scholarly journals Myopathy Associated with Treatment of Graves’ Disease

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1016
Author(s):  
Yoon-Kyung Ji ◽  
Shin-Hee Kim
Keyword(s):  
Creatine Kinase ◽  
Adverse Reaction ◽  
Thyroid Function ◽  
Serum Creatine Kinase ◽  
Free Thyroxine ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Pediatric Case ◽  
Antithyroid Treatment

Here, we report a case of an increase in serum creatine kinase (CK) concentration in an 11-year-old girl being treated for Graves’ disease with antithyroid drugs (ATDs). The patient complained of myalgia two weeks after methimazole treatment. Triiodothyronine (T3) and free thyroxine (FT4) levels were normal, but the serum CK level was significantly elevated. After switching to propylthiouracil, the serum CK level decreased to normal, and the myalgia was resolved. The development of myopathy during the treatment of hyperthyroidism may be considered as an adverse reaction of MMI. In this report, we present a rare pediatric case, along with a discussion on the possible causes of myopathy that occurred during the treatment of Graves’ disease. A careful follow-up (serum CK levels and thyroid function) and treatment reassessment should always be considered after antithyroid treatment.

scholarly journals Cross-sectional investigation of serum creatine kinase concentration in Graves disease patients treated with oral antithyroid drugs

Medicine ◽  
2020 ◽  
Vol 99 (43) ◽  
pp. e22898
Author(s):  
Ying Cheng ◽  
Zhiyong Sun ◽  
Dapeng Zhong ◽  
Li Ren ◽  
Hang Yang
Keyword(s):  
Creatine Kinase ◽  
Serum Creatine Kinase ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Cross Sectional

Triiodothyronine autoantibodies in Graves' disease: Their changes after antithyroid therapy and relationship with the thyroglobulin antibodies

1990 ◽  
Vol 122 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Pei-Wen Wang ◽  
Miau-Ju Huang ◽  
Rue-Tsuan Liu ◽  
Chung Dar Chen
Keyword(s):  
Thyroid Hormone ◽  
Antigenic Site ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroglobulin Antibodies ◽  
Control Subjects ◽  
Antithyroid Therapy ◽  
Positive Antibody ◽  
Antithyroid Treatment

Abstract. Sera of 63 patients with Graves' disease, and 49 control subjects were assayed for T3 autoantibodies by a sensitive radioimmunoassay after being stripped of the endogenous thyroid hormone. T3 autoantibodies were demonstrated in 27% of patients with Graves' disease. After antithyroid treatment, T3 autoantibodies in 75% of the patients with positive antibody before therapy changed to negative titre during a follow-up period of 1 to 12 months. Also, a significant decrease of T3 autoantibodies was observed at 1 month after therapy in all patients who received antithyroid treatment. A further study of T3 autoantibodies and anti-thyroglobulin antibodies showed that the latter were demonstrated in 100% of patients with positive T3 autoantibodies and that T3 autoantibodies existed in about one third of patients with positive anti-thyroglobulin antibodies. The results suggested that T3 autoantibodies could be a subpopulation of the heterogenous anti-thyroglobulin antibodies. Although the fall of T3 autoantibodies in some patients was correlated to that of anti-thyroglobulin antibodies, the overall correlation between T3 autoantibodies and anti-thyroglobulin antibodies was poor. In conclusion: 1. T3 autoantibodies may be suppressed by antithyroid drugs. 2. Being a subpopulation of anti-thyroglobulin antibodies, T3 autoantibodies may be caused by an antigenic site within the big thyroglobulin molecule, whereas their titre was not correlated with that of the overall heterogenous anti-thyroglobulin antibodies.

Graves' disease and radioiodine therapy

2008 ◽  
Vol 47 (04) ◽  
pp. 153-166 ◽  
Author(s):  
I. Weber ◽  
W. Eschner ◽  
F. Sudbrock ◽  
M. Schmidt ◽  
M. Dietlein ◽  
...  
Keyword(s):  
Success Rate ◽  
Thyroid Function ◽  
Therapeutic Dose ◽  
Radioiodine Therapy ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Inclusion Criteria ◽  
End Point ◽  
Point Measure ◽  
The Impact

SummaryAim: This study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: A total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: Relief from hyperthyroidism was achieved in 96 % of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p=0.22). Conclusion: Thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy.

Different aetiologies in post-partum thyroiditis?

1983 ◽  
Vol 104 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Per Anders Dahlberg ◽  
Rolf Jansson
Keyword(s):  
Thyroid Function ◽  
Autoimmune Thyroiditis ◽  
Thyroid Dysfunction ◽  
Post Partum ◽  
Lymphocytic Infiltration ◽  
Graves Disease ◽  
Thyroid Autoantibodies ◽  
Radioiodine Uptake ◽  
Thyroid Cytology

Abstract. During a 4 year period 19 women with post-partum onset of thyroid dysfunction have been seen in our clinic. Five women had high radioiodine uptake thyrotoxicosis (Graves' disease). Twelve women had hypothyroid symptoms starting within 3–6 months of delivery. All of these women had thyroid microsomal and/or cytoplasmic autoantibodies and thyroid lymphocytic infiltration suggesting aggravation of pre-existing subclinical autoimmune thyroiditis (Hashimoto's disease). At follow-up thyroid function gradually improved in all but signs of persistent thyroid hypofunction remained in seven. Thus women developing symptomatic postpartum hypothyroidism should be followed regularly and when thyroxine treatment is commenced in the post-partum period, it has to be continued indefinitely in many cases. Two women presented with transient low radioiodine uptake thyrotoxicosis and a small painless goitre. Thyroid cytology revealed thyroiditis but they had no thyroid autoantibodies. When followed after a succeeding delivery none of these women developed post-partum thyroid dysfunction in contrast to women in the autoimmune group. Probably the aetiology of thyroid dysfunction in these 2 women was different.

scholarly journals Predictive value of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism

2014 ◽  
Vol 171 (4) ◽  
pp. 451-460 ◽  
Author(s):  
Juliette Abeillon-du Payrat ◽  
Karim Chikh ◽  
Nadine Bossard ◽  
Patricia Bretones ◽  
Pascal Gaucherand ◽  
...  
Keyword(s):  
First Generation ◽  
Second Generation ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Thyroid Ultrasound ◽  
Second Trimester ◽  
Neonatal Hyperthyroidism ◽  
Fetal Thyroid ◽  
Current Guidelines

ContextHyperthyroidism occurs in 1% of neonates born to mothers with active or past Graves' disease (GD). Current guidelines for the management of GD during pregnancy were based on studies conducted with first-generation thyroid-binding inhibitory immunoglobulin (TBII) assays.ObjectiveThis retrospective study was conducted in order to specify the second-generation TBII threshold predictive of fetal and neonatal hyperthyroidism, and to identify other factors that may be helpful in predicting neonatal hyperthyroidism.MethodsWe included 47 neonates born in the Lyon area to 42 mothers harboring measurable levels of TBII during pregnancy. TBII measurements were carried out in all mothers; bioassays were carried out in 20 cases.ResultsNine neonates were born with hyperthyroidism, including five with severe hyperthyroidism requiring treatment. Three neonates were born with hypothyroidism. All hyperthyroid neonates were born to mothers with TBII levels >5 IU/l in the second trimester (sensitivity, 100% and specificity, 43%). No mother with TSH receptor-stimulating antibodies (TSAb measured by bioassay) below 400% gave birth to a hyperthyroid neonate. Among mothers of hyperthyroid neonates, who required antithyroid drugs during pregnancy, none could stop treatment before delivery. Analysis of TBII evolution showed six unexpected cases of increasing TBII values during pregnancy.ConclusionMaternal TBII value over 5 IU/l indicates a risk of neonatal hyperthyroidism. Among these mothers, a TSAb measurement contributes to identify more specifically those who require a close fetal thyroid ultrasound follow-up. These results should be confirmed in a larger series.

scholarly journals Differences in the Treatment Response to Antithyroid Drugs versus Electroconvulsive Therapy in a Case of Recurrent Catatonia due to Graves’ Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Takahiro Saito ◽  
Rie Saito ◽  
Hiroshi Suwa ◽  
Fumiatsu Yakushiji ◽  
Kenji Takezawa ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Treatment Response ◽  
Thyroid Function ◽  
Electroconvulsive Therapy ◽  
Physical Symptoms ◽  
First Episode ◽  
Antithyroid Drugs ◽  
Graves Disease

We reported a case which presented recurrent episodes of catatonia as a result of Graves’ disease with hyperthyroidism. The patient showed different treatment response in each episodes; in the first episode, psychiatric and physical symptoms were resolved by a combination of antithyroid and anxiolytic therapies, while in the second episode, the combination therapy did not ameliorate her symptoms and ECT was indicated. We postulated that decreased CSF level of TTR and the resulting susceptibility to the derangement of peripheral thyroid function might be involved in this different treatment response.

scholarly journals Hyperthyroidism and vascular cell adhesion molecule-1 are associated with a low ankle-brachial index

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu-Hsuan Li ◽  
I-Te Lee
Keyword(s):  
Cell Adhesion Molecule ◽  
Regression Coefficient ◽  
Ankle Brachial Index ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Vascular Cell Adhesion ◽  
Free T4 ◽  
Vascular Cell ◽  
Cell Adhesion Molecule 1

Abstract We aimed to assess the ankle-brachial index (ABI) in patients with Graves’ disease. In the cross-sectional assessments, 81 patients with drug-naïve Graves’ disease and 235 with euthyroidism were enrolled. ABI and vascular cell adhesion molecule-1 (VCAM-1) levels were assessed. In the prospective follow-up, 32 patients with Graves’ disease were assessed again after antithyroid drugs for at least 4 weeks, and 32 age- and sex-matched controls with euthyroidism were also followed up. Patients with Graves’ disease had a higher VCAM-1 level (1309 ± 292 vs. 1009 ± 168 ng/mL, P < 0.001) and a lower ABI (0.98 ± 0.11 vs. 1.06 ± 0.10, P < 0.001) than those with euthyroidism. ABI was significantly lower in patients with hyperthyroidism and a high VCAM-1 level than in those with euthyroidism and a low VCAM-1 level (regression coefficient: − 0.050, 95% confidence interval [CI] between − 0.080 and − 0.019; P = 0.001). After treatment with antithyroid drugs, the change in free thyroxine (T4) level was inversely associated with the percentage change in ABI (regression coefficient: − 0.003, 95% CI between − 0.005 and − 0.001, P = 0.001). A synergistic effect of VCAM-1 and free T4 on ABI reduction was observed. After a longitudinal follow-up, an increase in ABI was significantly correlated with a decrease in the free T4 level.

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