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At least 19 recordsLinked to original sources
PubMed1984

Determination of free thyroid hormones and their binding proteins in a patient with severe hyperthyroidism (thyroid storm?) and thyroid encephalopathy.

A patient with severe hyperthyroidism (thyroid storm?) and thyroid encephalopathy is described. During her illness only a slightly raised level of total thyroxine and a normal level of total triiodothyronine was found in contrast with very high levels of free thyroid hormones. Very low levels of thyroxine binding globulin, albumin and low levels of thyroxine binding prealbumin in contrast with nearly normal values of T3 resin uptake were observed. All parameters of thyroid function returned to normal after therapy.

Adult↗
PubMed1979

Changes in thyroid hormones by treatment with aspirin and prednisolone in subacute thyroiditis with hyperthyroidism.

Thyroid functions were studied in 11 patients with subacute thyroiditis accompanied by signs and symptoms of hyperthyroidism, and were compared with 13 patients with untreated thyrotoxicosis in which serum T4 was elevated to the identical level. Serum T3 was also elevated in subacute thyroiditis but to a significantly lower extent than in thyrotoxicosis. Therefore the ratio of T4/T3 was significantly higher in subacute thyroiditis than in thyrotoxicosis. Although duration of thyroid swelling was shorter in the group treated by prednisolone than by aspirin, the accelerated ESR, thyroid tenderness and fever subsided almost similarly in the two groups. Serum T4 and T3 levels declined more rapidly in treatment with prednisolone compared with aspirin. In patients treated by aspirin initial increase in T3 level occurred transiently with simultaneous decrease in the T4/T3 ratio. These changes suggest the increase in peripheral conversion of T4 to T3. Even in severe cases of subacute thyroiditis associated with hyperthyroidism, aspirin treatment is an effective therapy and there is no recurrence following withdrawal of the medication.

Adult↗
PubMed1993

Effects of radioiodine therapy in hyperthyroidism (thyroid function, thyroid volume, Graves' ophtalmopathy, thyrotoxic heart disease).

The study group consisted of 135 hyperthyroid patients--128 with Graves' disease and 7 with toxic multinodular goiter. A single dose of radioiodine was given in 110 cases (81.48%), two doses in 22 patients (16.3%) and three doses in 3 patients (2.22%); mean total dose was 6.8 mCi (range = 3-24 mCi). The main goal of radio iodine therapy is to achieve euthyroidism; after radioiodine treatment, 61 patients (45.2%) were euthyroid, 60 patients (44.4%) with permanent hypothyroidism and 14 (10.36%) with PERSISTING HYPERTHYROIDISM--the mean duration of follow-up being 4.2 years. After radioiodine therapy, goiter became absent in 30 patients (28%); in those patients, goiter was moderately enlarged or large before therapy. Around 63% (12 cases) of the patients with thyrotoxic atrial fibrillation reverted to sinus rhythm. During the last four years (1990-1994) the patients with Graves' ophthalmopathy from the study group were treated with Prednisone after radioiodine therapy; this corticotherapy contributes to the lower percentage (1.5%) of worsening Graves' ophthalmopathy after radioiodine therapy.

Adult↗
PubMed2006

Thyroid scintigraphy in hyperthyroidism.

Thyroid scintigraphy is a nuclear medicine procedure that produces a visual display of functional thyroid tissue based on the selective uptake of various radionuclides by thyroid tissue. Thyroid scintigraphy provides valuable information regarding both thyroid anatomy and physiology and can play an integral role in the diagnosis and management of cats with hyperthyroidism. Thyroid scintigraphy allows the direct visualization of the functional adenomatous thyroid tissue responsible for the development of hyperthyroidism. For this reason, thyroid scintigraphy will allow the diagnosis of hyperthyroidism before laboratory tests are consistently abnormal. Thyroid scintigraphy can also exclude a diagnosis of hyperthyroidism in cats with thyroid hormone elevations of nonthyroidal origin. Thyroid scintigraphy provides an additional method for determining the relative severity of thyroid disease that is less affected by the presence of concurrent nonthyroidal illness than laboratory evaluations. When treating hyperthyroid cats with radioiodine, the lowest effective dose should be administered. In an effort to administer the lowest radioiodine dose possible, the volume of adenomatous thyroid tissue present in the individual hyperthyroid cat should be considered. Thyroid scintigraphy provides an excellent method for evaluating the size of hyperfunctional thyroid tissue that is not limited by the presence of ectopic or intrathoracic thyroid tissue. Thyroid scintigraphy also provides valuable information in the diagnosis and evaluation of hyperthyroid cats with thyroid carcinoma.

Animals↗
PubMed1994

Hyperthyroidism, thyroid hormone therapy, and bone.

Clinically symptomatic osteoporosis and fractures from thyrotoxicosis have been rare since the availability of antithyroid drugs and radioiodine for the treatment of hyperthyroidism. However, the widespread use of bone density measurements and sensitive TSH assays in the past decade has demonstrated that women taking levothyroxine with subclinical hyperthyroidism have reduced bone density. Cortical bone is affected more than trabecular bone, and postmenopausal women are at a greater risk than premenopausal women. However, it is uncertain whether subclinical hyperthyroidism is associated with an increased risk of fracture. Hypothyroidism is associated with an increase in cortical bone width. The initiation of levothyroxine treatment in hypothyroid women results in a reduction in cortical bone width to levels seen in euthyroid controls after 6-12 months. There is no reduction in bone density when women with subclinical hypothyroidism are treated with levothyroxine for a year. A single study showing reduced bone density in patients receiving chronic levothyroxine replacement therapy requires confirmation and raises an important question: Does levothyroxine replacement therapy, which results in higher serum thyroxine concentrations than those seen in euthyroid controls, accurately mimic physiology?

Bone Density↗
PubMed1994

[Therapeutic results of radioiodine therapy of hyperthyroid thyroid gland diseases].

PATIENTS AND METHODS: The result of radioiodine treatment administered to 126 patients with hyperthyroidism between 1986 and 1991 were analysed retrospectively. The indications for radioiodine treatment were single hyperfunctioning nodules (n = 47), multinodular goitre (n = 33), diffuse goitre (n = 19) and Graves' disease (n = 27); the respective doses of 131I, calculated with the Doering and Kramer formula, were 300 Gy (30,000 rad), 150 to 200 Gy (15,000 to 20,000 rad), 100 to 120 Gy (100,000 to 120,000 rad) and 100 Gy (100,000 rad). The uptake of radioiodine was measured on a daily basis and in the case of 46 patients (36.5%) additional treatment given on the third day of treatment. RESULTS: For the patients undergoing regular follow-up, data were collected in 1992, at least six months post-therapy. Evaluation revealed a total applied dose of 131I of 20 +/- 12.4 mCi (median +/- SD) per patient. non-response to treatment making hospitalisation and renewed therapy necessary was observed in 1.6% of the group. In only two further patients did scintigraphy reveal compensated toxic adenoma. In 36% of patients with single hyperfunctioning nodules, 21% of those with multinodular goitre, 53% of those with diffuse goitre and 56% of those with Graves' disease hyperthyroidism was observed. In the great majority of cases, hypothyroidism occurred in the first year following treatment.

Adult↗
PubMed1980

Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis).

Spontaneously resolving hyperthyroidism (SRH) is a transient form of hyperthyroidism characterized by a painless, nontender, normal-sized or slightly enlarged thyroid gland, elevated levels of thyroxine and triiodothyronine, a depressed thyroid radioactive iodine uptake (RAIU), spontaneous resolution in two to five months, and a focal or diffuse lymphocytic thyroiditis on biopsy. Since 1962, 62 episodes of SRH were found in 56 individuals. Twelve thyroid biopsy specimens showed diffuse or focal lymphocytic thyroiditis. Testing of viral antibodies to a wide range of viruses demonstrated only one patient with notable titer change of 18 tested. Resolution of the hyperthyroidism took two to five months. Four patients were treated inappropriately. Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism appears to be a new syndrome that has dramatically increased in frequency in the past ten years. It is difficult to differentiate from common forms of hyperthyroidism unless RAIU is determined.

Adolescent↗
PubMed1982

Treatment of lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis).

The duration of the hyperthyroidism associated with lymphocytic thyroiditis (LT) with spontaneously resolving hyperthyroidism (SRH) was serially monitored in groups of patients who were not given any treatment (control subjects) or treated with propylthiouracil and/or propranolol hydrochloride and prednisone. The length of time for the thyroxine tests from diagnosis to the normal range was 57 +/- 17, 45 +/- 13, and 15 +/- 7 days (mean +/- SD) indicating a dramatic response to prednisone therapy but none to propylthiouracil and/or propranolol therapy. Five patients were found who had seven episodes of SRH while receiving thyroid hormone suppression therapy after having verified chronic LT (two patients) and LT-SRH (three patients). This indicates that thyroid suppression with thyroid hormone may be ineffective in preventing this disease. Two patients were treated by subtotal thyroidectomy because of recurrent or prolonged episodes of SRH. From this experience, the therapeutic alternatives available to the clinician are reviewed.

Humans↗
PubMed1987

Thyroid size and goitre frequency in hyperthyroidism.

Thyroid function, the clinical occurrence of goitre and thyroid gland volume, ultrasonically determined, were investigated in 310 consecutive untreated patients with hyperthyroidism. Of 173 patients with Graves' disease (39%), 67 had no goitre, while 53 patients (31%) had a normal thyroid volume. Twenty-three of 91 patients with multinodular glands (25%) had no goitre and ten patients (11%) had a normal thyroid volume. Of 46 patients with solitary autonomous nodules (7%), three had no goitre while six (13%) had a normal thyroid volume. Out of all the hyperthyroid patients (30%), 93 had no clinically detectable goitre, and 69 (22%) had a normal thyroid volume. The lack of a goitre in a large portion of patients with hyperthyroidism could be responsible for delayed diagnosis and subsequent treatment of these patients.

Adolescent↗
PubMed2005

[Perioperative thyroid storm in a patient with undiscovered hyperthyroidism].

Thyroid storm can develop in patients with longstanding untreated hyperthyroidism. It is more often precipitated by an acute event such as surgery, trauma, or infection. We experienced a case in whom thyroid storm occurred during surgery, while he had no preoperative diagnosis of thyroid disease. A 30-year-old man was scheduled for left tympanoplasty. Anesthesia was induced and maintained with sevoflurane and nitrous oxide in oxygen. Heart rate and rectal temperature went up to 140 beats x min(-1) and 39 degrees C, respectively, in 3 hours during surgery. Cooling blanket, cold fluid infusion, flurbiprofen, diltiazem, and verapamil were used to decrease body temperature and heart rate. Surgery was completed and after emergence he was in agitation for 4 hours along with hyperpyrexia and tachycardia. He was diagnosed as hyperthyroidism by postoperative physical and laboratory examination. Thiamazole and propranorol were administered. In one week, symptom has declined with body temperature and heart rate of around 36 degrees C and 90 beats x min(-1), respectively. We should be more careful about evaluation of preoperative patients.

Adult↗
PubMed2003

The management of subclinical hyperthyroidism by thyroid specialists.

Subclinical hyperthyroidism is a relatively common condition for which prospectively derived evidenced-based management guidelines do not exist. We have conducted a case-based mail survey to solicit opinions from members of the American Thyroid Association (ATA) about various issues that arise in the management of patients with this disorder. The survey was completed and returned by 185 of 300 (62%) of the original survey recipients. Four hypothetical cases varying in age, thyrotropin (TSH) level and underlying etiology were presented. The majority of respondents recommended further evaluation of all cases, most commonly choosing a radioactive iodine uptake (42%-71%), thyroid scan (39%-68%) and antithyroid (TPO/Tg) antibodies (49%-55%) as the additional tests to be ordered. The large majority (84%) recommended observation rather than active treatment for a young patient with a low but detectable serum TSH level. A small majority also recommended observation alone for a young woman with an undetectable serum TSH level (58%) and for an older woman with a low but detectable serum TSH value (63%). However, the majority (66%) favored treating an older woman with an undetectable serum TSH. When treatment was advised in the patients with subclinical hyperthyroidism, the respondents strongly favored anti-thyroid drugs when the etiology was Graves' disease and radioactive iodine when the etiology was toxic nodular thyroid disease. In the absence of adequate evidence-based guidelines, it is hoped that this survey of expert opinions may provide useful guidance for physicians providing care for patients with subclinical hyperthyroidism.

Antithyroid Agents↗