propylthiouracil and Emergencies

Topics: Agranulocytosis; Anti-Bacterial Agents; Antithyroid Agents; Drug Substitution; Emergencies; Female; Humans; Hyperthyroidism; Lung Abscess; Methimazole; Middle Aged; Propylthiouracil; Tomography, X-Ray Computed

A 63 year-old woman with hyperthyroidism was admitted to the Medical Intensive Care Unit for ARDS following damage to her lungs from propylthiouracil. She was placed on 250 mg SSKI PO TID as an alternative therapy until thyroidectomy could be performed. Four days after admission, she abruptly developed an acneiform rash on her face, shown to be iododerma. The eruption rapidly resolved after discontinuation of the SSKI.

Topics: Antithyroid Agents; Drug Eruptions; Emergencies; Facial Dermatoses; Female; Humans; Intensive Care Units; Middle Aged; Neutrophil Infiltration; Potassium Iodide; Propylthiouracil; Respiratory Distress Syndrome; Skin Diseases, Vesiculobullous; Thyrotoxicosis

A 35-year-old man with multiple bone fractures underwent an emergency operation. On arriving at the operating room, his heart rate was 160 beats x min(-1), and blood pressure was 100/50 mmHg. We anesthetized him with oxygen, sevoflurane, fentanyl and remifentanil. We suspected hypovolemia, and treated him with crystalloid and transfused red cells and fresh frozen plasma so that heart rate and blood pressure could be stabilized. Tachycardia of 140 beats x min(-1) persisted, and landiolol was continuously administered at a rate of 5-10 mg x hr(-1) after a 2.5 mg bolus injection. Heart rate became controlled around 120 beats x min(-1) without hypotension during anesthesia. Finally, we noticed thyroid crisis in this case, and diagnosed it with laboratory data after operation. We should be aware that atypical tachycardia is caused by thyroid crisis.

Topics: Adult; Anti-Arrhythmia Agents; Emergencies; Fractures, Bone; Graves Disease; Humans; Intraoperative Complications; Iodine Compounds; Male; Morpholines; Orthopedic Procedures; Propylthiouracil; Tachycardia; Thyroid Crisis; Urea

Topics: Antithyroid Agents; Dexamethasone; Emergencies; Humans; Hyperthyroidism; Iodides; Plasmapheresis; Propranolol; Propylthiouracil

We report a patient who developed eosinophilic pleuritis due to propylthiouracil. Although immunologic side effects associated with thionamides previously have been described, this is the first reported case of an isolated eosinophilic pleural reaction.

Topics: Emergencies; Eosinophilia; Graves Disease; Humans; Male; Middle Aged; Pleurisy; Propylthiouracil; Time Factors

Topics: Adult; Corneal Ulcer; Diplopia; Emergencies; Female; Glucocorticoids; Graves Disease; Humans; Hypophysectomy; Iodine Isotopes; Keratitis; Male; Middle Aged; Orbit; Papilledema; Propylthiouracil; Thyroidectomy; Vision Disorders