propylthiouracil and Pain

Topics: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Emergency Service, Hospital; Female; Graves Disease; Humans; IgA Vasculitis; Middle Aged; Pain; Propylthiouracil; Skin

Topics: Female; Graves Disease; Humans; Middle Aged; Pain; Postmenopause; Propylthiouracil; Remission Induction; Thyroiditis

An adolescent with Graves' disease presented with acute painful swelling of the thyroid gland and overlying erythema simulating acute suppurative or subacute thyroiditis. She had an elevated radioactive iodine uptake, thyroid stimulating antibodies, thyrotrophin binding inhibiting immunoglobulins, and a normal sedimentation rate and leucocyte count. The course of the thyrotoxicosis and painful thyroid was protracted, and the pain and tenderness of the thyroid recurred on two subsequent relapses.

Topics: Adolescent; Erythema; Female; Graves Disease; Humans; Iodine Radioisotopes; Pain; Propylthiouracil; Thyroid Function Tests; Thyroid Gland

The authors studied 389 Graves' hyperthyroid patients receiving either high propylthiouracil (PTU) or methimazole (MMI) daily doses or low doses to evaluate whether adverse effects were related to the thionamide drugs or its daily dose regimen. Group 1 patients (n = 286) received high PTU (728 +/- 216 mg/day, n = 92) or MMI (60 +/- 19 mg/day, n = 94) doses, and group 2 patients (n = 103) were treated with low PTU (255 +/- 85 mg/day, n = 39) or MMI (23 +/- 10 mg/day, n = 64) doses. Major adverse effects were observed in 11 (2.8%) patients. Of these, four (1.0%) had agranulocytosis, two (0.5%) were granulocytopenic and five (1.3%) had hepatotoxicity. Agranulocytosis occurred in two patients from each group, 0.7% and 1.9%, respectively from group 1 and group 2. There was no significant difference between the groups or the types of thionamide. There also was no correlation with the patients' age. All of the patients were hyperthyroid, and its onset occurred in the first to third month of treatment. Full recovery was achieved in all cases after drug withdrawal. Four of 5 patients with hepatotoxicity were treated with high PTU doses, and one patient received low MMI doses (p less than .05). All patients were euthyroid. Arthralgias, skin rash and gastric intolerance, the minor adverse effects of thionamides studied, were observed in 52 (13.4%) of the patients. Although no significant differences were found, most of the patients experiencing side effects were from group 1 an received MMI therapy. These adverse effects did not demand drug withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Agranulocytosis; Chemical and Drug Induced Liver Injury; Child; Dose-Response Relationship, Drug; Drug Eruptions; Graves Disease; Humans; Hyperthyroidism; Joints; Methimazole; Middle Aged; Pain; Propylthiouracil; Stomach Diseases

Topics: Abdomen; Anorexia; Body Weight; Dexamethasone; Diagnosis, Differential; Drug Therapy, Combination; Female; Gastrointestinal Diseases; Humans; Hyperthyroidism; Middle Aged; Pain; Potassium Iodide; Propranolol; Propylthiouracil; Vomiting

Topics: Acetazolamide; Adrenal Cortex Hormones; Analgesia; Dextrans; Drug Therapy; Epinephrine; Humans; Intubation; Intubation, Gastrointestinal; Meperidine; Norepinephrine; Pain; Pain Management; Pancreatitis; Parasympatholytics; Propylthiouracil; Secretin