propylthiouracil and Thyroiditis

Topics: Abortion, Spontaneous; Adult; Antithyroid Agents; Autoantibodies; Diabetes Mellitus, Type 1; Diabetes, Gestational; Female; Fertilization in Vitro; Gestational Age; Graves Disease; Humans; Hyperthyroidism; Hypothyroidism; Infant, Newborn; Infertility, Female; Iodine; Male; Menstrual Cycle; Menstruation Disturbances; Pregnancy; Pregnancy Complications; Prevalence; Propylthiouracil; Puerperal Disorders; Risk Factors; Thyroid Diseases; Thyroid Gland; Thyroid Hormones; Thyroiditis; Thyrotropin; Thyroxine; Ultrasonography

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

Thyrotoxicosis occurs more frequently during the post-partum period than at other times in women of childbearing age. Graves' disease and post-partum thyroiditis are two major causes of thyrotoxicosis in this period. The major task lies in differentiation of these two diseases in the post-partum period; since throtoxicosis caused by post-partum thyroiditis usually does not require treatment. The radioiodine uptake is elevated or normal in Graves' disease and low in post-partum thyroiditis, and TSH-receptor antibodies are positive in Graves' and negative in post-partum thyroiditis. Post-partum thyrotoxicosis due to Graves' disease may be treated with radioiodine but it requires radiation safety measurements for infant and is contraindicated if the mother is breast-feeding. Antithyroid drugs are the mainstay of the treatment of post-partum thyrotoxicosis. Recent investigations conclude that neither propylthiouracil nor methimazole cause any alterations in thyroid function and physical and mental development of infants breast-fed by lactating thyrotoxic mothers, and both can be safely administered in moderately high doses during lactation.

Topics: Antithyroid Agents; Breast Feeding; Female; Graves Disease; Humans; Infant, Newborn; Iodine Radioisotopes; Methimazole; Propylthiouracil; Puerperal Disorders; Radiotherapy; Thyroidectomy; Thyroiditis; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine

A 45 year-old man had a typical episode of subacute thyroiditis with tender goiter, depressed radioiodine uptake (RAIU) and elevated erythrocyte sedimentation rate. The titer of TSH binding inhibitor immunoglobulin (TBII), which had been 8.6% at initial presentation, rose to 14.9% in 2 weeks. TBII consisted of high titers (94%) of TSH stimulation-blocking antibodies (TBAb) and negative thyroid stimulating antibodies (TSAb). About 2 months after the first visit, TBII titers had risen to 48.9% and were persistently elevated for 5 months with high TBAb activity. The patient developed hypothyroidism with a maximum serum TSH level of 54.5 microU/ml. TBII and TBAb titers then gradually decreased, and the patient spontaneously recovered from hypothyroidism. Eighteen months after the episode of subacute thyroiditis, he became hyperthyroid with elevated TSAb and negative TBAb values. Doppler ultrasonography showed increased blood flow in the thyroid, and RAIU at 24 h was 53%. He was treated with antithyroid drugs, and soon became euthyroid. This case indicates that subacute thyroiditis can induce thyroid autoimmunity, and that the character of TSH receptor antibodies (TSHRAb) in these patients can change thereby modifying their thyroid function.

Topics: Antithyroid Agents; Autoantibodies; Autoimmune Diseases; Humans; Hyperthyroidism; Hypothyroidism; Immunoglobulins, Thyroid-Stimulating; Iodine Radioisotopes; Male; Middle Aged; Propylthiouracil; Receptors, Thyrotropin; Thyroid Gland; Thyroiditis; Thyrotropin; Thyroxine; Triiodothyronine; Ultrasonography

We measured the soluble cytokine CD27 in a variety of thyroid disorders. Soluble CD27 was increased in untreated Graves' hyperthyroidism and in euthyroid ophthalmopathy. Levels of sCD27 were normal after the establishment of euthyroidism with propylthiouracil (PTU) or radio iodine in primary hypothyroidism, chronic thyroiditis, and the hyperthyroid and euthyroid phases of subacute thyroiditis. Soluble CD27 is a marker for cellular activation as in Graves' hyperthyroidism, but it is not predictive of the outcome of PTU therapy.

Topics: Acute Disease; Adult; Aged; Antithyroid Agents; Biomarkers; Chronic Disease; Female; Graves Disease; Humans; Hypothyroidism; Iodide Peroxidase; Male; Middle Aged; Propylthiouracil; Receptors, Thyrotropin; Thyroid Diseases; Thyroiditis; Thyrotropin; Thyroxine; Tumor Necrosis Factor Receptor Superfamily, Member 7

Two Caucasian patients are described who had destructive postpartum thyroiditis (PPT) before the subsequent onset of Graves' hyperthyroidism (GH). HLA class II DQ typing in these two subjects identified putative susceptibility alleles previously detected in GH and PPT. Although PPT destructive thyroiditis preceding the development of GH is relatively uncommon, the occurrence of both these syndromes in the same patient suggests the possibility of an etiological role for thyroid antigen release and genetic susceptibility as pathogenic factors in the development of Graves' disease.

Topics: Abortion, Therapeutic; Adult; Female; Graves Disease; Humans; Iodine Radioisotopes; Middle Aged; Pregnancy; Propylthiouracil; Puerperal Disorders; Thyroiditis; Thyroxine

The soluble CD antigens sCD8, sCD23, and sCD25 are increased in untreated Graves' hyperthyroidism. These levels remain elevated when euthyroidism is established in response to propylthiouracil (PTU) therapy but decrease to control values after PTU treatment is discontinued, when euthyroidism has been established and maintained. Neither sCD8 nor sCD23 are elevated in patients with euthyroid Graves' ophthalmopathy nor in the hyperthyroid phase of subacute thyroiditis. sCD25 is increased to an intermediate degree in these disorders. Soluble CD8 > or = 450 U/ml is sensitive, specific, and predictive of PTU success as sole therapy or need for definitive therapy in untreated and PTU-treated Graves' hyperthyroidism, exceeding the predictive values of thyroid-stimulating hormone receptor antibody, thyroid peroxidase antibody, and T3 radioimmunoassay.

Topics: Adult; Aged; Antibodies; Antigens, CD; CD8 Antigens; Enzyme-Linked Immunosorbent Assay; Female; Graves Disease; Humans; Hyperthyroidism; Iodide Peroxidase; Iodine Radioisotopes; Male; Middle Aged; Predictive Value of Tests; Propylthiouracil; Radioimmunoassay; Receptors, IgE; Receptors, Interleukin-2; Receptors, Thyrotropin; Thyroiditis

A patient presenting with hyperthyroidism had a rapidly enlarging thyroid mass that histopathologically was a diffuse histiocytic lymphoma arising in a gland with Hashimoto's thyroiditis. The concurrent development of both hyperthyroidism and lymphoma may have resulted from similar immunologic abnormalities. Appreciation of the relationship between thyroid lymphoma and Hashimoto's thyroiditis, and their presentation with either hypothyroidism or hyperthyroidism should lead to an earlier diagnosis of lymphoma and improved survival.

Topics: Body Weight; Female; Humans; Hyperthyroidism; Lymphoma; Middle Aged; Propranolol; Propylthiouracil; Thyroid Neoplasms; Thyroidectomy; Thyroiditis

Topics: Adult; Aspirin; Blood Sedimentation; Diagnosis, Differential; Female; Graves Disease; Humans; Hyperthyroidism; Propylthiouracil; Thyroid Function Tests; Thyroiditis; Thyroiditis, Autoimmune; Thyroxine

Serum thyroglobulin (Tg), triiodothyronine (T3), and thyroxine (T4) concentrations were measured in sera from selected patients with hyperthyroidism due to Graves' disease and with subacute thyroiditis. In agreement with previous reports, the concentration of serum Tg was elevated in untreated hyperthyroidism due to Graves' disease, being 132 +/- 124 ng/ml (mean +/- SD) as opposed to 11 +/- 6.4 ng/ml in normal subjects. During treatment of hyperthyroidism with antithyroid drugs with or without iodide, reductions in thyroid hormone concentrations were not associated with a change in serum Tg. On the other hand, marked elevations in serum Tg to concentrations as high as 7000 ng/ml were observed within 24-48 hr after subtotal thyroidectomy or 131I treatment of patients with Graves' disease. These abrupt 10-50-fold increases in serum Tg were not associated with changes in serum T3 and T4. As previously demonstrated, patients with subacute thyroiditis may have elevated serum Tg concentrations that are not associated with elevations in serum T3 and T4. Serum Tg may remain elevated long after clinical and other biochemical mainfestations of this disease have disappeared. These data suggest that the disruption in thyroid function in patients with subacute thyroiditis may persist in a subclinical form for longer periods than previously suspected. Serum Tg appears to be a sensitive indicator of acute thyroidal damage due to surgical, radiation, or inflammatory trauma. The absence of parallel changes in serum Tg, T3, and T4 indicates that release of these thyroidal components can occur by different mechanisms and that nonthyroid tissues cannot efficiently generate T3 and T4 from circulating Tg. Accordingly, local or systemic stimulation of thyroidal Tg hydrolysis may be involved in the generation of hyperthyroidism sometimes seen in patients with subacute thyroiditis.

Topics: Child, Preschool; Female; Graves Disease; Humans; Potassium Iodide; Propylthiouracil; Thyroglobulin; Thyroidectomy; Thyroiditis; Thyroxine; Triiodothyronine

Topics: Adolescent; Female; Goiter; Hemorrhage; Humans; Hyperthyroidism; Hypoparathyroidism; Hypothyroidism; Iodine; Methylthiouracil; Postoperative Care; Postoperative Complications; Potassium Iodide; Preoperative Care; Propylthiouracil; Thyroid Diseases; Thyroidectomy; Thyroiditis; Time Factors; Vocal Cord Paralysis

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: Adult; Aged; Analysis of Variance; Antithyroid Agents; Calcitonin; Calcium; Female; Graves Disease; Humans; Hyperthyroidism; Hypocalcemia; Middle Aged; Phosphates; Propylthiouracil; Thyroid Gland; Thyroidectomy; Thyroiditis

Topics: Adjuvants, Immunologic; Animals; Antibody Formation; Autoimmune Diseases; Guinea Pigs; Lymph Nodes; Lymphocytes; Propylthiouracil; Thyroiditis

Topics: Child; Congenital Hypothyroidism; Diagnosis; Humans; Hyperthyroidism; Infant; Infant, Newborn; Propylthiouracil; Thyroid Function Tests; Thyroiditis; Thyroiditis, Autoimmune; Thyrotoxicosis; Thyroxine; Triiodothyronine

Topics: Adrenocorticotropic Hormone; Antithyroid Agents; Goiter; Graves Disease; Humans; Hyperthyroidism; Iodides; Iodine Isotopes; Prednisone; Propylthiouracil; Thyroid Function Tests; Thyroid Hormones; Thyroid Neoplasms; Thyroidectomy; Thyroiditis; Thyroiditis, Autoimmune

Topics: Carbohydrate Metabolism; Carbon Dioxide; Carbon Isotopes; Glucose; Hyperthyroidism; Manometry; Pharmacology; Propylthiouracil; Thyroid Gland; Thyroiditis

Topics: Body Weight; Carcinogens; Guinea Pigs; Iodides; Iodine; Neoplasms; Neoplasms, Experimental; Pathology; Propylthiouracil; Research; Thyroid Neoplasms; Thyroiditis; Toxicology