methimazole and Anemia

The present study investigates the potential ability of selenium, considered as an antioxidant with pharmacological property to alleviate oxidative stress and hematological parameter disorders induced by methimazole, an antithyroid drug. Pregnant Wistar rats were randomly divided into four groups of six each: group I served as negative control and received a standard diet; group II received 250 mg/L of methimazole in drinking water and a standard diet; group III received both methimazole (250 mg/L, orally) and selenium (0.5 mg/kg of diet) supplemented to the standard diet; group IV served as positive control and received a supplement of selenium in the diet (0.5 mg/kg of diet) as sodium selenite (Na(2)SeO(3)). Treatment was started from the 14th day of pregnancy until day 14 after delivery. Methimazole reduced the number of red blood cells, hemoglobin concentration and hematocrit in mothers and their pups. Besides, plasma iron, vitamins B(9), B(12), C and E levels were reduced. Lipid peroxidation increased, objectified by high malondialdehyde levels and lactate dehydrogenase activity in plasma, while glutathione, glutathione peroxidase, superoxide dismutase and catalase activities showed a significant decline. Co-administration of selenium through diet improved all the parameters cited above. It can be concluded that the administration of selenium alleviates methimazole-induced toxicity, thus demonstrating its antioxidant efficacy.

Topics: Anemia; Animals; Animals, Newborn; Animals, Suckling; Antioxidants; Antithyroid Agents; Ascorbic Acid; Disease Models, Animal; Female; Folic Acid; Glutathione; Hematologic Tests; Iron; Lipid Peroxidation; Male; Malondialdehyde; Methimazole; Oxidative Stress; Oxidoreductases; Pregnancy; Pregnancy Complications, Hematologic; Protective Agents; Rats; Rats, Wistar; Selenium; Vitamin B 12; Vitamin E

Many possible causes of resistance to human recombinant erythropoietin (rh-EPO) have been reported in patients with renal failure. This case presents an unusual cause of erythropoietin-resistant anemia in a patient with chronic renal failure. A 61-year-old male patient who was on chronic hemodialysis program due to diabetic nephropathy for seven months developed erythropoietin resistant anemia. No iron deficiency was revealed by laboratory data, no megaloblastic anemia were found by biochemical investigation, and no inflammatory states including infection or neoplastic diseases were disclosed by abdominal ultrasonography, chest X-ray, bone marrow aspiration and biopsy, or other methods (normal C-reactive protein levels). This hemodialysis patient had epoetin-resistant anemia with primary autoimmune hyperthyroidism. The anti-thyroid therapy was effective not only against the hyperthyroidism but also against his epoetin resistant anemia.

Topics: Anemia; Antithyroid Agents; Autoimmune Diseases; Drug Resistance; Erythropoietin; Humans; Hyperthyroidism; Kidney Failure, Chronic; Male; Methimazole; Middle Aged; Recombinant Proteins; Renal Dialysis

We describe a 26-year-old male hemodialysis patient with erythropoietin (EPO) resistant anemia associated with primary hyperthyroidism. Use of the anti-hyperthyroid drug, methimazole, led to improvement of his hyperthyroidism and anemia. Before the anti-hyperthyroid therapy, he had received transfusions to maintain an adequate hematocrit during recombinant human EPO therapy. After the therapy, his hyperthyroidism improved and his hematocrit gradually increased without any transfusion. These findings suggest that the patient's EPO resistant anemia was the result of primary hyperthyroidism, and that this complication is reversible if accurate treatment is given.

Topics: Adult; Anemia; Antithyroid Agents; Erythropoietin; Hematocrit; Humans; Hyperthyroidism; Kidney Failure, Chronic; Male; Methimazole; Recombinant Proteins; Renal Dialysis

To further elucidate the mechanism of increased serum ferritin levels in hyperthyroidism, the changes in erythrocytes and serum iron and total iron-binding capacity levels were examined in addition to serum ferritin levels in 13 hyperthyroid patients. The mean values of hemoglobin, red blood cells, and packed cell volume were increased by antithyroid therapy. While the serum levels of iron did not change, those of total iron-binding capacity increased significantly after achieving a euthyroid state. Increased serum ferritin levels returned to normal through antithyroid therapy. Furthermore, the serum ferritin levels of four anemic patients were significantly higher than those of nine nonanemic patients. Thus it is concluded that the increase in serum ferritin levels in patients with hyperthyroidism may be due to the direct action of thyroid hormones on its synthesis, while in some cases complicated with anemia impaired iron utilization by erythropoietic cells may also be involved.

Topics: Adult; Anemia; Erythrocyte Count; Female; Ferritins; Hematocrit; Hemoglobins; Humans; Hyperthyroidism; Iron; Male; Methimazole; Middle Aged; Propylthiouracil

Topics: Anemia; Anemia, Aplastic; Antithyroid Agents; Cortisone; Female; Humans; Hyperthyroidism; Methimazole; Pregnancy; Pregnancy Complications