Fluctuating thyroid hormones in Graves disease: a case series of brittle Graves

Author(s):  
Bilginer Muhammet Cuneyt ◽  
Sevgul Faki ◽  
Cevdet Aydin ◽  
Didem Ozdemir ◽  
Tam Abbas Ali ◽  
...  
2020 ◽  
Vol 33 (7-8) ◽  
pp. 483
Author(s):  
Inês Romão Luz ◽  
João Rio Martins ◽  
Mónica Jerónimo ◽  
Joana Serra Caetano ◽  
Rita Cardoso ◽  
...  

Introduction: Graves disease is characterized by the existence of autoantibodies directed to the thyrotropin receptor, which can have a stimulatory/inhibitory action, in women with the condition, their fetus or neonate. Our aim was to review the case series of these neonates in order to establish neonatal thyroid function predictors.Material and Methods: Retrospective cohort study of the database of the Department of Pediatric Endocrinology, including patients born to mothers with Graves’ disease, between 2002 and 2017. Clinical and biochemical data were collected from mothers and offspring.Results: Fifty newborns, from 46 women with a median of 3.5 years after diagnosis, were included. During all trimesters of pregnancy, more than half of women had positive autoantibodies directed to the thyrotropin receptor. Not every woman had a complete thyroid function evaluation every trimester. In 32 newborns, cord blood screening was done. During the neonatal period, there were three cases of hypothyroidism and two of hyperthyroidism. The mothers of these five newborns had higher levels of free thyroid hormones during the second trimester (p = 0.03). The level of antibodies directed to the thyrotropin receptor was significantly higher in the cord blood (p = 0.03) and in the first neonatal test (p = 0.03) of these dysthyroid newborns.Discussion: Our results reinforce the need for every pregnant woman with Graves’ disease to be subject to thyroid function and autoantibodies evaluation during every trimester, as well as the importance of evaluating these antibodies in cord blood.Conclusion: High levels of free thyroid hormones during the second trimester of pregnancy and antibodies directed to the thyrotropin receptor value in cord blood are predictors of dysthyroidism in neonates born from women with Grave’s disease.


1983 ◽  
Vol 19 (5) ◽  
pp. 619-627 ◽  
Author(s):  
E. ARTEAGA ◽  
J. M. LÓPEZ ◽  
J. A. RODRÍGUEZ ◽  
P. MICHAUD ◽  
G. LÓPEZ

1985 ◽  
Vol 69 (2) ◽  
pp. 113-121 ◽  
Author(s):  
C. A. Ollis ◽  
S. Tomlinson ◽  
D. S. Munro

Graves’ disease is the commonest form of hyperthyroidism in which excessive production of thyroid hormones by the hyperplastic overactive thyroid gland produces elevated serum levels of the thyroid hormones tri-iodothyronine (T3) and thyroxine (T4). Many of the manifestations of Graves’ disease, increased basal metabolic rate, increased heart rate, heat intolerance, sweating and nervousness, can be attributed to the peripheral actions of the excess thyroid hormones. The pathogenesis of many of the other dramatic features of Graves’ disease, such as the eye involvement or localized skin changes, is not fully understood, but circulating immunoglobulins with thyroid stimulating activity are almost certainly linked to excess thyroid hormone production and thereby cause the hyperthyroidism.


2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Kazunori Kageyama ◽  
Noriko Kinoshita ◽  
Makoto Daimon

Subacute thyroiditis is an inflammatory disorder of the thyroid. Graves’ disease is an autoimmune thyroid disease in which thyroid hormones are overproduced. Here we present a rare case of thyrotoxicosis due to the simultaneous occurrence of both diseases. Prompt diagnosis and therapy are required to prevent complications in patients with thyrotoxicosis.


2015 ◽  
Vol 17 (1) ◽  
pp. 53 ◽  
Author(s):  
V. N. Zorina ◽  
T. P. Maklakova ◽  
T. T. Sheppel ◽  
O. N. Boyko ◽  
R. M. Zorina ◽  
...  

2021 ◽  
Vol 17 (3) ◽  
pp. 22-26
Author(s):  
I. A. Matsueva ◽  
A. B. Dalmatova ◽  
T. V. Andreychenko ◽  
E. N. Grineva

Treatment of thyrotoxicosis caused by Graves’ disease or multinodular toxic goiter, is not difficult, in most cases, since the prescription of thionamides allows to normalize the level of thyroid hormones quickly and safety. But in a number of cases this therapy might be associated with serious side effects (agranulocytosis, toxic hepatitis, cholestasis), severe allergic reactions and also individual intolerance on thionamides. In such cases lithium carbonate is used, especially in severe thyrotoxic syndrome. It is known, that lithium can accumulate in the thyroid gland at a concentration 3–4 times higher than in the plasma. Perhaps, lithium uses Na+/I- ions. It can inhibit the synthesis and secretion thyroid hormones of thyroid gland. The article presents the cases reported the use of lithium carbonate in thyrotoxicosis treatment before thyroidectomy. Administering low doses of carbonate lithium (900 mg/ per day) renders significant decrease or normalization of thyroid hormones concentration within 7–14 days, thus it let perform thyroidectomy on the patients. No side effects have been identified with such a short course of lithium carbonate treatment.


2021 ◽  
Vol 92 (12) ◽  
pp. 980-986
Author(s):  
Edwin Hong-Teck Loh ◽  
Feng Wei Soh ◽  
Brian See ◽  
Benjamin Boon Chuan Tan

BACKGROUND: Graves’ Disease (GD) is a common cause of hyperthyroidism. Although definitive treatment with radioactive iodine (RAI) is preferred for military aircrew, there are cultural and individual differences in receptivity toward RAI, and clinical guidelines that recommend antithyroid drugs (ATD) as the first line therapy. We examined a case series of Republic of Singapore Air Force (RSAF) aviators with GD treated with ATD and the impact of their condition on aeromedical disposition.CASE SERIES: All RSAF aircrew diagnosed with GD and treated with ATD over a 15-yr period were retrospectively identified and analyzed to determine the impact on their fitness for flying duties. The mean age of the 13 aircrew was 33 ± 7.1 yr (range, 25–47 yr), with 11 (84.6%) being males. There were 10 (76.9%) who had ATD as the only treatment while 3 (23.1%) were initially treated with ATD but subsequently underwent RAI or surgery. Of the 10 treated with only ATD, 3 (30.0%) were returned to restricted flying, 6 (60.0%) were returned to unrestricted flying, and 1 (10.0%) is still undergoing ATD titration. There were 10 (76.9%) aircrew who were returned to some form of flying duties while on low doses of ATD.DISCUSSION: This case series suggests that ATD is a viable treatment modality in the aeromedical management of military aviators with GD and it is possible to return military aircrew on a stable maintenance dose of ATD to flying duties. A framework is proposed to support the aeromedical decision-making process for military aircrew in the treatment of GD.Loh EH-T, Soh FW, See B, Tan BBC. Aeromedical decision making for military aircrew with Graves’ disease. Aerosp Med Hum Perform. 2021; 92(12):980–986.


2010 ◽  
Vol 35 (4) ◽  
pp. 183-187 ◽  
Author(s):  
Hiroyuki Kinoshita ◽  
Mutsuko Yasuda ◽  
Shingo Kaneko ◽  
Ryo Usui ◽  
Seiji Inoshita ◽  
...  

2019 ◽  
Vol 32 (11-12) ◽  
pp. 327-31
Author(s):  
M. Suttan Assin ◽  
Jusuf Rukman ◽  
Jose R. L. Batubara ◽  
Purnama Wati S. P.

Thyroid hormones play an important role in the metabolic propesses. Its disturbances will involve several organs, consequently. A 5 year old girl with Graves' diseases, after several weeks of treatment with propylthiouracil (PTV), developed thyrotoxicosis crisis and diabetes mellitus with ketoacidosis; a condition which is usually fatal. Treatment toward the hyperthyroid state overcome the diabetic stage, eventually. This report is an example of an endocrinological interaction in a hyperthyroid patient. Therefore, the diabetogenic effect of hyperthyroxinemia should not be overlooked.


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