propylthiouracil and Fever

From March 1980 to August 1982, 108 patients with Graves' disease participated in a prospective study at Yonsei University College of Medicine. Preoperatively, 22 patients were prepared with propranolol alone (group 1) and 86 with propranolol and propylthiouracil (PTU) (group 2). The duration of preparation averaged 11.5 days for group 1 and 10.8 days for group 2. Bilateral subtotal thyroidectomy was performed, leaving 4 to 6 grams at both upper poles. No significant difference was noted in the average weight of the removed gland or the amount of blood loss between both groups. During the operation, the pulse rate of group 1 was significantly faster than that of group 2 but evened out by the day of discharge. The incidence of high fever during and immediately after operation was 27.3 per cent in group 1 which is greater than the 17.4 per cent in group 2. In group 1, the incidence of postoperative transient hypocalcemia was 27.3 per cent, transient or prolonged hypothyroidism was 13.6 per cent and recurrence of thyrotoxicosis was 4.5 per cent. In group 2, the values were 22.1, 18.6 and 4.7 per cent, respectively. High fever developed in one patient from group 1 during operation and this patient died on the third day postoperatively. From the results of our study, it appears to be more beneficial to administer both propranolol and PTU as preoperative medication to patients with Graves' disease prior to undergoing operation.

Topics: Adult; Clinical Trials as Topic; Drug Therapy, Combination; Female; Fever; Follow-Up Studies; Graves Disease; Humans; Hypocalcemia; Male; Postoperative Complications; Premedication; Preoperative Care; Propranolol; Propylthiouracil; Prospective Studies; Pulse; Random Allocation; Thyroidectomy; Time Factors

Sickness behavior is an expression of a motivational state triggered by activation of the peripheral innate immune system, whereby an organism reprioritizes its functions to fight infection. The relationship between thyroid hormone and immune cells is complex, and additional insights are needed about the involvement of the cross-talk between thyroid hormone, the central nervous system and immune function, as demonstrated by the consequences to sickness behavior. The aim of this work was to evaluate sickness behavior in hypothyroid mice. Control mice and mice treated with propylthiouracil (PTU) for 30days (0.05%; added to drinking water) received a single dose of LPS (200μg/kg; i.p.) or saline, and the behavioral response was assessed for 24h. We provide evidence that thyroid status acts a modulator for the development of depressive-like and exploratory behaviors in mice that are subjected to an immunological challenge because the PTU pretreatment delayed the LPS-induced behavioral changes observed in an open field test and in a forced swimming test. This response was observed concomitantly with a lower thermal index until 4h after the LPS administration. This result demonstrates that thyroid status modifies behavioral responses to immune challenge and suggests that thyroid hormones are essential for the manifestation of sickness behavior during endotoxemia.

Topics: Animals; Anorexia; Antithyroid Agents; Endotoxemia; Exploratory Behavior; Fever; Hypothyroidism; Illness Behavior; Lipopolysaccharides; Male; Mice; Motor Activity; Propylthiouracil

This study is aimed to explore the relationship between bone marrow characteristics and clinical prognosis of antithyroid drug (ATD) induced agranulocytosis. A retrospective study was conducted in the first affiliated hospital of the University of South China. A total of 33 hospitalized patients diagnosed with ATD-induced agranulocytosis were analyzed. The bone marrow characteristics were classified into two types. Type I was characterized by reduction or absence of granulocytic precursors and type II was recognized as hypercellular bone marrow with dysmaturity of granulocytic cells. Bone marrow of 20 cases (61%) were characterized with type I whereas 13 cases (39%) with type II. The median duration of neutrophil recovery and high-grade fever were 4.7 ± 1.0 days and 3.6 ± 2.5 days respectively for type II, compared to 8.0 ± 2.8 days and 8.6 ± 3.1 days for type I (p < 0.01 in both compared groups). However, there was no significant difference between the two types in terms of age, median duration of drug administration before the diagnosis of agranulocytosis, the amount of neutrophil count on admission and the total administration dose of granulocyte-colony stimulating factor (G-CSF) before bone marrow examination. Two cases of type I died of complications from infection. This study showed that the bone marrow characteristics of ATD-induced agranulocytosis could be classifed into two types. Also, the clinical prognosis was closely related to the bone marrow features. Type I is the dominant type which is usually associated with worse clinical prognosis compared to type II.

Topics: Adult; Agranulocytosis; Antithyroid Agents; Bone Marrow; Cell Differentiation; China; Female; Fever; Granulocyte Colony-Stimulating Factor; Granulocyte Precursor Cells; Hospitals, University; Humans; Hyperthyroidism; Male; Methimazole; Middle Aged; Prognosis; Propylthiouracil; Retrospective Studies; Young Adult

Topics: Antithyroid Agents; Exanthema; Female; Fever; Graves Disease; Humans; Middle Aged; Oral Ulcer; Propylthiouracil; Vasculitis

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

Topics: Child, Preschool; Dantrolene; Drug Therapy, Combination; Female; Fever; Humans; Propranolol; Propylthiouracil; Respiratory Insufficiency; Thyroid Crisis

The development of the febrile response to E. coli lipopolysaccharide (1.5 micrograms/kg, i.v.) in thyroid-deficient rabbits has been studied. Twenty-eight New Zealand White rabbits weighing 2.1-2.3 kg were used. Hypothyroidism was induced by treatment with propylthiouracil (100 or 200 mg/kg body wt./15 days). Thyroid-deficient animals showed a reduction in the febrile response to lipopolysaccharide, but the effect was significantly different (p less than 0.01) from the control only for rabbits treated with 200 mg/kg of propylthiouracil. Propranolol (2 mg/kg, i.p.) given 30 min before lipopolysaccharide also reduced (p less than 0.01) the fever response in control rabbits. The results of this experiment are consistent with the hypothesis that the reduction in the febrile response of thyroid-deficient rabbits is due to the reduced number of beta-adrenergic receptors, or to a change in the availability of neurotransmitter in thermogenically active tissues, such as brown fat.

Topics: Animals; Body Temperature; Fever; Hypothyroidism; Lipopolysaccharides; Male; Propranolol; Propylthiouracil; Pyrogens; Rabbits

Topics: Adult; Female; Fever; Graves Disease; Humans; Propylthiouracil

Intramuscular injection of staphylococcal enterotoxin B (SEB) at a dosage level of 50 microgram/kg of body weight caused death in Dutch rabbits. Lethality was not modified markedly by morphine pretreatment or by hyperthermia, thyrotoxicosis, propylthiouracil feeding, thyroparathyroidectomy, water deprivation, or fasting. The administration of acetylsalicylic acid to the SEB-inoculated rabbit also failed to protect the rabbits from the effect of SEB. Seemingly, the SEB molecular destruction was not markedly modified by alteration of cellular metabolism, and lethal effects of SEB remained unchanged in the morphine- or acetylsalicylic acid-treated rabbits. When SEB was given to six rabbits 3 days after total-body X-irradiation, fever persisted and three rabbits survived. An identical dose of SEB to nonirradiated rabbits produced fever initially, followed by hypothermia and death of all six rabbits.

Topics: Animals; Body Temperature; Enterotoxins; Fasting; Fever; Male; Morphine; Oxygen Consumption; Parathyroid Glands; Propylthiouracil; Rabbits; Staphylococcus; Thyroidectomy; Thyroxine; Water Deprivation; X-Rays

Topics: Adult; Female; Fever; Humans; Immune Complex Diseases; Leg Ulcer; Lung Diseases; Propylthiouracil; Purpura; Skin Transplantation; Transplantation, Autologous; Vasculitis

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: Adolescent; Agranulocytosis; Child; Child, Preschool; Drug Hypersensitivity; Female; Fever; Humans; Hyperthyroidism; Kidney Glomerulus; Leukocyte Count; Leukopenia; Lupus Erythematosus, Systemic; Male; Propylthiouracil; Urticaria