methimazole and Postoperative-Complications

A case of Basedow's disease, that developed after successful treatment of ulcerative colitis with a total colectomy, is presented, along with a review of the Japanese literature on the coexistence of hyperthyroidism and ulcerative colitis. A 26-year-old man was referred to our department, complaining of general fatigue, appetite loss, and palpitation. At age 14, blood was discovered in his stool and a diagnosis of ulcerative colitis was made. Since then, he has been treated with salazosulfapyridine and prednisolone. On examination, mild exophthalmos and thyroid swelling were observed. Both serum free T3 and T4 levels were increased along with a positive TSH receptor antibody, while TSH was decreased. Scintigraphic and ultrasonographic examinations of the thyroid gland showed diffuse enlargement. Treatment with thiamazole relieved the symptoms and normalized the thyroid function. Although a high incidence of autoimmune thyroid diseases in association with ulcerative colitis has been suggested, only 6 cases of hyperthyroidism coexisting with ulcerative colitis have been reported in Japan. A common immunological process has been suggested to be implicated in the pathogenesis of this association, however, the exact mechanism remains unclear.

Topics: Adult; Animals; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Antithyroid Agents; Autoimmune Diseases; Chronic Disease; Colectomy; Colitis, Ulcerative; Combined Modality Therapy; Comorbidity; Diarrhea; Female; Graves Disease; Humans; Hyperthyroidism; Japan; Male; Methimazole; Middle Aged; Postoperative Complications; Prednisolone; Sulfasalazine; Thyroid Function Tests

Upside-down reversal of vision (UDRV) is a rare form of metamorphopsia, or visual illusions that can distort the size, shape or inclination of objects. This phenomenon is paroxysmal and transient in nature, with patients reporting a sudden inversion of vision in the coronal plane, which typically remains for seconds or minutes, though occasionally persists for hours or days, before returning to normal. Distorted egocentric orientation (ie, the patient perceives the body to be tilted away from the vertical plane) is even more rare as a co-occurring phenomenon. To the best of our knowledge, this is the first reported case of a veteran who presented with UDRV and distorted egocentric orientation during hospitalisation on an inpatient physical medicine and rehabilitation setting following an elective hip surgery. This case serves not only to document the presence of rare visual illusions, but also illustrates the importance and value of an interdisciplinary team approach.

Topics: Aged; Antithyroid Agents; Arthroplasty, Replacement, Hip; Casts, Surgical; Endocrinology; Graves Disease; Hip Dislocation; Hospitals, Veterans; Humans; Illusions; Male; Methimazole; Neuropsychology; Patient Care Team; Perceptual Disorders; Postoperative Complications; Psychiatry; Reoperation; Veterans; Vision Disorders

Optimal treatment of Graves' disease (GD) remains controversial. The authors retrospectively reviewed the surgical cases of GD at a single academic tertiary center.. Demographic, clinical, and surgical data were analyzed for all patients with GD undergoing thyroidectomy over 25 years, in 3 periods: 1985 to 1993 (n = 32), 1994 to 2002 (n = 91), and 2003 to 2010 (n = 177).. There were 300 patients with GD (85.7% women; mean age, 39.3 years; median length of follow-up, 24.6 months). Overall, perioperative morbidity occurred in 36 patients (12.0%), and there was no mortality. Thyroidectomy-specific morbidity was very low, and the incidental malignancy rate was 10.3%.. Surgical treatment of GD has a very high safety profile, with low perioperative and thyroidectomy-specific morbidity, even in patients with overt hyperthyroidism. Incidental malignancy in patients with GD is not uncommon.

Topics: Ablation Techniques; Adult; Antithyroid Agents; Drainage; Female; Graves Disease; Humans; Incidental Findings; Iodine Radioisotopes; Length of Stay; Male; Massachusetts; Methimazole; Operative Time; Postoperative Complications; Preoperative Care; Propylthiouracil; Retrospective Studies; Thyroid Neoplasms; Thyroidectomy

Severe cardiovascular events, such as coronary vasospasm or acute myocardial infarction can occur during anaphylactic reactions. Although rare, this cause of ischaemic heart disease is known. We present the case of a patient who suffered an angina episode after an anaphylactic reaction due tot administering metamizole, with no significant lesions observed in the coronary catheterisation.

Topics: Aged, 80 and over; Anaphylaxis; Atrioventricular Block; Coronary Angiography; Coronary Vasospasm; Drug Hypersensitivity; Humans; Hypotension; Male; Methimazole; Postoperative Complications; Prostatic Hyperplasia; Recovery Room; Syndrome; Transurethral Resection of Prostate

Topics: Adrenal Insufficiency; Adult; Anesthetics, Intravenous; Anti-Inflammatory Agents; Antithyroid Agents; Cholecystectomy; Estradiol; Etomidate; Female; Fentanyl; Humans; Hydrocortisone; Hyperthyroidism; Methimazole; Polyendocrinopathies, Autoimmune; Postoperative Complications; Thyroiditis

A 78-year-old woman is presented with a multinodular toxic goiter and euthyroidism under continuous low-dose treatment with antithyroid drugs. A period of hyperthyroidism had been documented 3 years previously. In the preoperative management, prior to resection of a benign ovarian tumour, an intravenous urogram was performed. Perchlorate was given for thyroid protection. One day after surgery the clinical signs of thyroid storm were observed. Immediately, high-dose antithyroid drug therapy was started. Nevertheless, the patient died of acute cardiovascular failure 3 days later. This case report focuses on the risk of thyroid storm following iodine excess in the presence of relevant functional thyroid autonomy without adequate thyroid protection.

Topics: Aged; Cystadenoma; Fatal Outcome; Female; Goiter, Nodular; Humans; Hysterectomy; Iodine; Methimazole; Ovarian Neoplasms; Perchlorates; Postoperative Complications; Sodium Compounds; Thyroid Crisis; Thyroid Function Tests; Urography

On the basis of clinico-laboratory and radioimmunologic investigations in 139 patients with thyrotoxicosis, it is shown that in prescription of lithium carbonate with mercazol, more rapid decrease in the blood level of thyroid hormones, incidence of complications before and after the operation, cost expenditure is noted when compared to the other methods.

Topics: Graves Disease; Humans; Lithium; Lithium Carbonate; Methimazole; Postoperative Complications; Preoperative Care; Thyroid Hormones; Thyroidectomy

Topics: Antithyroid Agents; Humans; Hyperthyroidism; Methimazole; Postoperative Complications; Premedication; Thyroid Crisis; Thyroid Hormones

A combination of antithyroid drugs and thyreoidine appears to be the optimal preoperative treatment for patients with thyrotoxicosis. A combination of methimazole and thyroid in adequate dosages can eliminate thyrotoxicosis and prevent postoperative reactions and increased intraoperative bleeding.

Topics: Adrenal Cortex Hormones; Adrenal Insufficiency; Humans; Hyperthyroidism; Iodine; Methimazole; Postoperative Complications; Preoperative Care; Thyroid Crisis; Thyroid Hormones; Time Factors

The results of medical and surgical therapy were determined in 107 hyperthyroid children. After surgery, 85% of patients were rendered free of hyperthyroidism; however, 62% became hypothyroid. After medical treatment, 30% of patients were euthyroid and 2% became hypothyroid. The relapse rate, however, was higher after medical (22%) than after surgical (9%) therapy. Serious drug-related complications (arthritis-, hepatitis-, and collagen disease-like syndromes) occurred in 14% of patients. Complications occurred in 9% of surgically treated patients, but recurrent laryngeal nerve injury or permanent hypoparathyroidism did not occur. In medically treated patients, both a goiter size less than three times normal prior to treatment and a reduction in goiter size to less than two times normal at the completion of therapy correlated with a successful outcome.

Topics: Adolescent; Arthritis; Chemical and Drug Induced Liver Injury; Child; Child, Preschool; Collagen Diseases; Female; Humans; Hyperthyroidism; Hypothyroidism; Male; Methimazole; Postoperative Complications; Propylthiouracil; Thyroidectomy

From 1959 to 1970, 272 operations for thyrotoxicosis were performed. Most of the patients received anti-thyroid drugs and thyroid hormones preoperatively. The patients were continuously followed up. The primary results with low morbidity and no mortality as well as the long term results with a low rate of recurrence and a relatively high incidence of thyroid substitution are discussed. A safe and effective programme for surgical treatment of thyrotoxicosis is described. Anti-thyroid drugs and thyroid hormones should be administered as the method of choice in preparing these patients for surgery.

Topics: Adolescent; Adult; Aged; Antithyroid Agents; Carbimazole; Child; Female; Goiter; Humans; Hyperthyroidism; Hypocalcemia; Hypothyroidism; Laryngoscopy; Length of Stay; Male; Methimazole; Middle Aged; Paralysis; Postoperative Complications; Preoperative Care; Propylthiouracil; Recurrent Laryngeal Nerve; Thyroxine; Triiodothyronine

Topics: Adolescent; Child; Female; Graves Disease; Humans; Hyperthyroidism; Hypocalcemia; Laryngeal Edema; Male; Methimazole; Methods; Postoperative Complications; Potassium Iodide; Propranolol; Propylthiouracil; Thyroid Hormones; Thyroidectomy