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Indian Journal of Pediatrics 1999The neurobehavioural and neuropsychiatric changes associated with thyrotoxicosis are multiple and varied. This association is well recognised although the true incidence... (Review)
Review
The neurobehavioural and neuropsychiatric changes associated with thyrotoxicosis are multiple and varied. This association is well recognised although the true incidence of neuropsychiatric symptoms in thyrotoxicosis is not known. Review of available literature suggests that frank psychiatric symptoms in thyrotoxicosis may be in the order of 10%. In pediatric thyrotoxicosis the neuropsychiatric symptoms may be pronounced and may antedate the medical diagnosis by six months to one year. One of the classic presentation is deterioration in school performance. Frequently noticed cognitive and behavioural abnormalities in pediatric thyrotoxicosis are hyperactivity, irritability or anxious dysphoria, and problems of attention. Successful treatment of thyrotoxicosis usually leads to resolution of the major mental disturbances associated with it and delayed treatment possibly results in enduring neuropsychiatric problems. Awareness of neuropsychiatric symptomatology can help in early detection and appropriate management of children with thyrotoxicosis.
Topics: Adolescent; Attention Deficit Disorder with Hyperactivity; Child; Child Behavior Disorders; Female; Goiter; Humans; Mental Disorders; Thyrotoxicosis
PubMed: 10798069
DOI: 10.1007/BF02761219 -
Recenti Progressi in Medicina Nov 2005Overt thyrotoxicosis is defined as elevated serum free thyroxine (FT4) and free triiodothyronine (FT3), and suppressed thyrotropin (TSH) concentrations. Thyrotoxicosis... (Review)
Review
Overt thyrotoxicosis is defined as elevated serum free thyroxine (FT4) and free triiodothyronine (FT3), and suppressed thyrotropin (TSH) concentrations. Thyrotoxicosis with TSH suppression only (TTSO), and normal thyroid hormone concentrations, is also defined as mild thyrotoxicosis. Both overt thyrotoxicosis and TTSO may be caused by the same thyroid disorders. The most common cause of thyrotoxicosis is the use of excessive doses of L-thyroxine for the treatment of hypothyroidism, non-toxic goiter or thyroid carcinoma (exogenous thyrotoxicosis). Less commonly, the cause of thyrotoxicosis is endogenous. The endogenous thyrotoxicosis may be due to either overproduction and release of thyroid hormones from the gland with normal/high 24-hour thyroid radioiodine uptake (e.g., Graves disease and toxic nodular goiter), or release of excess thyroid hormones due to follicle disruption with low/absent 24-hour thyroid radioiodine uptake (e.g., sub-acute de Quervain thyroiditis). The present report briefly reviews the current problems regarding the clinical and therapeutical approach to thyrotoxicosis, and in particular the TTSO.
Topics: Humans; Thyrotoxicosis; Thyrotropin; Thyroxine; Triiodothyronine
PubMed: 16499167
DOI: No ID Found -
Schweizerische Medizinische... Oct 2000Amiodarone is the most important drug in the treatment of ventricular arrhythmias and is widely used for atrial fibrillation. Thyrotoxicosis, a classical side effect,... (Review)
Review
Amiodarone is the most important drug in the treatment of ventricular arrhythmias and is widely used for atrial fibrillation. Thyrotoxicosis, a classical side effect, was thought to be iodine induced, but recent evidence suggests that other mechanisms play an important role (toxic effect on thyreocytes, immunological effects). Thyrotoxicosis due to amiodarone is difficult to treat and is further complicated by the pro-arrhythmic potential of thyrotoxicosis and the fading antiarrhythmic effect after amiodarone withdrawal. The mechanism, diagnosis and therapy of amiodarone-induced thyrotoxicosis are discussed in the light of the available literature.
Topics: Amiodarone; Anti-Arrhythmia Agents; Atrial Fibrillation; Humans; Thyrotoxicosis
PubMed: 11100515
DOI: No ID Found -
Journal of Investigative Medicine High... 2022Acute suppurative thyroiditis is a rare and potentially life-threatening cause of thyroid inflammation requiring prompt recognition and management. There are few...
Acute suppurative thyroiditis is a rare and potentially life-threatening cause of thyroid inflammation requiring prompt recognition and management. There are few reported cases of thyrotoxicosis due to acute suppurative thyroiditis. We are reporting the case of a 9-year-old boy who presented to the emergency room with fevers, neck pain and swelling, night terrors, and emotional lability. He was hemodynamically stable with initial lab work remarkable for neutrophilia without leukocytosis, elevated inflammatory markers, and hyperthyroidism. Imaging of the neck revealed a heterogenous collection in the region of the left thyroid concerning for suppurative thyroiditis and adenitis. He was admitted to the hospital and initiated on intravenous antibiotics. Given lack of significant improvement in pain, he was taken to the operating room for drainage on hospital day 4 with remarkable clinical improvement in pain. He was discharged on oral antibiotics. Lab work obtained on postoperative day 15 showed resolution of hyperthyroidism and decreasing inflammatory markers. Subsequent imaging following resolution of the acute illness did not reveal any anatomic abnormality that may have predisposed him to developing acute suppurative thyroiditis. Thyrotoxicosis as a complication of acute suppurative thyroiditis is a rare occurrence, and is thought to be due to the release of preformed thyroid hormone from damaged thyroid follicles. The thyrotoxic state is often transient and resolves with appropriate management of acute suppurative thyroiditis. This complication is important to recognize, as failure to appropriately diagnose and treat acute suppurative thyroiditis can lead to poor outcomes, such as airway compromise and death.
Topics: Anti-Bacterial Agents; Child; Humans; Male; Pain; Thyroiditis, Suppurative; Thyrotoxicosis
PubMed: 36245235
DOI: 10.1177/23247096221127841 -
Archives of Internal Medicine
Topics: Adult; Female; Humans; Iodine; Thyrotoxicosis; Travel; Water Purification
PubMed: 9701112
DOI: 10.1001/archinte.158.15.1723 -
Xianggang Hu Li Za Zhi. the Hong Kong... 1989
Topics: Humans; Thyrotoxicosis
PubMed: 2753452
DOI: No ID Found -
The Australian and New Zealand Journal... Mar 2000Tasmania is an area of endemic iodine deficiency. Amiodarone is a class III anti-arrhythmic drug that is widely used for the management of ventricular and... (Review)
Review
BACKGROUND
Tasmania is an area of endemic iodine deficiency. Amiodarone is a class III anti-arrhythmic drug that is widely used for the management of ventricular and supraventricular tachydysrhythmias. Individuals from areas of endemic iodine deficiency appear more likely to manifest hyperthyroidism following amiodarone therapy, whereas hypothyroidism is a more frequent complication in iodine-replete communities.
METHODS
Cases series. The clinical and biochemical response to medical and surgical management of five consecutive Tasmanian patients presenting with severe type-II amiodarone-associated thyrotoxicosis was reviewed.
RESULTS
Five patients were identified. Combinations of antithyroid therapy including propylthiouracil, lithium carbonate, dexamethasone and cholestyramine were used. Thyroidectomy was required in two cases (40%) due to severe unremitting thyrotoxicosis despite combined drug regimens. Anaesthesia and total thyroidectomy were undertaken without complication despite the presence of severe hyperthyroidism at the time of surgery. In both cases thyroid histopathology demonstrated degenerative and destructive follicular lesions with multinuclear cell infiltrate and focal fibrosis.
CONCLUSION
Amiodarone-associated thyrotoxicosis may be severe and refractory to medical therapy. Despite the potential risks of anaesthesia associated with uncontrolled thyrotoxicosis, thyroidectomy should be considered in the setting of life-threatening thyrotoxicosis.
Topics: Acute Disease; Aged; Amiodarone; Anti-Arrhythmia Agents; Humans; Male; Middle Aged; Tasmania; Thyroid Gland; Thyroidectomy; Thyrotoxicosis; Treatment Outcome
PubMed: 10765898
DOI: 10.1046/j.1440-1622.2000.01780.x -
CMAJ : Canadian Medical Association... Feb 2013
Topics: Aged; Angioplasty, Balloon, Coronary; Antithyroid Agents; Carbimazole; Contrast Media; Diagnosis, Differential; Heart Failure; Humans; Male; Radiography; Stents; Thyrotoxicosis; Triiodobenzoic Acids
PubMed: 23148056
DOI: 10.1503/cmaj.120734 -
Annals of Internal Medicine Jul 1999
Topics: Adult; Amiodarone; Cardiovascular Diseases; Contraindications; Humans; Male; Middle Aged; Plasmapheresis; Preoperative Care; Risk Factors; Thyrotoxicosis
PubMed: 10391824
DOI: 10.7326/0003-4819-131-1-199907060-00023 -
Acute Medicine 2021A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high...
A 30-year-old female patient with a past medical history of pernicious anaemia presented with pleuritic chest pain, palpitations, fatigue, coryzal symptoms and a high temperature. She was hypoxic and tachycardic and was extensively investigated as well as aggressively treated. A type 1 'gut feeling' assessment by the admitting medical registrar made the diagnosis possible as thyroid function tests were grossly deranged and pointed to Graves' disease causing heart failure, complicated by pneumonia. The patient was discharged on carbimazole, antibiotics and beta blockers. Due to a resultant thrombocytopaenia, she has now been swapped onto propylthiouracil and is under active follow up.
Topics: Adult; Antithyroid Agents; Female; Graves Disease; Heart Failure; Humans; Propylthiouracil; Thyrotoxicosis
PubMed: 33749695
DOI: No ID Found