propylthiouracil and Myxedema

The relation between serum concentrations of thyroglobulin antibodies (TgAb), thyroid-stimulating antibodies (TSAb) and serum immunoglobulins during treatment of Graves' disease was studied in 36 consecutive patients treated randomly with 131-iodine (n = 16) or propylthiouracil (n = 20). The patients were investigated before treatment was started and on seven occasions within the following year. In the entire patient group 78% were positive for TSAb and 47% for TgAb. There was a significant correlation between TSAb and TgAb in 15 patients concomitantly positive. There were no significant changes in serum immunoglobulins during treatment in either group of patients. In the radioiodine-treated group of patients TgAb was reduced after 1 week, whereas TSAb showed insignificant variations. After 5-10 weeks both antibodies increased, for TgAb with a median peak level 3 time above the initial concentration. Of 16 patients treated with radioiodine five developed myxoedema and four of these were positive for TgAb. There was a relation between the development of myxoedema and the ratio between increases of TSAb and TgAb. Increase in TSAb was not related to serum thyroglobulin (Tg) measured in TgAb-negative patients. Propylthiouracil showed minor effects on the studied variables, but with lower mean values of Tg, TgAb and TSAb at the end of the observation period. The results indicate an immunological relation between TSAb and TgAb, although differences between their course exist in some situations.

Topics: Adult; Aged; Antibodies; Autoantibodies; Female; Graves Disease; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins, Thyroid-Stimulating; Iodine Radioisotopes; Male; Middle Aged; Myxedema; Propylthiouracil; Serum Albumin; Thyroglobulin

1. The effect of moderate endurance exercise on blood glucose concentration and on glucoregulatory hormones was studied in nine thyrotoxic and five myxoedematous humans before and 3 months after anti-thyroid and substitution therapy, respectively. 2. At rest, the fasting concentrations of insulin and pro-insulin correlated positively with the prevailing total tri-iodothyronine concentration, whereas the concentrations of noradrenaline and cortisol correlated inversely with the tri-iodothyronine concentration. 3. During exercise the plasma insulin, pro-insulin and C-peptide concentrations decreased. The plasma glucagon concentration increased slightly in thyrotoxic patients before and after treatment and was largely unchanged in myxoedematous patients in either state. 4. The plasma noradrenaline concentration increased before and after treatment in both groups, with concentrations two times higher in the myxoedematous than in the thyrotoxic patients. Treatment for 3 months did not change this pattern. The plasma adrenaline concentration increased in both groups, but in the untreated thyrotoxic patients the increase was two to three times greater than that after treatment or that in the myxoedematous group. 5. The blood glucose concentration decreased in eight of nine untreated thyrotoxic patients, but was largely unchanged after treatment or in the myxoedematous patients. A strong negative correlation was found between the decline in blood glucose concentration and the increase in plasma adrenaline concentration in the thyrotoxic group. 6. Thus, during exercise untreated thyrotoxic patients are prone to hypoglycaemia, show an inadequate glucagon response, and exhibit a large counter-regulatory increase in plasma adrenaline concentration.

Topics: Adult; Blood Glucose; Epinephrine; Female; Humans; Insulin; Male; Middle Aged; Myxedema; Norepinephrine; Physical Exertion; Proinsulin; Propylthiouracil; Thyrotoxicosis; Thyroxine

In order to elucidate the relationship between the auditory function and the thyroid state, experiments were designed to study the effect of hypothyroidism on the onset of auditory brain stem response (ABR) in 26 adult myxedematous albino rats. A state of hypothyroidism was induced by daily oral administration of 6-N-propyl-2-thiouracil (PTU). In 23 out of 26 rats we found minor changes in the amplitudes of all ABR waves without any correlation with the rats' T4 variation. We noted a conspicuous, dynamic, and reversible change in the amplitude of the third wave (N3) of ABR which correlates directly with the thyroxin (T4) levels in the rats' blood. The electrophysiological finding in this report indicates a lesion in the auditory tracts in the brain stem but mainly in the second main relay station of the central auditory pathway, i.e., the superior olivary complex.

Topics: Animals; Brain Stem; Evoked Potentials, Auditory; Models, Biological; Myxedema; Propylthiouracil; Rats; Thyrotropin; Thyroxine; Time Factors

Propylthiouracil (PTU) inhibits peripheral deiodination of thyroxine (T4) and triiodothyronine (T3) and decreases the metabolic effectiveness of T4 in animals. To assess the effect of PTU on extrathyroidal conversion of T4 to T3 in man, 15 studies were performed in athyreotic patients treated with 100 or 200 mug of L-T4 daily for 1 mo before the addition of PTU, 250 mg every 6 h for 8 days. serum T3, T4, and thyrotropin (TSH) were measured daily by radioimmunoassay; serum TSH response to 500-mug thyrotropin-releasing hormone (TRH) was measured before and on the last day of giving PTU. On the 100-mug LT4 dose, serum T3 fell from 120 plus or minus 5 (SE) to 83 plus or minus 6 ng/dl (P less than 0.005) with return to 113 plus or minus 5 ng/dl after stopping PTU; serum T4 (4.5 plus or minus 0.3 mug/dl) did not change. Similar results were seen in patients taking 200 mug of L-T4 daily. On the 100-mug dose of L-T4 the fall in T3 was accompanied by a reciprocal rise in serum TSH to 195 plus or minus 33% of initial concentration (P less than 0.01) with return to 104 plus or minus 8% after PTU. The serum TSH response to TRH (DELTAMUU/ml over base line) was greater during PTU therapy than during the control period. On 100-mug L-T4 DELTA TSH rose from 64 plus or minus 19 to 101 plus or minus 23 muU/ml (P less than 0.005). Expressed as percent of base-line TSH concentration, TSH rose from 140 plus or minus 52 to 280 plus or minus 44% (control vs. PTU) at 15 min, 265 plus or minus 72 to 367 plus or minus 63% at 30 min, 223 plus or minus 54 to 313 plus or minus 54% at 45 min, 187 plus or minus 45 to 287 plus or minus 51% at 60 min, and 145 plus or minus 22 to 210 plus or minus 28% at 120 min after TRH. The data suggest that PTU blocks extrathyroidal conversion of T4 to T3, thus increasing pituitary TSH secretion and augmenting the TSH response to TRH.

Topics: Depression, Chemical; Humans; Injections, Intravenous; Male; Myxedema; Parkinson Disease; Propylthiouracil; Thyroid Diseases; Thyroidectomy; Thyrotropin; Thyrotropin-Releasing Hormone; Thyroxine; Triiodothyronine

Three patients with hemiagenesis of the typhoid gland are described. One was clinically euthyroid, whereas the other two were more unusual in that one had coincident Graves' disease with thyrotoxicosis, and one had primary myxodema. In all three cases diagnosis of hemiagenesis was established by the administration of thyroid-stimulating hormone (TSH). The literature on hemiagenetic thyroid glands with and without associated thyroid disease is reviewed. Although the anomaly is uncommon, awareness and recogniton of its existence may clarify an otherwise puzzling clinical thyroid evaluation, and thus possible avert an unnecessary surgical procedure.

Topics: Adult; Congenital Abnormalities; Female; Graves Disease; Humans; Hyperthyroidism; Iodine Radioisotopes; Male; Middle Aged; Myxedema; Propylthiouracil; Radionuclide Imaging; Thyroid Gland; Thyrotropin; Thyroxine

Topics: Animals; Basement Membrane; Capillaries; Disease Models, Animal; Dogs; Inclusion Bodies; Lipid Metabolism; Male; Methimazole; Microscopy, Electron; Mitochondria, Muscle; Myocardium; Myxedema; Pectoralis Muscles; Propylthiouracil

Topics: Adult; Calcitonin; Calcium; Female; Humans; Hypercalcemia; Hyperthyroidism; Injections, Intravenous; Male; Middle Aged; Myxedema; Propylthiouracil; Thyroidectomy; Time Factors

Topics: Adult; Basal Metabolism; Female; Humans; Hyperthyroidism; Iodine Radioisotopes; Male; Middle Aged; Myxedema; Propylthiouracil; Thyroid Function Tests; Thyroxine-Binding Proteins

Topics: Adult; Aged; Antibodies; Chronic Disease; Female; Humans; Hyperthyroidism; Hypothyroidism; Iodine Isotopes; Male; Methimazole; Middle Aged; Myxedema; Propranolol; Propylthiouracil; Pulse; Thiocyanates; Thyroid Diseases; Thyroid Function Tests; Thyroiditis; Time Factors; Triiodothyronine

Topics: Female; Humans; Hyperthyroidism; Middle Aged; Myxedema; Propylthiouracil

Topics: Aged; Heart Failure; Humans; Hyponatremia; Hypopituitarism; Male; Myxedema; Propylthiouracil; Triiodothyronine; Vasopressins

Topics: Adolescent; Adult; Antithyroid Agents; Blood Cell Count; Diagnosis, Differential; Diagnostic Errors; Female; Goiter; Heart Auscultation; Humans; Hyperthyroidism; Iodine Radioisotopes; Male; Methylthiouracil; Myxedema; Nervous System Diseases; Neurotic Disorders; Propylthiouracil; Radioisotope Dilution Technique; Thiazoles; Thiouracil; Thiourea; Thyrotropin

Topics: Adolescent; Adult; Aged; Antibodies; Female; Follow-Up Studies; Humans; Hyperthyroidism; Hypothyroidism; Iodine; Iodine Isotopes; Male; Middle Aged; Myxedema; Postoperative Complications; Propylthiouracil; Solutions

Topics: Adrenal Glands; Aldosterone; Atrophy; Growth Hormone; Heart Rate; Human Growth Hormone; Hyperthyroidism; Liver; Myxedema; Pharmacology; Potassium; Propylthiouracil; Rats; Research; Respiration; Sodium; Spleen; Thyroxine; Urine

Topics: Blood Chemical Analysis; Chromatography; Geriatrics; Goiter; Hyperthyroidism; Iodine Isotopes; Monoiodotyrosine; Myxedema; Neoplasms; Propylthiouracil; Thiourea; Thyronines; Thyroxine; Tyrosine

Topics: Adolescent; Antithyroid Agents; Child; Female; Goiter; Graves Disease; Guanethidine; Heart Diseases; Humans; Hyperthyroidism; Infant; Iodides; Iodine Isotopes; Myxedema; Ophthalmology; Perchlorates; Pituitary Gland; Potassium; Pregnancy; Pregnancy Complications; Propylthiouracil; Radiotherapy; Reserpine; Thyroid Function Tests; Thyroidectomy; Thyrotoxicosis; Toxicology

Topics: Biological Transport; Blood Protein Electrophoresis; Blood Proteins; Chemical Phenomena; Chemistry; Humans; Hyperthyroidism; Hypothyroidism; In Vitro Techniques; Iodine Isotopes; Myxedema; Pharmacology; Pregnancy; Propylthiouracil; Thyroid Function Tests; Thyroid Hormones; Thyroxine; Triiodothyronine

Topics: Edema; Graves Disease; Hyperthyroidism; Myxedema; Propylthiouracil; Thiouracil