Studies have demonstrated the detrimental effects of overt hyperthyroidism on sexual functioning.Here,we comprehensively reviewed the studies that focused on the association between overt hyperthyroidism and erectile dysfunction (ED).After the systematic searching for relevant studies,we find that overt hyperthyroidism is significantly associated with the high risk of ED.The prevalence of ED in patients with hyperthyroidism ranges from 3.05% to 85%,while that in general population is 2.16% to 33.8%.A study reported that the erectile functioning of the hyperthyroidism patients was improved (International Index of Erectile Function:22.1±6.9 vs. 25.2±5.1) after the achievement of euthyroidism.The underlying mechanism of the increase in the risk of ED by overt hyperthyroidism might be correlated to the dysfunction of hypothalamus-pituitary-thyroid axis,dysregulation of sex hormones,abnormal expression of thyroid hormone receptors,and psychiatric or psychological disturbances (e.g.,depression,anxiety,and irritability).Since limited clinical trials have been conducted,additional well-designed cohorts with sizable samples are warranted to elucidate the evidence and mechanism of hyperthyroidism predisposing to ED.The present review indicates that overt hyperthyroidism and the risk of ED are associated,which reminds the clinicians should assess the thyroid stimulating hormone in hyperthyroidism patients presenting with ED,especially in those without positive conventional laboratory findings for causing ED.
Male ; Humans ; Erectile Dysfunction/etiology* ; Anxiety ; Hyperthyroidism/complications* ; Thyrotropin

In this abstract we report a case of Albright's syndrome associated with hypophosphatemic rickets and hyperthyroidism in a six-year-old girl. She had suffered from repeated fractures of her long bones owing to multiple locations of radiolucent areas and generalized skeletal demineralization. The biopsy in the lucent area revealed histologic appearance of fibrous dysplasia.
Child ; Female ; Femoral Fractures/etiology ; Fibrous Dysplasia, Polyostotic/*complications ; Human ; Hyperthyroidism/*complications ; Phosphates/*blood ; Rickets/*complications

Acute hepatitis E occur commonly as outbreaks in endemic areas, but can occur sporadically in other part of the world. Acute hepatitis E has been reported rarely in Korea. A case of concurrent acute hepatitis E virus (HEV) infection and hyperthyroidism was reported in an inactive hepatitis B surface antigen carrier. We experienced two cases of concomitant acute HEV infection in patients with hyperthyroidism. The first case had acute HEV infection with subclinial hyperthyroidism while taking propylthiouracil. The second case suffered from acute HEV infection in a patient with Graves' disease intractable to propylthiouracil. Herein, we suggest the possible association between HEV infection and hyperthyroidism.
Acute Disease ; Adult ; Female ; Hepatitis E/*complications ; Humans ; Hyperthyroidism/*complications/virology ; Male

Adsorption ; Adult ; Female ; Humans ; Hyperthyroidism ; complications ; therapy ; Liver Diseases ; complications ; therapy ; Liver, Artificial ; Male ; Middle Aged

Preoperative euthyroidism is needed to minimize the risk of intraoperative and postoperative complications, such as thyroid storm by surgery. Antithyroid drugs or steroid hormones are commonly used in primary hyperthyroidism for euthyroidism. However, there is no definite consensus for the preoperative management of a TSH secreting pituitary adenoma for the restoration of euthyroidism. Antithyroid drugs are not used for long-term the management of a TSH secreting pituitary adenoma, as they may cause rapid growth and greater invasiveness of the tumor due to a feedback mechanism, but they can be used for short-term management before neurosurgery. We experienced one case of a TSH secreting pituitary adenoma, which showed rapid free thyroid hormone increase due to the short term administration of antithyroid drugs for only 10 days. A somatostatin analogue, octreotide at a dose of 0.1mg, twice a day, was then tried. About 4 weeks later, her serum TSH and free T4 had normalized, with a concomitant clinical improvement. She subsequently underwent an uncomplicated trans-sphenoidal resection of the pituitary adenoma. Antithyroid drugs can induce a rapid thyroid hormone increase, but can only be used for a short-term period, so they should be administered with caution or their use reconsidered
Antithyroid Agents ; Consensus ; Hyperthyroidism ; Neurosurgery ; Octreotide ; Pituitary Neoplasms* ; Postoperative Complications ; Somatostatin ; Thyroid Crisis ; Thyroid Gland* ; Thyrotropin

Preoperative euthyroidism is needed to minimize the risk of intraoperative and postoperative complications, such as thyroid storm by surgery. Antithyroid drugs or steroid hormones are commonly used in primary hyperthyroidism for euthyroidism. However, there is no definite consensus for the preoperative management of a TSH secreting pituitary adenoma for the restoration of euthyroidism. Antithyroid drugs are not used for long-term the management of a TSH secreting pituitary adenoma, as they may cause rapid growth and greater invasiveness of the tumor due to a feedback mechanism, but they can be used for short-term management before neurosurgery. We experienced one case of a TSH secreting pituitary adenoma, which showed rapid free thyroid hormone increase due to the short term administration of antithyroid drugs for only 10 days. A somatostatin analogue, octreotide at a dose of 0.1mg, twice a day, was then tried. About 4 weeks later, her serum TSH and free T4 had normalized, with a concomitant clinical improvement. She subsequently underwent an uncomplicated trans-sphenoidal resection of the pituitary adenoma. Antithyroid drugs can induce a rapid thyroid hormone increase, but can only be used for a short-term period, so they should be administered with caution or their use reconsidered
Antithyroid Agents ; Consensus ; Hyperthyroidism ; Neurosurgery ; Octreotide ; Pituitary Neoplasms* ; Postoperative Complications ; Somatostatin ; Thyroid Crisis ; Thyroid Gland* ; Thyrotropin

Adolescent ; Humans ; Hyperthyroidism ; etiology ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications

INTRODUCTIONSubclinical hyperthyroidism (SH, grade 1, thyrotropin (TSH) ≥0.1 mU/L and grade 2, TSH <0.1 mU/L) is a common disorder with increased prevalence in older subjects. There is evidence for increased morbidities in SH, such as atrial fibrillation and osteoporosis. We aim to study the natural history and comorbidities of SH from patients referred to a tertiary endocrine clinic in Singapore as they are currently unknown.

MATERIALS AND METHODSRetrospective evaluation of SH subjects for natural progression and comorbidities.

RESULTSOne hundred and thirteen SH subjects (male/female: 24/89, mean age: 67.2 years, grade 1/grade 2: 60/53) were identified from the endocrine clinic. The aetiology of SH include 52 multinodular goitre, 15 Graves' disease, 7 toxic adenoma and 39 unclassified. A minority of SH patients (5.3 %) progressed to overt hyperthyroidism while 13% remitted to euthyroid state (1 to 3 years with a mean follow-up of 18 months) in the total cohort. Most of the patients remained in SH state during follow-up (50/60 in grade 1 SH and 42/53 in grade SH). However, no single predictive factor could be identified for progression or remission of SH. The prevalence of morbidities in SH subjects include ischaemic heart disease (16.8%), heart failure (8.9%), tachyarrhythmias (13.3%), any cardiovascular disease (28%), cerebrovascular disease (28%), osteoporosis (28%), and any fracture (15.9%).

CONCLUSIONMost of SH cases in our cohort remain in subclinical state with very few progressing to overt hyperthyroidism. Significant proportion of SH subjects have vascular disease, but this association needs to be confirmed in prospective controlled studies.

Aged ; Disease Progression ; Female ; Humans ; Hyperthyroidism ; complications ; diagnosis ; Male ; Prospective Studies ; Tertiary Care Centers

PURPOSE: Subtotal thyroidectomy has been the standard operation for Graves' disease in achieving a favorable outcome in recovery of euthyroid state. However, the postoperative outcomes following subtotal thyroidectomy differ by surgeon and postoperative thyroid dysfunctions develop as time passes. Here, we have studied the validity of total thyroidectomy for Graves' disease patients, with a comparison to subtotal thyroidectomy. METHODS: A total of 299 patients with Graves' disease underwent thyroid operation consecutively in Asan Medical Center, Seoul, Korea from December 1995 to December 2005. Among them, 241 cases had subtotal thyroidectomy and 43 had total thyroidectomy. The subtotal thyroidectomy cases were divided into 3 groups according to estimated remnant thyroid; <4 g, 4< or =~<6 g and > or =6 g. Also, according to postoperative thyroid function, the patients were divided into euthyroid, hypothyroidism and hyperthyroidism groups. The postoperative changes of thyroid function, postoperative complications and hospital days were analyzed. RESULTS: In subtotal thyroidectomy, postoperative thyroid function showed euthyroid in 25 (10.4%), hypothyroidism 206 (85.5%) and hyperthyroidism 10 (4.1%). However, total thyroidectomy showed no persistent hyperthyroidism or recurrence. The postoperative thyroid function state changed in 24 patients out of 148 who had more than 2 years postoperative follow-up. Hyper-functional changes developed with higher rates (Hypo-6 vs. hyper-18). The postoperative complication rate was higher in subtotal thyroidectomy including bleeding, hoarseness and hypocalcemia. CONCLUSION: In our study, the patients showing normal thyroid function after subtotal thyroidectomy were very limited and thyroid dysfunction developed continuously with time lapse, especially towards hyperthyroid state. Therefore, we suggest that total thyroidectomy should be considered as a treatment option in Graves' disease.
Follow-Up Studies ; Graves Disease ; Hemorrhage ; Hoarseness ; Humans ; Hyperthyroidism ; Hypocalcemia ; Hypothyroidism ; Korea ; Postoperative Complications ; Recurrence ; Thyroid Gland ; Thyroidectomy

BACKGROUND: The optimal extent of thyroid resection in Graves' disease has not been clearly determined. A significant proportion of patients experience recurrence of the disease after subtotal thyroidectomy. Total thyroidectomy can eliminate the source of the disease. However, many surgeons are reluctant to conduct a total thyroidectomy because it has been known to be associated with increased postoperative morbidity. METHODS: Thirty-six patients underwent subtotal thyroidectomy (ST, n=19) or total/near total thyroidectomy (T/NT, n=17) for Graves' disease after treatment with antithyroid drugs. Relapse of the hyperthyroidism, surgical complications, and serum calcium levels were evaluated. RESULTS: Operation time was not prolonged by the extent of thyroidectomy (ST: 106+/-32.1 min., T/NT: 118+/-34.3 min.). Transient hypocalcemia was observed in 5 patients (29.4%) after a total or a near total thyroidectomy, whereas 3 patients (15.7%) experienced transient hypocalcemia after a subtotal thyroidectomy. All patients showed normal serum calcium level 1 month after the operation and had become free of hypocalcemic symptoms. No patient had injury to the recurrent laryngeal nerve, regardless of the extent of the surgery. Recurrence of the hyperthyroidism was observed in 3 patients who had undergone a subtotal thyroidectomy. CONCLUSIONS: Total thyroidectomy can be conducted safely in patients with Graves' disease without any increase in postoperative complications, such as hypoparathyroidism or injury to the recurrent laryngeal nerve. Therefore, total thyroidectomy appears to be an effective alternative treatment modality for Graves' disease.
Antithyroid Agents ; Calcium ; Graves Disease* ; Humans ; Hyperthyroidism ; Hypocalcemia ; Hypoparathyroidism ; Postoperative Complications ; Recurrence ; Recurrent Laryngeal Nerve ; Thyroid Gland ; Thyroidectomy*