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Renal, thyroid and parathyroid function during lithium treatment: laboratory tests in 207 people treated for 1-30 years.

A total of 207 patients (diagnoses revised according to DSM-III-R) attended our outpatient clinic and were treated with lithium for 1-30 years. They were subjected to conventional renal, thyroid and parathyroid function tests. With increasing treatment duration, the renal tests showed only moderate deviations from expected reference values. No patient developed renal insufficiency. Oversubstitution (thyrotropin < or = 0.1 mU/l) was suspected in 25% of the patients on thyroxine. Cross-sectionally unrecognized hypothyroidism was found in 6% of the patients. Elevated ionized serum calcium was found in 25% and elevated serum intact parathyroid hormone in 23% of the patients.

Adult↗

[Proceedings: Pituitary thyroid axis in subacute thyroiditis (author's transl)].

We studied 10 patients with subacute thyroiditis. All had an increase in free thyroxine index, PBI, T4 and PBI/T4 ratio, an absence of thyroidal radioiodine uptake and no increase in plasma TSH after TRH injection. Exogenous TSH increased the uptake in 6/9 patients. The three patients who did not respond to TSH had higher PBI/T4 ratio than others. After treatment for one month there was either a normalization of laboratory tests either a subnormal thyroid function associated with an absence of response to TRH. All tests became normal two months later.

Humans↗

Thyroid function tests in euthyroid dogs treated with L-thyroxine.

The effects of treatment with L-thyroxine (1 mg/m2 of body surface/d, PO, for 8 weeks) on the thyroxine (T4) and triiodothyronine (T3) responses to thyrotropin (TSH) and thyrotropin-releasing hormone (TRH) administration were determined in 10 euthyroid Beagles; 4 other dogs acted as controls. The TSH response test was performed before treatment and at weeks 2, 4, and 8 of treatment in all dogs and at 2 and 4 weeks after cessation of treatment in 6 dogs. The TRH response test was performed before treatment and at week 6 of treatment in all dogs and at 5 weeks after cessation of treatment in 6 dogs. Suppression of the T3 response to TSH was evident at treatment week 2, whereas the T4 response was suppressed at week 4 and remained suppressed for the duration of the study. Four weeks after stopping treatment, T4 and T3 responses to TSH in 2 dogs were within the hypothyroid range. The T4 response to TRH was completely suppressed after 6 weeks of thyroxine treatment, but returned to pretreatment values by 5 weeks after cessation of treatment. Suppression of thyroid and pituitary function is evident after administration of a replacement dose of L-thyroxine to euthyroid dogs.

Animals↗

Primary and secondary hypothyroidism in nasopharyngeal carcinoma.

We investigated the thyroid and pituitary functions of six of the seven patients with nasopharyngeal carcinoma who had been previously treated with external radiation, and who were seen at the San Francisco Veterans Administration Hospital within a recent 18 month period. Two patients had primary hypothyroidism, and four had secondary hypothyroidism. These findings suggest that thyroid and pituitary abnormalities are frequent complications of both nasopharyngeal carcinoma and its treatment.

Adult↗

[Structural and functional status of the hypophyseal-thyroid system in prenatally irradiated children].

In order to evaluate the morphologic-and-functional state of the hypophysis-thyroid system long after the Chernobyl accident we examined 1491 children from the northern territories of the Zhitomir region. Of these, 261 had not been in utero exposed to radioiodine, 1230 pediatric subjects proved to be postconception-exposed. In utero radioiodine has not been found to affect the thyroid size in any noticeable way. The degree of structural-and-functional indices for the thyreostat system in prenatally irradiated children depends on the stage of the thyroid development just when there happened to be an exposure to radioiodine.

Air Pollution, Radioactive↗

Persistent pituitary-thyroid dysfunction patients following renal transplantation.

Pituitary-thyroid function, which is known to be altered in patients with chronic renal insufficiency, has been evaluated after successful kidney transplantation in 36 patients and compared with that in 15 healthy subjects. Thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) was in the low range of normal in 24, and markedly decreased in 12 patients (< 0.0005). In the former group serum thyroxine was normal, whereas triiodothyronine was lowered; in the latter group thyroxine, although within the normal range, and triiodothyronine levels were reduced when compared with that of healthy controls. This differential TSH response to TRH was unrelated to kidney transplant function, duration of renal insufficiency or duration of the preceding hemodialysis, or to the dose and dosing schedule of prednisolone therapy. However, a slight negative correlation between the dose of prednisolone administered and TSh responsiveness to TRH as well as serum triiodothyronine was established (P < 0.05). Thus, corticoid treatment may in part be responsible for the alteration in TSH secretion and in the peripheral conversion of thyroxine to triiodothyronine. Other, as yet undefined factors, such as patients' variability in pituitary susceptibility to the polypragmatic therapy administered, have to be suspected as the major causes of the persistent pathological pituitary-thyroid function tests observed after renal transplantation.

Adolescent↗