The effects of dopaminergic blockade on serum TSH and prolactin levels in thyrotoxicosis

Abstract. In the first part of this study, we have demonstrated that, in 7 patients with untreated thyrotoxicosis, a 7 day regime of the long acting dopamine antagonist metoclopramide (10 mg orally 8 hourly) produces more adequate dopaminergic blockade at pituitary level than a single oral 10 mg dose of the compound as assessed by serum prolactin responses. Subsequently, we have employed this protracted oral metoclopramide regime to evaluate the contribution of dopaminergic tone to the abnormal TSH and prolactin responsiveness of thyrotoxicosis. Serum TSH and prolactin responses to iv TRH (200 μg) were measured in 10 untreated thyrotoxic patients before and after a 7 day period of metoclopramide 10 mg orally 8 hourly. Ten euthyroid individuals were studied in similar fashion, their serum samples being analysed for prolactin levels alone, thus providing a control group for prolactin responsiveness to TRH, before and after metoclopramide. In the thyrotoxic patients basal TSH levels did not change as a consequence of metoclopramide therapy and the TSH response to TRH remained flat. Basal prolactin levels were similar in thyrotoxic and euthyroid individuals and the increase in prolactin, seen in both groups after metoclopramide, was smaller in the thyrotoxic group than in the euthyroid group. Prolactin responsiveness to TRH was significantly impaired in the thyrotoxic subjects as compared to euthyroid subjects. After metoclopramide there was a significant decline in prolactin responsiveness in the euthyroid group, and a similar, though insignificant, trend in the thyrotoxic patients. We conclude that in thyrotoxicosis dopaminergic tone plays no major part in the suppression of TSH levels, nor in the impaired prolactin responsiveness to TRH.

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Pituitary responses to a dopamine antagonist at different times of the day in normal women

Acta Endocrinologica ◽

10.1530/acta.0.1000481 ◽

1982 ◽

Vol 100 (4) ◽

pp. 481-485 ◽

Cited By ~ 5

Author(s):

F. R. Pérez-López ◽

C. M. González-Moreno ◽

M. D. Abós ◽

J. A. Andonegui ◽

R. H. Corvo

Keyword(s):

Serum Prolactin ◽

Dopamine Antagonist ◽

Hormonal Changes ◽

Healthy Women ◽

Serum Lh ◽

Normal Women ◽

The Times ◽

Serum Tsh

Abstract. In order to determine whether or not pituitary responsiveness to the dopaminergic antagonist clebopride changes during the nyctohemeral cycle, 10 healthy women with regular cycles were given 1 mg of clebopride orally at 09.00 h and 24.00 h with at least a 5 day interval between each test. In addition, 5 of the women were given a placebo instead of clebopride at midnight to evaluate the spontaneous hormonal changes. During the 24.00 h test the women had significantly higher P < 0.05) mean TSH basal levels. Serum prolactin (Prl) increased significantly (P < 0.001) after clebopride administration while these changes did not occur when placebo was used instead of clebopride at midnight. The Prl response to clebopride was qualitatively similar at 09.00 h and at 24.00 h. Clebopride given at midnight induced a significant increase (P < 0.05) in serum TSH while this change did not occur when the drug was given at 09.00 h or when placebo was given at midnight. The administration of clebopride resulted in no discernible alterations in serum LH, FSH or GH in either the 09.00 h or the 24.00 h tests. Thus, Prl responses to clebopride were similar in the morning and at midnight, TSH significantly increased after clebopride at midnight whereas this did not occur when the drug was given in the morning, and no significant changes were induced in LH, FSH or GH at the times studied.

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Aldosterone responsiveness to metoclopramide in hyperprolactinaemia

Clinical Science ◽

10.1042/cs0720277 ◽

1987 ◽

Vol 72 (3) ◽

pp. 277-282

Author(s):

B. P. O'Malley ◽

D. Mercey ◽

E. Clarke ◽

M. Maguire ◽

J. Jackson ◽

...

Keyword(s):

Study Groups ◽

The Other ◽

Dopamine Antagonist ◽

Basal Serum ◽

Serum Aldosterone ◽

Significant Difference ◽

Long Acting ◽

Tsh Levels

1. Basal serum aldosterone levels in 13 hyperprolactinaemic females did not differ significantly from those of nine control individuals. 2. There was increased responsiveness of circulating aldosterone levels to the long acting dopamine antagonist metoclopramide (10 mg intravenously) in the hyperprolactinaemic patients as compared with the controls. 3. Prolactin responsiveness to metoclopramide was reduced in the patients as compared with the controls, such being considered characteristic of a prolactinoma. 4. Basal serum thyrotrophin (TSH) levels, although within the euthyroid range, were increased in the patients as compared with the controls. There was no significant difference in the TSH responsiveness to metoclopramide between the study groups. However, in the five patients with exaggerated responses of TSH to metoclopramide, basal TSH levels were significantly higher than in the other patients. 5. One explanation for these results is that prolactin can directly or indirectly modulate the aldosterone response to metoclopramide.

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The Source of Serum Ferritin during Infection. Studies with Concanavalin A–Sepharose Absorption

Clinical Science ◽

10.1042/cs0590385 ◽

1980 ◽

Vol 59 (5) ◽

pp. 385-387 ◽

Cited By ~ 18

Author(s):

G. Birgegård

Keyword(s):

Serum Ferritin ◽

Concanavalin A ◽

Normal Subjects ◽

Normal Serum ◽

Control Group ◽

Serum Samples ◽

Tissue Samples ◽

Group Of Seven ◽

Acute Infections ◽

Before And After

1. Serum samples were collected from ten patients hospitalized for acute infections and from a control group of seven normal subjects. Tissue ferritin was obtained by purification of ferritin from normal human liver and from the ferritin standard of a commercially available assay kit. 2. The serum and tissue samples were incubated with concanavalin A-Sepharose, which has the ability to bind normal serum ferritin. 3. Concanavalin A, a plant lectin which binds to glucose, can be coupled to Sepharose particles and by incubation and centrifugation ferritin in normal serum can be absorbed to about 70%. The serum and tissue samples were incubated with concanavalin A-Sepharose and the ferritin content was measured before and after. 4. It was found that ferritin in the serum of patients with acute infections was absorbed to the same extent as in normal serum (about 80%), irrespective of the initial value. Only about 20% of the tissue ferritin was absorbed. 5. It is concluded that the ferritin in serum during infection is of the same glucosylated type as the ferritin normally present in serum, whereas intracellular ferritin is not glycosylated. This indicates that the elevation of serum ferritin during infection is caused by a release along the normal pathways, i.e. an augmented synthesis, not by leakage from damaged cells.

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Gamma-Aminobutyric Acid (GABA) in the CSF of Schizophrenic Patients Before and After Neuroleptic Treatment

The British Journal of Psychiatry ◽

10.1192/bjp.132.2.145 ◽

1978 ◽

Vol 132 (2) ◽

pp. 145-148 ◽

Cited By ~ 49

Author(s):

D. Lichtshtein ◽

J. Dobkin ◽

R. P. Ebstein ◽

J. Biederman ◽

R. Rimon ◽

...

Keyword(s):

Significant Decline ◽

Aminobutyric Acid ◽

Control Group ◽

Gamma Aminobutyric Acid ◽

Neuroleptic Treatment ◽

Normal Individuals ◽

Significant Difference ◽

Before And After ◽

Schizophrenic Patients ◽

Drug Free

Gamma-aminobutyric acid (GABA) levels in the CSF were measured in 9 normal individuals, 17 drug-free schizophrenic patients and 10 of these same schizophrenic patients after neuroleptic treatment. There was no significant difference between CSF level of GABA in the control group compared to those in schizophrenic patients; however, 6 of the 7 lowest GABA levels were from schizophrenic patients. There was a significant decline of 12 per cent in mean GABA levels in the CSF after a mean of two months of neuroleptic treatment.

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Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.4086 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Abdul Rehman Khokhar ◽

Abdul Majeed Cheema

Keyword(s):

Sample Size ◽

Congenital Hypothyroidism ◽

Case Control Study ◽

Sampling Technique ◽

Case Control ◽

Control Group ◽

Study Group ◽

Serum Tsh ◽

Control Study ◽

Tsh Levels

Objectives: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism. Methods: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied. Results: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group. Conclusions: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan. doi: https://doi.org/10.12669/pjms.37.5.4086 How to cite this:Khokhar AR, Cheema AM. Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4086 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Association between Thyroid Stimulating Hormone and Respiratory Distress Syndrome of Newborn in the Preterm Infants

10.21203/rs.3.rs-40381/v1 ◽

2020 ◽

Author(s):

Young Jin Kim ◽

Byoung Kook Kim ◽

Yong Hyuk Kim

Keyword(s):

Thyroid Hormone ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Control Group ◽

Lower Serum ◽

Significant Difference ◽

Serum Tsh ◽

Tsh Levels

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

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TARC and MDC Are the Only Chemokines with Highly Increased Levels in Serum of Hodgkin Lymphoma Patients.

Blood ◽

10.1182/blood.v108.11.2268.2268 ◽

2006 ◽

Vol 108 (11) ◽

pp. 2268-2268

Author(s):

Marijke Niens ◽

Lydia Visser ◽

Ruth F. Jarrett ◽

Gerard J. te Meerman ◽

Sibrand Poppema ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Plasma Cells ◽

Serum Levels ◽

Control Group ◽

P Value ◽

Strongly Correlated ◽

Serum Samples ◽

Immunological Mechanisms ◽

Before And After ◽

Eosinophilic Granulocytes

Abstract Chemokines (cytokines with chemoattractant properties) can recruit different subsets of cells and therefore play an important role in the formation and maintenance of the non-neoplastic reactive infiltrate present in Hodgkin lymphoma (HL). The infiltrate consisting of lymphocytes, plasma cells, histiocytes and eosinophilic granulocytes is the most abundant part of the tumor mass in HL and surrounds the minority of neoplastic cells, the so-called Hodgkin-Reed Sternberg (HRS) cells. Several studies have shown that HRS cells and cells in the reactive infiltrate produce multiple chemokines. Especially TARC (CCL17) and MDC (CCL22) are highly produced by HRS cells. Altered serum chemokine levels might be related to HL prognosis or disease activity, since immunological mechanisms are crucial in HL pathogenesis. So far, only TARC and IL-8 levels have been studied in the serum of HL patients. In this study serum levels of nine chemokines including, Eotaxin, Fractalkine, IP10, MCP1, MDC, Mig, MIP1a, RANTES, and TARC were examined in serum of 163 untreated HL patients and 334 healthy controls using ELISA. In a subset of nine patients we also examined serum chemokine levels after treatment. Serum levels of TARC and MDC were significantly increased in 82% and 57% of the HL patient group compared to 12% and 5% in the control group, respectively. Serum Fractalkine and Mig levels did not show a difference between patients and controls, whereas serum levels of Eotaxin, IP10, MCP1, MIP1a, and RANTES were significantly decreased in HL patients. Analysis of the different subtypes revealed that the Nodular Sclerosis (NS) cases contained increased serum TARC and MDC levels compared to the Mixed Cellularity (MC) cases (p-value= 0,000). Serum TARC levels strongly correlated with serum MDC levels (r=0.82, p<0.01). Of the nine patients with serum samples before and after treatment, seven showed decreased serum TARC and MDC levels after treatment. One patient with increased levels before treatment did not show decrease in chemokine levels after treatment and died of disease. The last patient did not have increased chemokine levels before treatment and showed similar low levels in both serum samples. The other chemokines did not show a difference in serum levels in the before and after treatment samples. This is the first study testing a broad set of chemokines in serum of HL patients. Of all chemokines tested, TARC and MDC were the only chemokines with increased serum levels in the vast majority of HL patients and these can be used to monitor treatment efficiency.

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Pregnancy outcomes in women with severe hypothyroidism

Acta Endocrinologica ◽

10.1530/eje-13-0228 ◽

2013 ◽

Vol 169 (3) ◽

pp. 313-320 ◽

Cited By ~ 19

Author(s):

Dania Hirsch ◽

Sigal Levy ◽

Varda Nadler ◽

Vered Kopel ◽

Bracha Shainberg ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Control Group ◽

Study Group ◽

Maximum Serum ◽

Health Maintenance ◽

Median Serum ◽

The Impact ◽

Serum Tsh ◽

Tsh Levels

ObjectiveHypothyroidism during pregnancy has been associated with adverse obstetrical outcomes. Most studies have focused on subjects with a mild or subclinical disorder. The aims of the present study were to determine the relative rate of severe thyroid dysfunction among pregnant women with hypothyroidism, identify related factors and analyse the impact on pregnancy outcomes.DesignA retrospective case series design was employed.MethodsThe study group included 101 pregnant women (103 pregnancies) with an antenatal serum TSH level >20.0 mIU/l identified from the 2009–2010 computerised database of a health maintenance organisation. Data were collected from the medical records. Pregnancy outcomes were compared with those of a control group of 205 euthyroid pregnant women during the same period.ResultsThe study group accounted for 1.04% of all insured pregnant women with recorded hypothyroidism during the study period. Most cases had an autoimmune aetiology. All women were treated with levothyroxine (l-T4) during pregnancy. Maximum serum TSH level measured was 20.11–150 mIU/l (median 32.95 mIU/l) and median serum TSH level 0.36–75.17 mIU/l (median 7.44 mIU/l). The mean duration of hypothyroidism during pregnancy was 21.2±13.2 weeks (median 18.5 weeks); in 36 cases (34.9%), all TSH levels during pregnancy were elevated. Adverse pregnancy outcomes included abortions in 7.8% of the cases, premature deliveries in 2.9% and other complications in 14.6%, with no statistically significant differences from the control group. Median serum TSH level during pregnancy was positively correlated with the rate of abortions+premature deliveries and rate of all pregnancy-related complications (P<0.05).ConclusionsAbortions and premature deliveries occur infrequently in women with severe hypothyroidism. Intense follow-up and l-T4 treatment may improve pregnancy outcomes even when target TSH levels are not reached.

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Role of catecholamines in regulating ovine median eminence blood flow

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1990.258.5.r1242 ◽

1990 ◽

Vol 258 (5) ◽

pp. R1242-R1249

Author(s):

R. B. Page ◽

M. Gropper ◽

E. Woodard ◽

J. Townsend ◽

S. Davis ◽

...

Keyword(s):

Blood Flow ◽

Choroid Plexus ◽

Median Eminence ◽

Serum Prolactin ◽

Dopamine Antagonist ◽

Drug Infusion ◽

Neural Lobe ◽

Dopamine Infusion ◽

D2 Agonist ◽

Before And After

Blood flow was measured in the ovine median eminence and neural lobe before and after the intravenous infusion of dopamine (n = 7), the D1 agonist SKF 38393 (n = 4), the D2 agonist bromocriptine (n = 4), and the dopamine antagonist haloperidol (n = 5). It was also measured before and after the intracarotid infusion of dopamine into eight naive sheep and seven sheep pretreated with phenoxybenzamine. Radiolabeled microspheres were used to determine regional cerebral and regional neurohypophysial blood flows (RNHBF) in these 35 adult female sheep anesthetized with pentobarbital sodium. Samples for serum prolactin measurement by radioimmunoassay were obtained before and after drug infusion. Intravenous dopamine infusion did not change median eminence or neural lobe blood flow (RNHBF) but increased renal and choroid plexus blood flow. Intravenous haloperidol caused a significant fall in RNHBF and blood flow in choroid plexus, caudate nucleus, and kidneys. Intracarotid dopamine infusion decreased RNHBF but increased choroid plexus blood flow. RNHBF was significantly greater in the seven sheep pretreated with phenoxybenzamine than in the eight naive sheep. These findings do not support a role for dopamine in the regulation of median eminence blood flow. The last observation does add support to the hypothesis that norepinephrine or epinephrine interaction with alpha-receptors plays a role in the control of ovine median eminence blood flow and hence in the regulation of delivery of humoral messages from the brain to the anterior pituitary gland.

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Tolerance to oats in dermatitis herpetiformis

Gut ◽

10.1136/gut.43.4.490 ◽

1998 ◽

Vol 43 (4) ◽

pp. 490-493 ◽

Cited By ~ 63

Author(s):

T Reunala ◽

P Collin ◽

K Holm ◽

P Pikkarainen ◽

A Miettinen ◽

...

Keyword(s):

Small Bowel ◽

Dermatitis Herpetiformis ◽

Clinical Symptoms ◽

Cell Receptor ◽

Gluten Free Diet ◽

Control Group ◽

Gluten Free ◽

Serum Samples ◽

Before And After ◽

Small Bowel Mucosa

Objectives—Recent studies on coeliac disease have shown that oats can be included in a gluten-free diet without adverse effects on the small bowel. The presence of a rash is also a sensitive indicator of gluten ingestion in dermatitis herpetiformis, and this was used to study whether patients with this disease could also tolerate oats.Patients/Methods—Eleven patients with dermatitis herpetiformis in remission on a gluten-free diet were challenged daily with 50 g oats for six months. Clinical symptoms were recorded, serum samples taken, and skin and small bowel biopsies performed before and after the oat challenge. A control group comprised of 11 patients with dermatitis herpetiformis on a conventional gluten-free diet was also studied.Results—Eight patients challenged with oats remained asymptomatic, two developed a transient rash, and one withdrew because of the appearance of a more persistent but mild rash. Three of the 11 controls also developed a transient rash. IgA endomysial antibodies remained negative in all patients. The small bowel villous architecture, the densities of intraepithelial CD3 and α/β and γ/δ T cell receptor positive lymphocytes and crypt epithelial cell DR expression remained unaltered during the oat challenge.Conclusions—The results confirm the absence of oat toxicity on the gluten sensitive small bowel mucosa and suggest that the rash in patients with dermatitis herpetiformis is not activated by eating oats.

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