Female ; Humans ; Hyperthyroidism ; drug therapy ; etiology ; Infant, Newborn ; Male

Graves' disease (GD) accounts for 10%-15% of thyroid disorders in children and adolescents. The use of antithyroid drugs as the initial treatment option in GD is well accepted. An average two years remission is achieved in about 30% of children treated with antithyroid drugs. However, the optimal treatment duration and the predictive marker of remission after antithyroid drug therapy are still controversial. Additionally, 131I therapy and surgery are considered the option for treatment in children and adolescents with GD. We review the treatment options for pediatric GD and the possible determinants of remission and relapse on antithyroid drug treatment in children and adolescents.
Adolescent* ; Antithyroid Agents ; Child* ; Drug Therapy ; Graves Disease* ; Humans ; Hyperthyroidism ; Recurrence ; Thyroid Gland

OBJECTIVETo investigate the value of iodine-131 therapy for hyperthyroidism complicated hyperthyroid heart disease(HHD) induced by Graves' disease or Plummer disease.

METHODSTotally 40 HHD cases who were confirmed in our department from 2009 to 2010 were enrolled in this study. All patients received serum thyroid hormones and associated antibodies tests, 12-lead electrocardiogram, and/or thyroid imaging before and after iodine-131 therapy to access the treatment effectiveness.

RESULTSAmong 31 patients with HHD due to Graves' disease and 9 due to Plummer disease, iodine-131 treatment resulted in euthyroidism in 15 and 5 patients and hypothyroid in 7 and 2 patients, while 9 and 2 remain hyperthyroid, respectively.Serum free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were statistically significant(P<0.05) before and after iodine-131 therapy, while no significant difference for serum thyrotrophin receptor antibody, antithyroid peroxidase autoantibody, and anti-thyroglobulin antibody.Atrial fibrillation was the most common cardiac complication of hyperthyroidism(n=25, 62.5%) .The remission rate after iodine-131 treatment was 76.0%.

CONCLUSIONIodine-131 therapy can effectively and timely control hyperthyroid in HHD patients.

Adult ; Heart Diseases ; drug therapy ; etiology ; Humans ; Hyperthyroidism ; complications ; drug therapy ; Iodine Radioisotopes ; therapeutic use ; Middle Aged

OBJECTIVETo observe the clinical efficacy of Jiakangling Capsule (JC) combined with reduction of 1311 in treatment of Graves hyperthyroidism.

METHODSTotally 387 Graves hyperthyroidism patients were randomly assigned to the treatment group (200 cases) and the control group (187 cases). Patients in the treatment group took JC combined with reduction of 131I. The 131I dosage per gram of thyroid tissue was 50-80 microCi. They additionally took JC one week after taking 1311 for one consecutive month. Patients in the control group took 131 routinely as one disposable treatment. The 131I dosage per gram of thyroid tissue was 70-120 microCi, without using JC or other anti-thyroid drugs. All patients were reexamined after 24-month treatment. Whether hyperthyroidism was cured, incurred, or permanent was observed. Efficacies of thyroglobulin antibody (TGAb) and thyroid microsome antibody (TMAb) were compared between the two groups.

RESULTSCompared with the control group, the incurred ratio increased in the treatment group [3.2% (6/187) vs. 16.0% (32/200), P < 0.01], the incurred ratio of strong positive TGAb and TMAb patients increased [3.5% (2/57) vs. 27.1% (16/59), P < 0.01], the permanent hypothyroidism ratio decreased [21.1% (12/57) vs. 3.4% (2/59), P < 0.05 ].

CONCLUSIONJC combined with reduction of 1311 was superior in treating Graves hyperthyroidism induced permanent hypothyroidism than routine 1311 treatment, especially for strong positive TGAb and TMAb patients.

Autoantibodies ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Graves Disease ; drug therapy ; Humans ; Hyperthyroidism ; drug therapy ; Hypothyroidism ; Iodine Radioisotopes

Climacteric ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperthyroidism ; drug therapy ; Methimazole ; therapeutic use ; Middle Aged ; Phytotherapy

Adult ; Carbimazole ; therapeutic use ; China ; Cholestyramine Resin ; therapeutic use ; Female ; Graves Disease ; drug therapy ; Humans ; Hyperthyroidism ; drug therapy ; Patient Admission ; Sepsis ; complications ; Thyroid Gland ; drug effects ; Treatment Outcome

PURPOSE: This study was carried out to evaluate the age and sex distribution, clinical manifestation, presence of the antithyroid antibody, the clinical outcome following antithyroid drug treatment in children with Graves' disease. METHODS: A total 45 children with Graves' disease were entered into the study. Diagnosis was based on clinical manifestation, elevated thyroid function and increased homogeneous 99mTc thyroid uptake on thyroid scan. All patient were treated with prophylthiouracil or methimazole, and assessed concerning about clinical symptoms and signs, existence of antithyroid antibody and states of thyroid function and outcome following antithyroid drug treatment during 3 years of therapy. Remission was defined as a euthyroid state without clinical manifestation and presence of TRAb, while relapse was defined as the recurrence of hyperthyroidism within 12 months of no medication after antithyroid therapy at least for 3 years. RESULTS: 1) The most prevalent age group was 10 to 15 years(82.8%) and female is more prevalent than male(M : F=1 : 14). 2) Goiter, emotional instability, hyperactivity, palpitation, sweating and exophthalmos are the most common symptoms in orders.3) The detection rate of TRAb, AMA and ATA before treatment were 93.3%, 86.7% and 62.2% respectively. 4) The euthyroid state showed in 36(80.0%) of 45 patients within 8 weeks after treatment. 5) The TRAb values remained positive in 27(60.0%) of 45 patients during the first 1 year of antithyroid therapy. 6) Remission rate was 58.8%(26 cases) and relapse rate of remission cases 73.1%. CONCLUSIONS: The present study suggests that children with Graves' disease will continue to require long term clinical and laboratory assessment after discontinuation of antithyroid drug therapy.
Child* ; Diagnosis ; Drug Therapy ; Exophthalmos ; Female ; Goiter ; Graves Disease* ; Humans ; Hyperthyroidism ; Methimazole ; Recurrence* ; Sex Distribution ; Sweat ; Sweating ; Thyroid Gland

Raynaud syndrome is a medical condition that causes pain, numbness, and changes in skin color at the distal extremities. Raynaud syndrome can be subdivided into primary Raynaud's and secondary Raynaud's. The former is diagnosed when the cause is unknown and the latter is caused by an underlying condition, such as connective tissue diseases, injury, smoking, or certain medications. Both cancer chemotherapy and β-blockers are relatively common causes of Raynaud syndrome but there are no reports of its association with methimazole administration. The authors encountered a 43-year old woman with hyperthyroidism who developed digital ulcers associated with Raynaud syndrome after a methimazole treatment. Her digital ulcers and Raynaud syndrome were improved after methimazole was replaced with propylthiouracil and conventional therapy. This paper reports this case along with a review of the relevant literature.
Connective Tissue Diseases ; Drug Therapy ; Extremities ; Female ; Humans ; Hyperthyroidism ; Hypesthesia ; Methimazole* ; Propylthiouracil ; Skin Pigmentation ; Smoke ; Smoking ; Ulcer

OBJECTIVETo evaluate the relationship between the incidence of abnormal thyroid function of newborns and maternal hyperthyroidism with antithyroid drug therapy.

METHODThe clinical data of 35 neonates born to mothers with hyperthyroidism from 1983 to 2003 in Peking Union Medical College Hospital were retrospectively analyzed. According to the maternal thyroid function and the antithyroid drugs taken during pregnancy, subjects were divided into different groups.

RESULTSThe proportion of abnormal thyroid function in newborn was 48.6% (17/35). The prevalences of primary hypothyroidism, subclinical hypothyroidism, hypothyroxinemia, and central hypothyroidism were 29.4%, 29.4%, 35.3%, and 5.9%, respectively. The incidence of abnormal thyroid function of neonates whose mothers did not take the antithyroid drugs (ATDs) until the third trimester of pregnancy was significantly higher than those without and with ATDs during the first or second trimester (P < 0.01). The incidence of abnormal thyroid function significantly increased in premature neonates, neonates whose mothers with modest or heavy pregnant hypertension, or neonates whose core serum thyroid-stimulating hormone or serum anti-thyroid peroxidase antibodies levels were abnormal.

CONCLUSIONThe risk of abnormal thyroid function of infants whose hyperthyroid mothers did not take ATDs until the third trimester of pregnancy may be increased. Prompt diagnosis and appropriate treatment of hyperthyroidism in pregnant women are essential for the prevention of neonatal thyroid functional abnormality.

Adult ; Antithyroid Agents ; adverse effects ; Female ; Humans ; Hyperthyroidism ; complications ; drug therapy ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications ; drug therapy ; Retrospective Studies ; Thyroid Diseases ; congenital ; epidemiology ; etiology ; Time Factors

OBJECTIVETo observe the therapeutic effect of combined therapy of modified Kangjia Recipe (KR) and western medicine propylthiouracil (PTU) on hyperthyroidism and to assess its advantage.

METHODSNinety patients with hyperthyroidism were divided into the treatment group (TG) and the control group (CG). The 60 patients in TG treated with KR and PTU, and the 30 patients in CG treated with PTU alone. The treatment course of both groups was 3 months. The serum thyroid hormone (TH) level, clinical symptoms and signs, and adverse reaction were observed before and after treatment.

RESULTSThe serum TH level, clinical symptoms and signs were significantly improved after treatment in both groups (all P < 0.01). The total effective rate was 93.3% in TG, which was higher than that in CG (83.3%, P < 0.01); and the efficacy in improving palpitation, fidget, aversion to heat, sweating and insomnia was better in the TG than that in the CG respectively (P < 0.05). As for the incidence of adverse reaction, it that was lower in the TG than in the CG.

CONCLUSIONKD has good efficacy in treating hyperthyroidism, and the combined treatment of Chinese and Western medicine shows obvious advantages.

Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Hyperthyroidism ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Propylthiouracil ; administration & dosage