propylthiouracil and Diarrhea

Establishing the diagnosis of thyroid storm is difficult in the ED, especially where there is no antecedent history of thyroid disease or clinical clues like goitre, exophthalmos or altered mentation, yet early recognition and treatment are essential in reducing mortality and morbidity from this endocrine emergency. We present a case where suspected infective gastroenteritis in a newly diagnosed diabetic masked the major symptomatology of thyroid storm, and review the diagnosis and management of thyrotoxic crisis.

Topics: Anti-Arrhythmia Agents; Antithyroid Agents; Chills; Diabetes Complications; Diabetes Mellitus; Diagnosis, Differential; Diarrhea; Emergency Medicine; Female; Fever; Gastroenteritis; Humans; Insulin; Middle Aged; Propranolol; Propylthiouracil; Tachycardia; Thyroid Crisis

We recently observed 2 lactase-deficient women with Graves' disease who consistently developed severe diarrhea after ingestion of thionamide (methimazole and propylthiouracil) tablets containing lactose as carrier. The strict temporal relationship between ingestion of lactose-containing tablets and appearance of intestinal symptoms, as well as the absence of side effects following ingestion of methimazole tablets without lactose as carrier, provided the clue for the diagnosis. To our knowledge, severe diarrhea resulting from carrier lactose has not been previously reported for antithyroid drugs, and should be considered in occasional cases of patients with gastrointestinal symptoms on thionamide therapy.

Topics: Adult; Antithyroid Agents; beta-Galactosidase; Diarrhea; Drug Carriers; Female; Graves Disease; Humans; Lactase; Lactose; Lactose Intolerance; Methimazole; Propylthiouracil

Topics: Diarrhea; Female; Humans; Hyperthyroidism; Intestinal Mucosa; Iodine Radioisotopes; Middle Aged; Propylthiouracil; Thyrotropin-Releasing Hormone; Triiodothyronine

Topics: Adrenal Cortex Hormones; Aspirin; Atrial Fibrillation; Diarrhea; Fever; Guanethidine; Humans; Iodides; Propranolol; Propylthiouracil; Psychoses, Substance-Induced; Reserpine; Stress, Physiological; Surgical Procedures, Operative; Sweating; Thyroid Crisis; Vitamin B Complex

Topics: Body Weight; Diarrhea; Female; Humans; Hyperthyroidism; Infant; Propylthiouracil; Thyroid Function Tests

Topics: Adrenal Glands; Angiography; Animals; Constipation; Diarrhea; Gastrointestinal Motility; Hyperthyroidism; Hypothyroidism; Male; Oxygen Consumption; Parathyroid Glands; Propylthiouracil; Radiometry; Rats; Thyroid Function Tests; Thyroid Gland; Thyroidectomy; Thyroxine; Triiodothyronine; Vagotomy; Vagus Nerve