propylthiouracil and Down-Syndrome

We report three patients with Down syndrome that developed a hyperthyroidism. A 25 years old female and a 18 years old male had Basedow Graves disease and were treated with radioiodine. A 19 years old male had a Hashitoxicosis and is presently being treated with propylthiouracyl. Clinical and subclinical thyroid dysfunction is frequent in patients with Down syndrome and the risk increases with age. Therefore a surveillance with yearly TSH measurements should be done in these patients, since signs and symptoms of thyroid disease are barely detected in them. Hypothyroidism is the most frequent dysfunction but hyperthyroidism is also associated to Down syndrome.

Topics: Adolescent; Adult; Age of Onset; Down Syndrome; Female; Humans; Hyperthyroidism; Hypothyroidism; Iodine Radioisotopes; Male; Propylthiouracil

During a period of 7 years at our institution, four girls and one boy with Down's syndrome, ages 9 to 16 years, were examined and treated for hyperthyroidism. Two patients had Graves' disease and they responded to propylthiouracil (PTU) with a predictable clinical course resulting in remission within 4 years. The remaining three patients included in this report had hyperthyroid profiles similar to those of the two with Graves' disease except for their antibody panels. These patients, in addition to the elevated thyroid-stimulating immunoglobulin (TSI) level observed in Graves' disease, also had significantly elevated antimicrosomal antibody (AMA) and antithyroglobulin antibody (ATGA) at the time of diagnosis. Elevated TSI level was again present in two patients who had a recurrence of hyperthyroidism after PTU therapy was discontinued. Treatment of these three patients was best done with the continuation of PTU therapy at a lower dose and the addition of thyroxine as soon as mild hypothyroidism developed. Treatment with PTU and thyroxine was continued until the TSI level was no longer elevated. Levels of AMA and ATGA remained elevated long after the TSI level became normal. All three patients eventually had hypothyroidism and continue to require thyroxine replacement.

Topics: Adolescent; Antithyroid Agents; Autoantibodies; Child; Down Syndrome; Female; Graves Disease; Humans; Hyperthyroidism; Hypothyroidism; Immunoglobulins, Thyroid-Stimulating; Male; Microsomes; Propylthiouracil; Recurrence; Remission Induction; Thyroglobulin; Thyroxine

Topics: Chromosomes; Down Syndrome; Drug Therapy; Humans; Hyperthyroidism; Propylthiouracil; Trisomy

Topics: Adolescent; Child; Cystic Fibrosis; Down Syndrome; Humans; Hypertension; Intelligence Tests; Models, Theoretical; Peptic Ulcer; Pharmaceutical Preparations; Pharmacogenetics; Pharmacology; Poisons; Propylthiouracil; Quinine; Saliva; Taste

Topics: Child; Down Syndrome; Humans; Mothers; Propylthiouracil; Taste; Taste Threshold; Thiourea

Topics: Child; Down Syndrome; Guanine; Humans; Parents; Propylthiouracil; Taste