methimazole and Syndrome

Insulin autoimmune syndrome (IAS) is an uncommon disorder characterized by hyperinsulinemic hypoglycemia related to insulin-binding autoantibodies. To the best of our knowledge, we report the first case of a pregnant female with IAS.. The 26-year-old patient with Graves disease and 10 weeks pregnant developed IAS after approximately 6 months treatment with methimazole. The patient exhibited recurrent spontaneous hypoglycemia.. On evaluation, laboratory findings detected both high fasting insulin (>1000 mIU/L) and insulin autoantibodies. An oral glucose tolerance test showed elevated insulin concentrations with disproportionately elevated C-peptide levels. The imaging study showed nomasslesionsinthepancreas,and the patient was clinically diagnosed with IAS.. The patient had an abortion, discontinued methimazole and switched to oral prednisone (30 mg once daily) and propylth- iouracil (100 mg 3 times daily) for 3 months.. At the 3-month follow-up visit, hypoglycemic episodes had disappeared and insulin antibody levels were no longer detectable.. We have described this case and reviewed the relevant literature concerning diagnosis and treatment of IAS. Importantly, this case indicates that clinicians should view pregnancy as another factor of hypoglycemia in IAS.

Topics: Abortion, Spontaneous; Adult; Autoimmune Diseases; Female; Follow-Up Studies; Gestational Age; Graves Disease; Humans; Hypoglycemia; Insulin; Insulin Antibodies; Methimazole; Prednisone; Pregnancy; Pregnancy Complications; Rare Diseases; Risk Assessment; Syndrome

Topics: Adrenal Cortex Hormones; Antithyroid Agents; Autoimmune Diseases; Diet, Carbohydrate-Restricted; Genotype; Histocompatibility Testing; HLA Antigens; Humans; Hypoglycemia; Immunosuppressive Agents; Insulin; Insulin Antibodies; Methimazole; Sulfhydryl Compounds; Syndrome

Topics: Adult; Antithyroid Agents; Arthritis; Female; Graves Disease; Humans; Methimazole; Propylthiouracil; Syndrome

Topics: Autoantibodies; Autoimmune Diseases; Diagnosis, Differential; HLA Antigens; Humans; Hyperglycemia; Hyperinsulinism; Hypoglycemia; Insulin Antibodies; Methimazole; Syndrome; Tiopronin

Topics: Autoantibodies; Autoimmune Diseases; History, 20th Century; HLA Antigens; Humans; Hypoglycemia; Insulin Antibodies; Japan; Methimazole; Syndrome; Tiopronin

Topics: Autoantibodies; Diagnosis, Differential; HLA-DR Antigens; Humans; Hypoglycemia; Immunoglobulin G; Insulin; Methimazole; Prognosis; Syndrome

Topics: Female; Graves Disease; Humans; Hypothyroidism; Immunosuppressive Agents; Male; Methimazole; Mutation; Propylthiouracil; Receptors, Thyrotropin; Syndrome; Thyroid Gland; Thyroid Hormones

We describe a recent clinical case experience of antithyroid arthritis syndrome and literature search from 1965 to 1996 on antithyroid medication and associated arthritis using MEDLINE and EMBASE. The antithyroid arthritis syndrome is a transient migratory polyarthritis that occurs within 2 months of starting thionamide treatment, and resolves within 4 weeks of stopping therapy. Discontinuation of medication is necessary. Alternative forms of treatment for hyperthyroidism should be sought. Nonsteroidal antiinflammatory drug or treatment of the rheumatic complaints is recommended or if unsuccessful, corticosteroid treatment.

Topics: Aged; Antithyroid Agents; Arthritis; Female; Graves Disease; Humans; Methimazole; Syndrome

A 36-year-old woman who had had Graves' disease for 6 years was admitted with severe thrombocytopenia. Evans' syndrome was diagnosed. The patient's family history showed multiple cases of Graves' disease but no cases of Evans' syndrome. Both conditions in this patient improved with corticosteroid and thiamazole therapy. Several autoimmune antibodies were found, but a common autoimmune mechanism was not clearly shown. Although the combination of Graves' disease and Evans' syndrome had not occurred previously in her family, genetic factors may play an important role in the pathogenesis of both conditions.

Topics: Adrenal Cortex Hormones; Adult; Anemia, Hemolytic, Autoimmune; Antithyroid Agents; Drug Therapy, Combination; Female; Graves Disease; Humans; Methimazole; Purpura, Thrombocytopenic, Idiopathic; Syndrome

The number of case reports of insulin autoimmune syndrome (IAS) induced by methimazole (MMI) is increasing. The purpose of this study is to explore the clinical characteristics and provide a scientific reference for clinical diagnosis, treatment and prevention.. The literature on IAS cases and case series induced by MMI in Chinese and English was collected for retrospective analysis.. A total of 106 patients (males 33, females 73) were described in the Chinese and English literature. The median age of patients with IAS induced by MMI was 37 years (range 15-76) occurring during both regular and irregular MMI therapy or after resumption of medication. The onset of symptoms occurred at night or early morning, within days in some and up to 6 months in others; the symptoms were neuropathic in 65.31% and related to the autonomic nervous system in 33.67%. Blood glucose concentration in samples presumably taken during the hypoglycaemic phase was 1.7 mmol/L (median; range 0.03-4.7); insulin concentrations were elevated ≥100 mU/L (ref range) and associated with low C-peptide levels (<10 μg/L; ref range). Tests for IgG insulin autoantibodies (IAA) were positive in 104 patients (98.02%) and negative in two patients (1.98%). The 75-g oral glucose tolerance test (OGTT) showed impaired glucose tolerance and diabetic curves. Pancreatic imaging was unremarkable on computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. Withdrawal of MMI alone or with corticosteroid treatment reduced hypoglycaemic episodes within days to 3 months. IAA decreased and became negative in 3 months (median; range 1-12). Follow-up showed no recurrent hypoglycaemic episodes at 5 months (median; range 1-60).. Methimazole-induced IAS is a clinically rare autoimmune disease with hypoglycaemia that occurs during medication treatment that should be treated promptly.

Topics: Adolescent; Adult; Aged; Antithyroid Agents; Autoimmune Diseases; Blood Glucose; C-Peptide; Female; Humans; Immunoglobulin G; Insulin; Male; Methimazole; Middle Aged; Syndrome; Young Adult

Topics: Adult; Antithyroid Agents; Arthritis; Colchicine; Female; Humans; Methimazole; Syndrome

Insulin autoimmune syndrome (IAS) is a rare endocrine disease characterized by repeated fasting hypoglycemia or episodes of hypoglycemia late after meals, elevated serum insulin, and positivity for insulin autoantibody (IAA) or insulin receptor antibody (IRA). We summarize the clinical manifestations and treatment experiences of 3 patients with IAS.. One patient with >20-year history of type 2 diabetes mellitus had irregular episodes of hypoglycemia 2 years of after treatment with insulin. Another patient with a 6-year history of type 2 diabetes mellitus presented irregular episodes of hypoglycemia after 6 months of treatment with insulin. One patient with a history of Graves' disease showed hypoglycemia after administration of thiamazole.. Serum islet cell antibody (ICA) and glutamic acid decarboxylase antibody (GADA) were negative, while antibody insulin autoantibodies were positive in all the 3 patients. Two patients demonstrated diabetes mellitus after an oral glucose tolerance test, while one had normal glucose tolerance. Furthermore, serum insulin levels significantly elevated and did not matched C peptide levels. No abnormalities were found on enhanced MRI of the pancreas, and all 3 patients were clinically diagnosed with IAS.. In case one, insulin aspart 30 injection was withdrawn after admission. In addition, the patient was prescribed sublingual acarbose 3 times daily. Two weeks after admission, prednisone acetate was administered orally once daily at night. In case 2, insulin aspart 30 injection was withdrawn after admission, the patient was prescribed sublingual acarbose 3 times daily with a meal. Five days after admission, oral prednisone acetate was administered once daily at night. In case 3, oral propylthiouracil was prescribed and thiamazole withdrawn after admission, and the patient consumed an extra meal before sleeping.. At the 3-month follow-up visit, the hypoglycemic episodes had disappeared, serum insulin levels were significantly decreased, and insulin antibody (IA) levels were no longer detectable in all 3 patients.. For those patients with high-insulin hypoglycemia, IAA should be evaluated if serum insulin concentrations are inconsistent with C peptide levels. Therapeutically, a lower dose of glucocorticoids with more appropriate medication timing can be used to achieve good results.

Topics: Adult; Aged; Antithyroid Agents; Autoantibodies; Autoimmune Diseases; Diabetes Mellitus, Type 2; Female; Graves Disease; Humans; Hypoglycemia; Hypoglycemic Agents; Insulin; Male; Methimazole; Middle Aged; Syndrome

Antithyroid arthritis syndrome is a constellation of symptoms of myalgia, arthralgia, arthritis, fever and rash associated with the use of antithyroid medications. We report a case of a patient with severe hyperthyroidism likely secondary to Graves' disease who presented with the abovementioned symptoms after being treated with methimazole (antithyroid medication). Our aim is to increase awareness regarding this uncommon but disabilitating and life-threatening adverse effect of antithyroid medications among clinicians. We also discuss the proposed pathophysiology for this immunological reaction as well as management options in these patients.

Topics: Antithyroid Agents; Arthralgia; Arthritis; Drug Eruptions; Female; Fever; Humans; Hyperthyroidism; Methimazole; Middle Aged; Syndrome

Graves' disease is the most common reason of hyperthyroidism in children. Graves' disease with accompanying functioning nodules is defined as Marine-Lenhart syndrome. This syndrome has not been described in children before. Here, a 15-year-old girl with Graves' disease and a coexisting cold nodule is presented. A thyroid scan showed diffuse uptake of Tc-99m pertechnatate in both lobes and decreased uptake in accordance with the left lobe nodule. The nodule was histologically diagnosed as benign. The patient was diagnosed with type 1 diabetes mellitus and polyglandular autoimmune syndrome during clinical follow-up. The differential diagnoses of Graves' disease with coexisting nodules should include the Marine-Lenhart syndrome. Treatment options should be determined taking this rare condition into account.

Topics: Adolescent; Antithyroid Agents; Diabetes Mellitus, Type 1; Female; Graves Disease; Humans; Iodine Radioisotopes; Methimazole; Polyendocrinopathies, Autoimmune; Syndrome

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

A 60-year-old woman was admitted to a hospital complaining of dizziness and general fatigue in October, 2004. Because of heart failure and severe anemia, she was referred to our hospital. Based on a positive direct Coombs test and an elevated level of platelet-associated IgG (PAIgG), the patient was diagnosed as having autoimmune hemolytic anemia (AIHA) associated with idiopathic thrombocytopenic purpura (ITP), i.e., Evans syndrome. Basedow disease was also diagnosed due to hyperthyroidism with an elevation of anti-thyroid stimulating hormone (TSH) receptor antibodies. Both the Evans syndrome and Basedow disease were considerably ameliorated with plasma exchange, corticosteroid and thiamazole therapy. Although Basedow disease is known to be associated with hematological disorders such as AIHA or ITP, the combination of Basedow disease and Evans syndrome is rare. We report here a case of Basedow disease associated with Evans syndrome.

Topics: Anemia, Hemolytic, Autoimmune; Drug Therapy, Combination; Female; Graves Disease; Humans; Methimazole; Methylprednisolone; Middle Aged; Plasma Exchange; Pulse Therapy, Drug; Purpura, Thrombocytopenic, Idiopathic; Syndrome; Treatment Outcome

Topics: Antithyroid Agents; Atenolol; Biological Transport; Female; Graves Disease; Humans; Iodine Radioisotopes; Methimazole; Middle Aged; Radiography; Radionuclide Imaging; Syndrome

Two sibs from an inbred Arab family are described with an autosomal syndrome of choanal atresia, hypothelia/athelia and thyroid gland anomalies overlapping Bamforth syndrome, ANOTHER syndrome and methimazole embryopathy. In one case the syndrome described was lethal. Cases with similar features are reviewed and genetic mutations discussed.

Topics: Abnormalities, Multiple; Child, Preschool; Choanal Atresia; Congenital Hypothyroidism; Facies; Female; Genes, Recessive; Humans; Infant; Infant, Newborn; Male; Methimazole; Nipples; Syndrome; Thyroid Gland

The patient, a 24-year-old man, had suffered from hunger, sweating, tachycardia and palpitation for three years. He was diagnosed as having Graves' disease (GD) and treated with methimazole (MMI) for 3 months. He noted that palpitation and perspiration seemed to particularly occur when he was hungry, and thus he was examined to determine whether these symptoms were caused by hypoglycemia. As a markedly elevated immunoreactive insulin level and the presence of insulin antibody in serum were found, he was diagnosed as having insulin autoimmune syndrome (IAS). HLA typing revealed the patient to be positive for group Bw62/Cw4/DR4, which is reportedly a specific HLA type in MMI-treated euthyoroid GD patients with IAS. In spite of the continuation of MMI treatment, the % binding of IRI decreased and the hypoglycemic episode disappeared. In contrast to the previously reported MMI induced IAS in GD cases, MMI is unlikely to have exacerbated IAS in the present case, although his HLA combination is identical to that of the previous cases.

Topics: Adult; Antithyroid Agents; Autoantibodies; Autoimmune Diseases; Follow-Up Studies; Graves Disease; Histocompatibility Testing; Humans; Hyperthyroidism; Hypoglycemia; Insulin; Male; Methimazole; Syndrome; Thyroid Hormones

Bilateral kidney agenesias (Potter syndrome) in a newborn of a hyperthyroid woman receiving methimazole during early pregnancy. This is a clinical case of a hyperthyroid woman that received methimazole during early pregnancy who gave birth to a girl with bilateral kidney agenesis. The initial clinical data was the presence of oligohydramnios detected by an ultrasound (US) at 19 gestational weeks. Another US at the term of the gestation showed anhydramnios, absence of renal silhouettes and bladder, which was corroborated when the girl was born. She died two days after she was born. Sufficient evidence exists that the methimazole administered during the early pregnancy can cause diverse congenital malformations including Potter's syndrome.

Topics: Abnormalities, Multiple; Antithyroid Agents; Face; Female; Humans; Hyperthyroidism; Infant, Newborn; Kidney; Methimazole; Pregnancy; Pregnancy Complications; Pregnancy Trimester, First; Prenatal Exposure Delayed Effects; Syndrome

Thyroid scintigrams of two women (aged 48 and 58) with Plummer's disease showed unusual radioiodine accumulation during treatment with methimazole (MMI). Before MMI therapy, the scintigrams revealed most of the radioiodine uptake only in the nodules of the patients and very little uptake in the non-nodular portions of the thyroid. After initiation of MMI therapy, scintigrams performed at three and eight months revealed that the hot nodules had become hypofunctional and that the surrounding tissues had normal radioiodine accumulation. The findings indicate that the nodules in Plummer's disease continue to concentrate MMI selectively compared with normal surrounding thyroid tissue during therapy.

Topics: Adenoma; Female; Humans; Hyperthyroidism; Iodine Radioisotopes; Methimazole; Middle Aged; Radionuclide Imaging; Syndrome; Thyroid Gland; Thyroid Neoplasms

Topics: Adult; Autoantibodies; Autoimmune Diseases; Carbimazole; Cross-Sectional Studies; Female; Graves Disease; Humans; Hypoglycemia; Insulin Antibodies; Male; Methimazole; Syndrome; Taiwan

Topics: Adolescent; Autoantibodies; C-Peptide; Female; Glucose Tolerance Test; Graves Disease; Humans; Insulin Antibodies; Methimazole; Syndrome

An infant girl with choanal atresia, athelia, minor anomalies, and mild to moderate mental retardation was born to a woman treated for hyperthyroidism throughout pregnancy with methimazole and propranolol. The patient's defects may be due to methimazole teratogenicity or could represent a previously undescribed syndrome affecting ectodermal structures.

Topics: Abnormalities, Drug-Induced; Adult; Breast; Child, Preschool; Choanal Atresia; Female; Follow-Up Studies; Humans; Hyperthyroidism; Infant; Infant, Newborn; Methimazole; Nipples; Pregnancy; Pregnancy Complications; Syndrome

"Autoimmune" hypoglycemia is a syndrome consisting of fasting hypoglycemia, hyperinsulinemia, and insulin-binding antibodies in a patient who has never been exposed to exogenous insulin. The stimulus for insulin-antibody formation and the mechanism of the hypoglycemia in this condition remain unknown. Three patients with this rare syndrome had severe hypoglycemia of limited duration. Two had received a drug containing a sulfhydryl group (methimazole and penicillamine) as treatment for an autoimmune disorder (Graves' disease and rheumatoid arthritis, respectively). A third patient who underwent surgery for a suspected insulinoma was found to have pancreatic beta cell hyperplasia. Drugs containing a sulfhydryl group may have a role in the etiology of the syndrome. Additionally, our findings suggest a relationship between circulating insulin antibodies and beta cell hyperplasia.

Topics: Autoantibodies; Diagnosis, Differential; Female; Humans; Hyperplasia; Hypoglycemia; Insulin Antibodies; Insulinoma; Islets of Langerhans; Male; Methimazole; Middle Aged; Pancreatic Neoplasms; Penicillamine; Syndrome

Topics: Autoimmune Diseases; Graves Disease; Humans; Hypoglycemia; Insulin Antibodies; Methimazole; Syndrome

Topics: Autoimmune Diseases; Humans; Hypoglycemia; Insulin Antibodies; Methimazole; Syndrome

Using peripheral blood lymphocytes from 8 healthy individuals and 5 patients with untreated Graves' disease, direct effects of methimazole (MMI) and propylthiouracil (PTU) on lectin-induced lymphocyte proliferative response were studied. Lymphocytes were cultured for 72 hr in the presence of lectins and antithyroid drugs. Lymphocyte DNA synthesis was counted by incorporation of 3H-thymidine. MMI at 1,000 microM enhanced lectin-induced lymphoproliferation of peripheral blood lymphocytes from both patients with Graves' disease and healthy individuals, at every point of culture time, while PTU showed a tendency toward suppression. These results suggest that this lympho-stimulation by MMI may be a causative factor related to insulin autoimmune syndrome, as deduced from the clinical reports that insulin autoimmune syndrome is, sometimes, found in patients with Graves' disease treated with MMI. This lympho-stimulation was evident regardless of the time of MMI addition, thus indicating that MMI is, by its action, a lymphoid stimulator and may lead to the insulin autoimmune syndrome in predisposed subjects with underlying Graves' disease.

Topics: Autoimmune Diseases; Concanavalin A; Graves Disease; Humans; Insulin Antibodies; Lymphocyte Activation; Methimazole; Phytohemagglutinins; Pokeweed Mitogens; Propylthiouracil; Syndrome

The human Sipple syndrome associates a thyroid-C-cell tumor and a pheochromocytoma. A treatment with the antithyroid drug thiamazole allows obtaining experimentally a similar syndrome in rat. Present paper seeks to analyse changes which happened in the medullary zone of adrenal glands before and during the development of the tumors. During the treatment by thiamazole both adrenal cortex and medulla were atrophied. After the treatment was stopped, the weight of the gland increased, as compared with its previous state, and this was chiefly due to the hyperplasia of medullary cells, from which pheochromocytomas originate. The initial atrophy of adrenal gland depends on the thiamazole-induced hyperthyroidism, but the mechanism of the medullary hyperplasia subsequent to the treatment ending is unknown. It results probably from a secondary hyperthyroidism.

Topics: Adrenal Gland Neoplasms; Adrenal Medulla; Animals; Male; Methimazole; Neoplasms, Experimental; Pheochromocytoma; Rats; Rats, Inbred Strains; Syndrome; Thyroid Neoplasms

A 74 year old woman was found to have elevated serum thyroid-stimulating hormone (TSH) levels and elevated serum thyroid hormone levels, with clinical euthyroidism. There was no evidence of a pituitary tumor. TSH levels increased substantially during methimazole therapy. Administration of dexamethasone was followed by a prompt fall in serum TSH levels. Triiodothyronine (T3) was administered over a period of 20 days in doses from 25 micrograms to as much as 100 micrograms daily causing a rise in serum T3 above 700 ng/100 ml, a decline of T4 and a blunting of the response to thyrotrophin-releasing hormone (TRH), with normal metabolic responses (pulse rate, photomotogram, cholesterol). These results suggest that the patient's disorder is due to partial target organ resistance to thyroid hormones.

Topics: Aged; Dexamethasone; Female; Humans; Methimazole; Syndrome; Thyroid Hormones; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine

Sipple syndrome, associating a C cells or parafollicular thyroid tumor and a pheochromocytoma of the medullary part of adrenal gland, can be experimentally induced with the use of an antithyroid drug, the thiamazole, in the rat. The treatment is applied here either between 3 and 11 months, or between 6 and 14 months of age. Tumors appear a long time after the treatment is stopped. Hypotheses are proposed to explain this phenomenon.

Topics: Adrenal Gland Neoplasms; Animals; Male; Methimazole; Neoplasms, Experimental; Pheochromocytoma; Rats; Syndrome; Thyroid Neoplasms

We have investigated the thyroid uptake of Tl-201 in 37 patients with various types of goiter, and in six with normal thyroids. Significant thallium uptake was found in all cases in which there was thyroid enlargement, including Graves' disease, toxic thyroid nodule, primary hypothyroidism, simple goiter, Hashimoto's disease, thyroid carcinoma, and thyroid adenoma. If goiter was absent, however, there was no demonstrable uptake--e.g., in secondary hypothyroidism, subacute thyroiditis, and the normal controls. Thallium uptake did not correlate with thyroid function tests such as BMR, T3-RU, T3, T4, TSH, antithyroid antibodies, or the 24-hr I-131 uptake. In 23 patients with diffuse goiter, on the other hand, maximum Tl-201 uptake correlated well with thyroid weight: r = 0.836 (p less than 0.001); y = 0.02 x + 0.06.

Topics: Adenoma; Antithyroid Agents; Contrast Media; Goiter; Goiter, Nodular; Graves Disease; Humans; Hypothyroidism; Iodipamide; Methimazole; Radioisotopes; Radionuclide Imaging; Syndrome; Thallium; Thyroid (USP); Thyroid Diseases; Thyroid Function Tests; Thyroid Neoplasms; Thyroiditis; Thyroiditis, Autoimmune; Thyrotropin

A case of thyrotoxicosis associated with neuropathy and encephalomyelitis is reported which gradually improved as regards the hyperthyroidism and the neurological deficit during treatment with Tapazole. The possible role of the nervous system of an excess of thyroxine or an autoimmune factor as a cause of the involvement is discussed.

Topics: Adult; Encephalomyelitis; Humans; Hyperthyroidism; Male; Methimazole; Syndrome

An 18-yr-old woman with clinical and laboratory features of hyperthyroidism had persistently elevated serum levels of immunoreative thyrotropin (TSH). During 11 yr of follow-up there had been no evidence of a pituitary tumor. After thyrotropin-releasing hormone (TRH), there was a marked increase in TSH and secondarily in triiodothyronine (T3), the latter observation confirming the biologic activity of the TSH. Exogenous T3 raised serum T3 and several measurements of peripheral thyroid hormone effect, while decreasing serum TSH, thyroxine (T4), and thyroidal radioiodine uptake. After T3, the TRH-stimulated TSH response was decreased but was still inappropriate for the elevated serum T3 levels. Dexamethasone reduced serum TSH but did not inhibit TRH stimulation of TSH. Propylthiouracil reduced serum T4 and T3 and raised TSH. This patient represents a new syndrome of TSH-induced hyperthyroidism, differing from previous reports in the absence of an obvious pituitary tumor and in the responsiveness of the TSH to TRH stimulation and thyroid hormone suppression. This syndrome appears to be caused by a selective, partial resistance of the pituitary to the action of thyroid hormone. This case is also compared with previous reports in the literature of patients with elevated serum levels of immunoreactive TSH in the presence of elevated total and free thyroid hormones. A classification of these cases, termed "inappropriate secretion of TSH," is proposed.

Topics: Adolescent; Child; Depression, Chemical; Dexamethasone; Female; Humans; Hyperthyroidism; Metabolism, Inborn Errors; Methimazole; Pituitary Gland; Prolactin; Syndrome; Thyroid Function Tests; Thyroid Hormones; Thyrotropin; Thyroxine; Triiodothyronine

Topics: Abnormalities, Multiple; Antithyroid Agents; Congenital Hypothyroidism; Humans; Iodine; Iodine Radioisotopes; Methimazole; Radioisotopes; Syndrome; Thyroid Gland