propylthiouracil and Endocrine-System-Diseases

Antithyroid drugs (ATDs) may have teratogenic effects when used in early pregnancy.. To review the association between the time period of ATD exposure in early pregnancy and the development of birth defects.. We identified publications on birth defects after early pregnancy exposure to the ATDs methimazole (MMI; and its prodrug carbimazole (CMZ)) and propylthiouracil (PTU). Cases of birth defects after ATD treatment had been initiated or terminated within the first 10 weeks of pregnancy were identified and studied in detail.. A total of 92 publications were read in detail. Two recent large controlled studies showed ATD-associated birth defects in 2-3% of exposed children, and MMI/CMZ-associated defects were often severe. Out of the total number of publications, 17 included cases of birth defects with early pregnancy stop/start of ATD treatment, and these cases suggested that the high risk was confined to gestational weeks 6-10, which is the major period of organogenesis. Thus, the cases reported suggest that the risk of birth defects could be minimized if pregnant women terminate ATD intake before gestational week 6.. Both MMI and PTU use in early pregnancy may lead to birth defects in 2-3% of the exposed children. MMI-associated defects are often severe. Proposals are given on how to minimize the risk of birth defects in fertile women treated for hyperthyroidism with ATDs.

Topics: Antithyroid Agents; Carbimazole; Congenital Abnormalities; Endocrine System Diseases; Female; Humans; Male; Pregnancy; Pregnancy Complications; Propylthiouracil

Age-specific criteria must be taken into consideration in the treatment of hormonal dysregulations during senescence and senium. A general transmission of the endocrine conditions of younger periods of life to the senium is not possible and induces the possibilities of complications which are demonstrated at the example of the thyroidal and parathyroidal metabolism. The course of endocrine crises is the severer the older the patients concerned are. Dealing with the pathophysiological findings, the author demonstrates and explains therapeutic standards according to own experiences.

Topics: Age Factors; Aged; Carbimazole; Critical Care; Endocrine Glands; Endocrine System Diseases; Humans; Parathyroid Diseases; Prednisolone; Propylthiouracil; Thyroid Crisis; Thyroid Diseases

The medicolegal impact of adverse events in surgical endocrine disease has not been described previously. This study was undertaken to determine the causes, costs, and outcomes of endocrine malpractice litigation.. Jury verdict reports from the U.S. civil court system from 1985 through 1991 were reviewed. Sixty-two malpractice cases were identified from 21 states.. The 62 cases were classified into three categories, totaling 63 adverse events: (1) complications (n = 34, 54%) from thyroid (n = 32, 51%) or parathyroid (n = 2, 3%) surgery; (2) delayed diagnosis (n = 22, 35%) of thyroid cancer (n = 11, 18%), adrenal tumors (n = 9, 14%), and hyperparathyroidism (n = 2, 3%); and (3) medical morbidity (n = 7, 11%) from radioactive iodine (n = 5, 8%) or from propylthiouracil (n = 2, 3%). Surgical injuries, mostly recurrent nerve injuries by general surgeons, accounted for the greatest number of cases and the highest cost of litigation.. Medical malpractice involving endocrine disease results in expensive litigation, a result of serious harm. Technical misadventures account for most cases, followed closely by delays in diagnosis. These data may aid design of risk prevention strategies in endocrine disease.

Topics: Costs and Cost Analysis; Diagnostic Errors; Endocrine System Diseases; Humans; Information Systems; Iodine Radioisotopes; Malpractice; Postoperative Complications; Propylthiouracil

Topics: Endocrine System Diseases; Hyperthyroidism; Musculoskeletal Diseases; Propylthiouracil; Thiourea; Thyroid Gland

Topics: Diabetes Complications; Diabetes Mellitus; Endocrine System Diseases; Hyperthyroidism; Propylthiouracil; Thiourea; Thyroid Gland

Topics: Disease Management; Endocrine System Diseases; Hyperthyroidism; Musculoskeletal Diseases; Propylthiouracil; Thiourea; Thyroid Gland