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https://www.readbyqxmd.com/read/28912982/severe-thyrotoxicosis-secondary-to-povidone-iodine-from-peritoneal-dialysis
#1
Kirstie Lithgow, Christopher Symonds
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28878279/changes-in-resting-state-cerebral-activity-in-patients-with-hyperthyroidism-a-short-term-follow-up-functional-mr-imaging-study
#2
Bo Liu, Qian Ran, Daihong Liu, Si Zhang, Dong Zhang
To investigate the brain functional abnormality of hyperthyroid patients before and after treatment for one month using resting-state functional magnetic resonance imaging (rs-fMRI). Amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analysis were performed in 27 new-onset untreated hyperthyroid patients relative to 30 healthy controls. In addition, follow-up data were available for 19 patients treated with methimazole for one month. Compared with healthy controls, patients exhibited lower ALFF in the right posterior cingulate cortex (PCC); increased FC in the bilateral anterior insula (AI), bilateral posterior insula (PI) and left anterior lobe of the cerebellum (ALC); and decreased FC in the bilateral lateral prefrontal cortex (LPFC), the right medial temporal gyrus (MTG) and the bilateral PCC...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28870408/thyroid-storm-and-warm-autoimmune-hemolytic-anemia
#3
Joseph A Moore, Louise Gliga, Srikanth Nagalla
Graves' disease is often associated with other autoimmune disorders, including rare associations with autoimmune hemolytic anemia (AIHA). We describe a unique presentation of thyroid storm and warm AIHA diagnosed concurrently in a young female with hyperthyroidism. The patient presented with nausea, vomiting, diarrhea and altered mental status. Laboratory studies revealed hemoglobin 3.9g/dL, platelets 171×10(9)L(-1), haptoglobin <5mg/dL, reticulocytosis, and positive direct antiglobulin test (IgG, C3d, warm)...
August 18, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28804147/ismp-adverse-drug-reactions-levofloxacin-induced-neuroexcitation-and-hallucinations-statin-induced-muscle-rupture-mefloquine-induced-rhabdomyolysis-methimazole-induced-cholestatic-hepatitis-decitabine-induced-hand-and-foot-syndrome
#4
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: mmancano@temple.edu). Your report will be published anonymously unless otherwise requested...
May 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28781778/glucose-metabolism-before-and-after-radioiodine-therapy-of-a-patient-with-graves-disease-assessment-by-continuous-glucose-monitoring
#5
Yun Hu, Gu Gao, Reng-Na Yan, Feng-Fei Li, Xiao-Fei Su, Jian-Hua Ma
Hyperthyroidism causes impaired glucose tolerance, insulin resistance (IR) and insulin secretion. However, the glucose variability affected by thyroid dysfunction remains unclear. Glucose variability was assessed by continuous glucose monitoring (CGM) in a non-diabetic patient with Graves' disease (GD), to the best of our knowledge, for the first time. A 28-year-old man with GD, who had been taking methimazole for 4 years, was treated with radioiodine on August 17th 2016. Although the patient exhibited normal glycated hemoglobin (HbA1c; 5...
August 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28780518/birth-defects-after-use-of-antithyroid-drugs-in-early-pregnancy-a-swedish-nationwide-study
#6
Stine Linding Andersen, Stefan Lönn, Peter Vestergaard, Ove Törring
OBJECTIVE: Antithyroid drugs (ATDs) may have teratogenic effects, but more evidence is needed on the risk and types of birth defects after the use of Methimazole (MMI) and Propylthiouracil (PTU). This study aimed to evaluate the association between the use of ATDs in early pregnancy and birth defects. DESIGN: Swedish nationwide register-based cohort study. METHODS: The study included 684,340 children live-born in Sweden from 2006-2012. Exposure groups defined by maternal ATD use in early pregnancy were: MMI (n=162); PTU (n=218); MMI and PTU (n=66); ATD before or after, but not in pregnancy (n=1,551); and non-exposed (never ATD (n=682,343))...
August 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28767416/effect-of-subclinical-hypothyroidism-on-the-skeletal-system-and-improvement-with-short-term-thyroxine-therapy
#7
Cuixia Gao, Yu Wang, Tingting Li, Jing Huang, Limin Tian
The purpose of the study was to observe changes in the skeletal system of rats with subclinical hypothyroidism (SCH) and to determine whether L-thyroxine (L-T4) administration suppresses those changes. Sixty male Wistar rats were randomly divided into control, SCH, and SCH+T4 groups. SCH was induced in rats by administration of methimazole (MMI), and rats in the SCH+T4 group were treated with L-T4 after 45 days of MMI administration. The SCH group had higher thyroid-stimulating hormone (TSH) level than the control and SCH+T4 groups...
July 26, 2017: Oncotarget
https://www.readbyqxmd.com/read/28759749/effects-of-long-term-oral-administration-of-methimazole-on-femur-and-tibia-properties-in-male-wistar-rats
#8
Marcin R Tatara, Marcin Gołyński, Radosław P Radzki, Marek Bieńko, Witold Krupski
Physiological concentrations of thyroid hormones are crucial for skeletal growth and development, physiological bone turnover and bone homeostasis maintenance. Methimazole (1-methyl-2-mercaptoimidazole) is an antithyroid drug used for the treatment of the hyperthyroidism in humans and animals. The aim of the study was to determine effects of long-term oral methimazole treatment in male Wistar rats on biochemical bone metabolism markers, as well as morphological, geometric, densitometric and mechanical properties of femur and tibia...
July 28, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28750432/hyperthyroidism-in-patients-with-graves-ophthalmopathy-and-thyroidal-skeletal-and-eye-muscle-specific-type-2-deiodinase-enzyme-activities
#9
Ildikó Molnár, József A Szentmiklósi, Éva Somogyiné-Vári
Graves' ophthalmopathy is characterized by hyperthyroidism, which is associated with higher serum T3 levels than T4 due to deiodinase enzymes.The effect of Graves' patient's sera (n=52) with elevated thyroid hormone and TSH receptor or thyroid peroxidase antibody (anti-TPO) levels was investigated on thyroidal, skeletal and eye muscle type 2 deiodinase enzyme (DII) activities. DII activities were measured with (125)I-T4 substrate, while thyroid hormone and antibody levels with immunoassays.In Graves' ophthalmopathy, sera with elevated FT4 or FT3 levels reduced DII activites remarkably in all tissue fractions...
July 27, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28725332/thyrotoxic-valvulopathy-case-report-and-review-of-the-literature
#10
Keniel Pierre, Sushee Gadde, Bassam Omar, G Mustafa Awan, Christopher Malozzi
We report a 42-year-old female who was admitted for abdominal pain, and also endorsed dyspnea, fatigue and chronic palpitations. Past medical history included asthma, patent ductus arteriosus repaired in childhood and ill-defined thyroid disease. Physical examination revealed blood pressure of 136/88 mm Hg and heart rate of 149 beats per minute. Cardiovascular exam revealed an irregularly irregular rhythm, and pulmonary exam revealed mild expiratory wheezing. Abdomen was tender. Electrocardiogram revealed atrial fibrillation with rapid ventricular response which responded to intravenous diltiazem...
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28725155/a-case-of-severe-erythema-nodosum-induced-by-methimazole
#11
Selma Emre, Didem Ozdemir, Sibel Orhun, Goknur Kalkan, Sertac Sener
Erythema nodosum (EN), is the most common variant of septal panniculitis and is possibly a delayed hypersensitivity reaction triggered by a wide range of antigenic stimuli. Hypersensitivity reactions due to medications have been recognized as a cause of 3-10% of EN cases. Case reports of EN associated with the anti-thyroid drugs are quite rarely reported in the literature even if there is a common use of anti-thyroid drugs. We report an EN case due to methimazole. The complaints of patients arose immediately fifteen days after the beginning of methimazole treatment...
July 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28723125/pharmacokinetics-on-a-chip-using-label-free-sers-technique-for-programmable-dual-drug-analysis
#12
Jiayuan Fei, Lei Wu, Yizhi Zhang, Shenfei Zong, Zhuyuan Wang, Yiping Cui
Synergistic effects of dual or multiple drugs have attracted great attention in medical fields, especially in cancer therapies. We provide a programmable microfluidic platform for pharmacokinetic detection of multiple drugs in multiple cells. The well-designed microfluidic platform includes two 2 × 3 microarrays of cell chambers, two gradient generators, and several pneumatic valves. Through the combined use of valves and gradient generators, each chamber can be controlled to infuse different kinds of living cells and drugs with specific concentrations as needed...
June 23, 2017: ACS Sensors
https://www.readbyqxmd.com/read/28716776/increased-risk-for-thionamide-induced-agranulocytosis-in-elderly-patients-a-case-presentation-and-literature-review
#13
Sumera Bukhari, Muhammad Khan, Naresh Kumar, Vinuta Mohan
Thionamides, such as methimazole and propylthiouracil, are used for the management of hyperthyroidism. Agranulocytosis is a rare adverse effect of thionamides and elderly patients are especially vulnerable. Here we discuss a case of an 80-year-old woman who developed agranulocytosis and pneumonia approximately 4 weeks after starting low dose methimazole therapy. Despite aggressive treatment with broad-spectrum antibiotics and granulocyte colony stimulating factor, she developed multiorgan failure and died. Our goals are to identify risk factors common to elderly patients and hopefully improve outcomes in this population when prescribed thionamides...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28702139/ramipril-associated-cholestasis-in-the-setting-of-recurrent-drug-induced-liver-injury
#14
David Forner, Tasha Kulai, Thomas Arnason, Steven E Gruchy, Magnus MacLeod
Aim: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to treat hypertension. Although generally well tolerated, the adverse effects of ACEIs include hypotension, cough, acute kidney injury and hyperkalemia. Rare reports of ACEI-induced hepatotoxicity have been described, most notably a cholestatic pattern of injury related to captopril. A 67-year-old male presented to the emergency department with a three-week history of jaundice, pruritis and weakness. Eight weeks before, he began taking ramipril and clopidogrel...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28690956/thyrotoxicosis-mimicking-st-elevation-myocardial-infarction
#15
Ingrid Rymer De Marchena, Anna Gutman, Julie Zaidan, Harout Yacoub, Wissam Hoyek
Hyperthyroidism is well known to be associated with cardiac disease. Delay in making the diagnosis and occurrence of complications are common and are associated with a worse outcome. A 54-year-old male, non-smoker, with no past medical history and no significant family history presented to our hospital with severe left sided chest pain, "crushing" in nature. Electrocardiogram showed ST-segment elevations in the inferior leads. Troponin I level was 0.32 ng/mL (normal range 0-0.05 ng/mL) on presentation. The patient underwent an emergent coronary angiography which showed no evidence of occlusive coronary artery disease...
June 7, 2017: Curēus
https://www.readbyqxmd.com/read/28685517/free-thyroxine-anti-thyroid-stimulating-hormone-receptor-antibody-titers-and-absence-of-goiter-were-associated-with-responsiveness-to-methimazole-in-patients-with-new-onset-graves-disease
#16
Hoon Sung Choi, Won Sang Yoo
BACKGROUND: Anti-thyroid drug therapy is considered a treatment of choice for Graves' disease; however, treatment response varies among individuals. Although several studies have reported risk factors for relapse after initial treatment, few have assessed responsiveness during the early treatment period. Our study aimed to identify the clinical characteristics for responsiveness to methimazole. METHODS: We included 99 patients diagnosed with Graves' disease for the first time...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28679141/impaired-metabolism-of-selenomethionine-in-graves-disease-a-biokinetics-study-of-soft-gel-capsule-formulation
#17
Leonidas H Duntas, Anastasios Boutsiadis, Athanasios Tsakris
Patients with Graves' disease are known to have low selenium (Se) status, Se supplementation resulting in clinical and biochemical improvement. Selenomethionine (SeMet) in a new soft gel capsule formulation was used in a pilot study in 6 patients with acute Graves' disease and low selenium levels (61.3±12.9 μg/l) before and in 4/6 patients 3 months after combined treatment with methimazole and SeMet 200 μg/day (113.3±46.3 μg/l), as well as in 6 euthyroid controls (82±11.8 μg/l). The biokinetics were studied following ingestion of 200 μg SeMet (single dose) soft gel capsule, Se serum concentrations being measured at various time points within 24 h...
August 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28671971/effects-of-methimazole-and-propylthiouracil-exposure-during-pregnancy-on-the-risk-of-neonatal-congenital-malformations-a-meta-analysis
#18
Rongjing Song, Hepu Lin, Yue Chen, Xiuying Zhang, Wanyu Feng
OBJECTIVE: The aim of this study was to determine the effect of exposure to different antithyroid drugs during pregnancy on the incidence of neonatal congenital malformations. METHODS: A meta-analysis was performed to compare the incidence of neonatal congenital malformations after exposure to different antithyroid drugs during pregnancy. Twelve studies that met the inclusion criteria were included in this meta-analysis. PubMed, Embase, and CENTRAL databases were searched from inception until January 2017...
2017: PloS One
https://www.readbyqxmd.com/read/28653416/design-of-anti-thyroid-drugs-binding-studies-and-structure-determination-of-the-complex-of-lactoperoxidase-with-2-mercaptoimidazole-at-2-30-%C3%A3-resolution
#19
Harsh V Sirohi, Prashant K Singh, Naseer Iqbal, Pradeep Sharma, Amit K Singh, Punit Kaur, Sujata Sharma, Tej P Singh
Lactoperoxidase (LPO) belongs to mammalian heme peroxidase superfamily, which also includes myeloperoxidase (MPO), eosinophil peroxidase (EPO), and thyroid peroxidase (TPO). LPO catalyzes the oxidation of a number of substrates including thiocyanate while TPO catalyzes the biosynthesis of thyroid hormones. LPO is also been shown to catalyze the biosynthesis of thyroid hormones indicating similar functional and structural properties. The binding studies showed that 2-mercaptoimidazole (MZY) bound to LPO with a dissociation constant of 0...
June 27, 2017: Proteins
https://www.readbyqxmd.com/read/28639966/risk-of-embryopathies-with-use-of-antithyroidal-medications
#20
Stine L Andersen
PURPOSE OF REVIEW: Hyperthyroidism in pregnant women should be adequately treated to prevent maternal and fetal complications. The treatment of choice in pregnancy is antithyroidal medications (ATDs). The risk of embryopathies associated with the use of Methimazole (MMI) and Propylthiouracil (PTU) in early pregnancy is a matter of clinical attention and concern. This review describes current evidence and how scientific findings are reflected in current clinical guidelines. RECENT FINDINGS: Embryopathies after the use of ATDs were previously mainly described in case reports and considered rare...
July 20, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
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