Relapse and exacerbation of Graves' disease during pregnancy is rare, and thionamide induced agranulocytosis is an uncommon side effect. We report a case of a pregnant woman in her 24th week of gestation that experienced a relapse of Graves' disease that was complicated by propylthiouracil induced agranulocytosis. Following the discontinuation of propylthiouracil and administration of a broad-spectrum of antibiotics, agranulocytosis subsided within 10 days. A total thyroidectomy to avoid any future relapse was planned and a short course of a beta-adrenergic blocker and Lugol solution were prescribed before the operation. At the 28th week of gestation, a total thyroidectomy was performed without complications and thyroxine replacement therapy was commenced. At the 40th week of gestation, labor was induced and a 3, 370 g healthy male infant was born without clinical features of thyrotoxicosis. We report herein on the patient and the treatment options for this rare and complicated case.
Thyroidectomy ; Recurrence ; Propylthiouracil/administration & dosage/*adverse effects ; Pregnancy Complications/*therapy ; Pregnancy ; Humans ; Graves Disease/*complications/*therapy ; Female ; Antithyroid Agents/administration & dosage/*adverse effects ; Agranulocytosis/chemically induced/*complications ; Adult

Adolescent ; Adult ; Aged ; Antithyroid Agents ; therapeutic use ; Female ; Graves Disease ; blood ; drug therapy ; Humans ; Iodides ; urine ; Iodine ; administration & dosage ; Male ; Middle Aged ; Propylthiouracil ; therapeutic use ; Prospective Studies ; Sodium Chloride, Dietary ; administration & dosage ; Thyroid Hormones ; blood

Adolescent ; Adult ; Aged ; Antithyroid Agents ; administration & dosage ; adverse effects ; therapeutic use ; Biomarkers ; blood ; Female ; Hepatitis B ; complications ; pathology ; Hepatitis, Viral, Human ; complications ; pathology ; Humans ; Hyperthyroidism ; complications ; drug therapy ; Liver Function Tests ; Male ; Methimazole ; administration & dosage ; adverse effects ; therapeutic use ; Middle Aged ; Propylthiouracil ; administration & dosage ; adverse effects ; therapeutic use ; Retrospective Studies ; Severity of Illness Index ; Thyroid Function Tests ; Young Adult

OBJECTIVETo observe the clinical effects of prunrllae oral solution in treating hyperthyrea.

METHOD56 cases with hyperthyrea were randomized into two groups; group A1 was treated by classic method, B1 was treated by classic method combined with prunrllae oral solution. The size, vessel caliber of thyroidea, volume of blood flow and blood flow rate pre-and post-treatment were measured by color supersonic, meanwhile, 20 normal thyroidea were measured as control group.

RESULTThe size and vessel caliber of thyroidea of the two groups pre-treatment were obviously bigger than those of the control group, the volume of blood flow and blood flow rate were obviously slower than those of the control group (P < 0.001), the sizes of thyroidea of the two groups became smaller, especially the group B1 was more obvious, and there was no significant difference in the size of thyroidea between group B1 and control group.

CONCLUSIONIt is indicated that combined treatment of traditional Chinese medicine (prunrllae oral solution) and western medicine is superior to western medicine in treating hyperthyrea.

Administration, Oral ; Adult ; Antithyroid Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Graves Disease ; drug therapy ; pathology ; Humans ; Hyperthyroidism ; drug therapy ; pathology ; Male ; Methimazole ; therapeutic use ; Middle Aged ; Phytotherapy ; Plants, Medicinal ; chemistry ; Prunella ; chemistry ; Thyroid Gland ; drug effects ; pathology