy. This classification is based on the opposition of diffuse hyperfunctional hyperplasia (with or without nodes) and localised toxic adenomas (single or multiple).

Humans↗
PubMed1991

[Thyroid carcinoma with hyperthyroidism as the major clinical manifestations].

Twenty-two patients (17%) with thyroid cancer evidenced by major clinical features of hyperthyroidism were encountered out of 129 patients with thyroid cancer operated on. Clinical complains consisted of palpitation, dyspnea, nervousness, increased appetite, and weight loss. Preoperative BMR of 12 patients ranged from +17% to +41%, averaging +31.4%. Definite diagnosis was made by preoperative biopsy in two patients, the remainder was misdiagnosed as having primary hyperthyroidism (12), nodular goiter (6), and adenoma (2). The causes of misdiagnosis, coexistence of thyroid cancer and hyperthyroidism, and prognosis were discussed. we conclude that fine needle biopsy is the most effective way to establish correct preoperative diagnosis.

Adenocarcinoma↗
PubMed1991

[Clinical study on the alterations of erythrocyte membrane lipids and Ca2+, Mg2(+)-ATPase activity in hyperthyroid patients].

Erythrocyte membrane cholesterol, phospholipid, basic Ca2+. Mg2+--ATPase activity and the reaction of the enzyme to membrane-free hemolysate solution in vitro were measured in 32 untreated hyperthyroid patients and compared with the results in 30 age matched normal subjects. Erythrocyte membrane basic Ca2+. Mg2+--ATPase activity is found to be significantly higher in hyperthyroidism and has a significantly positive correlation both to the serum T3 Level and pulse pressure. RBC membrane Ca2+. Mg2(+)-ATPase reaction to membrane-free hemolysate solution is weaker than that in the controls. The amount of red blood cell membrane cholesterol is significantly increased and serum cholesterol is decreased in hyperthyroidism. No significant correlation between the enzyme activity and the amount of the erythrocyte lipids were found.

Adolescent↗
PubMed1991

[Shortened preoperative preparation in diffuse hyperthyroid goiter: experience in 34 patients].

Conventional preparation of goitrous hyperthyroid patients using lugol and propranolol may take 2 weeks. This period may be shortened using sodium iopodate and dexamethasone. We used 500 mg of sodium iopodate and 1 mg dexamethasone for 4 days in 34 hyperthyroid patients. Surgical indication derived from failure to medical treatment (68%), large goiter (27%) or adverse reaction to PTU (6%). Clinical euthyroidism was achieved after 4 days in all patients. T3 levels decreased from 482 +/- 26.2 to 137.6 +/- 3.7 ng/dl and T4 from 20.6 +/- 1.04 to 15.2 +/- 0.5 micrograms/dl (p < 0.005). Surgery was uneventful in 33 patients, one subject developed supraventricular tachycardia responsive to verapamil. Electron microscopy of the removed thyroid tissue revealed marked decrease of superficial villi and large phagosomes. Thus, sodium iopodate and dexamethasone are effective and safe for preoperative preparation of hyperthyroid patients.

Adolescent↗
PubMed1991

[Intrahepatic cholestasis in hyperthyroidism].

Three cases of cholestatic liver disease related to hyperthyroidism are reported. Features indicative of a role of the endocrine disease in the pathogenesis of the cholestatic syndrome were the appearance of liver damage in temporal relation with the clinical onset of thyroid hyperfunction and its disappearance with the amelioration of the hyperthyroidism; the absence of congestive heart failure and of infectious, toxic or obstructive agents of liver damage; the pathological and biochemical findings of intrahepatic cholestasis. Hyperthyroidism can be rarely complicated by a severe cholestatic syndrome that may dominate the clinical presentation and course.

Biopsy↗
PubMed1990

[Role of surgery in the treatment of diffuse hyperthyroidisms].

A prospective study was set up to help in the choice of treatment for diffuse hyperthyroidism: antithyroid drugs, radioactive iodine or surgery? Over a 20-year period 477 patients with diffuse hyperthyroidism were operated upon and followed up every year. Early complications were uncommon; permanent functional sequelae, usually not troublesome, were observed in only 1.8 percent of the cases. The endocrine status obtained remained stable beyond 2 years in 98 percent of the patients. Ten years after surgery, failure or relapse were recorded in 3 percent of the cases, hypothyroidism in 27 percent and euthyroidism in 78 percent. These results appear to be better than those of the other methods reported in the literature. Antithyroid drugs expose to relapse in 50 percent of the cases. With radioactive iodine, the cumulative incidence of hypothyroidism is 3.6 percent per year and 100 percent in 30 years. The recent preference for non-surgical therapeutic methods does not seem to be soundly founded. Except when diffuse hyperthyroidism occurs in adolescents or in elderly or high surgical risk adults, surgery performed by a well-trained multidisciplinary team deserves to be considered.

Adolescent↗
PubMed1977

Effect of propranolol on the plasma cyclic AMP and cyclic GMP levels to massive doses of glucagon in euthyroid and hyperthyroid subjects.

The plasma c-AMP level increases significantly in response to pharmacologica doses (1 mg i. v.) of glucaton. Beta blocking agents somewhat inhibit this increase in both euthyroid and hyperthyroid subjects. Catecholamine release elicited by glucagon thus plays some part in the response. In euthyroid subjects 2 microgram/kg glucagon still produces a significant increase in the plasma c-AMP concentration and propranolol fails to counteract this response. The c-AMP response elicited by identical doses of glucagon is more marked in hyperthyroid than in euthyroid subjects and can be somewhat reduced by propranolol. This indicates that in hyperthyroid patients even low doses of glucagon stimulate the release of catecholamines or enhance the responsiveness of beta receptors. The plasma c-GMP level increases in response to glucagon loading but in a lesser degree than does the c-AMP concentration. The response of c-GMP to glucagon is more protracted than the response of c-AMP and propranolol fails to counteract it.

Adult↗
PubMedDate not supplied

Association of hyperthyroidism and ulcerative colitis. Report of two cases.

The association of hyperthyroidism and ulcerative colitis (UC) is presented in two cases: a 61-year-old man and a 54-year-old woman. In the first case the onset of hyperthyroidism was detected at the age of 25, and the onset of ulcerative colitis at the age of 36. The second case presented severe hyperthyroidism started at the age of 51. In the latter case ulcerative colitis had been detected ten year earlier. To our knowledge this report seems to be the first one considering this association from the endocrinological standpoint. The association of these two diseases might suggest that the disturbance of even one organ specific immune lesion implies a wider disorder. Thus one might assume that the association of multiple organ-specific immune diseases represents an unsuccessful attempt to equilibrate the repertoire of idiotypes and anti-idiotypes belonging to the immune network.

Autoimmune Diseases↗
PubMed1990

Gustatory differences in hypothyroid and hyperthyroid tasters and non-tasters.

Gustatory differences in Phenylthiocarbamide (PTC) tasters and non-tasters were studied in hypothyroid and hyperthyroid subjects. After presenting for PTC sensitivity, gustatory responses to 7 dilutions of test solutions for glucose (sweet), sodium chloride (salt), citric acid (sour) and quinine sulphate (bitter) were studied in PTC tasters and non-tasters. The intensity and pleasantness responses for 4 basic tastes were measured on a 7-point and 6-point category scale respectively. Sixty percent of subjects of hyperthyroid and 40% of hypothyroid subjects were tasters. Hypothyroid subjects showed more gustatory differences as compared to hyperthyroids. The diminished intensity perception for sweet and bitter taste was much more prominent in non-tasters than tasters hypothyroids. The greater hedonic value for salt was largely observed among hypothyroid tasters.

Citrates↗
PubMed1990

Hyperthyroid hypokalemic periodic paralysis in a Hispanic male.

A case of hyperthyroid periodic paralysis in a Hispanic male is reported, the disorder in this race being described only once before. He presented with complete paralysis below the neck, and his admission potassium of 1.3 mEq/L is the lowest reported in the literature. Correction of the hypokalemia resolved his symptoms. Radionuclide imaging and thyroid function tests revealed the presence of hyperthyroidism which was managed medically. The pathophysiology of hyperthyroid hypokalemic periodic paralysis is discussed.

Adult↗
PubMed1990

[Fructosamine values in hyperthyroidism, hypothyroidism and gammopathy].

Fructosamine values in two groups of hypo- and hyperthyroid patients were compared with the values in a reference group of non-diabetics. In hyperthyroid patients the fructosamine values were significantly lower than in the reference group. Also the mean concentrations of albumin and total protein in serum are significantly lower for hyperthyroid patients compared to hypothyroid patients. The results do not provide evidence for a simple relationship between fructosamine and protein values in these patient groups. Therefore we do not recommend to relate fructosamine to protein or albumin using correction factors. Under conditions of thyrotoxicosis fructosamine is no reliable indicator of previous serum glucose concentrations. The test is not affected by monoclonal IgG gammopathy.

Adult↗
PubMed1990

[Amyotrophic lateral sclerosis syndrome and hyperthyroidism. Cure with antithyroid drugs].

We report the case of a 62-year old man presenting with generalized muscular weakness, amyotrophy, dysarthria and dysphagia. Neurological examination showed bilateral pyramidal signs and lingual fasciculations. The clinical diagnosis was amyotrophic lateral sclerosis, since only shivers and weight loss pointed to hyperthyroidism. However, after several months the patient developed typical manifestations of hyperthyroidism. After treatment of hyperthyroidism, the neurological symptoms disappeared. Although this association is extremely rare, one must have in mind the possibility of thyroid dysfunction when studying patients with amyotrophic lateral sclerosis.

Amyotrophic Lateral Sclerosis↗
PubMed1990

Complete heart block complicating hyperthyroidism: a case report.

Complete heart block developed in a 29-year-old man with hyperthyroidism and acute febrile illness. The definite cause of acute febrile illness was unknown. The results of bacteriological and viral studies were negative. Endomyocardial biopsy revealed no evidence of carditis which is the common cause of heart block. All the abnormalities resolved completely after the fever subsided and the patient was treated with an antithyroid drug. Available information indicates that a high degree of heart block can sometimes occur in hyperthyroidism in either the presence or absence of additional factors which can independently impair atrioventricular conduction. This course of events which occurred in this patient suggest that complete heartblock may have been the direct manifestation of the hyperthyroid state, however, the acute febrile illness may have been an aggravating factor in the development of abnormal atrioventricular conduction.

Adult↗
PubMed1989

[Retrospective studies of the long-term course of various forms of hyperthyroidism with special reference to prognostic aspects].

In 153 patients, who from 1978 to 1982 were under treatment for clinically and radiochemically proven hyperthyroidism, thyroid function was re-examined at an observation interval of 5-10 years. Overall, the remission rate after initial treatment was 75%; after 5-10 years, 123 patients (80%) showed an euthyroid metabolic condition. Following conservative therapy alone, euthyroidism was seen unexpectedly often in patients with supposed autonomy. This is probably due to a transitory iodine contamination and a heterogeneous case material, as the differentiation from Basedow's hyperthyroidism may be difficult. The conservative initial therapy with thyrostatic drugs is indicated for both forms of hyperthyroidism. Based on the hitherto known prognostic criteria, a reliable prediction of the clinical course of a given case cannot be provided.

Adenoma↗