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https://www.readbyqxmd.com/read/27809623/onset-of-graves-disease-during-pregnancy-in-a-woman-with-established-hypothyroidism
#1
María Alberiche, Rosa María Sánchez-Hernández, Xabier López Mérida, Ana María Wägner
BACKGROUND: Pregnancy strongly influences the thyroid gland and its function. Thyroid guidelines recommend a 30 to 50% increase of the preconceptional levothyroxine dose in women with hypothyroidism, when pregnancy is diagnosed. CASE: A 33 year-old, 8-week pregnant woman with hypothyroidism, presents with a 2-week history of palpitations, sweating, nervousness and fatigue. Physical examination shows tachycardia (108 bpm), distal tremors and diffuse goiter. After biochemical confirmation of hyperthyroidism, her levothyroxine dose is reduced and finally interrupted...
November 4, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27798756/the-economic-impact-of-levothyroxine-dose-adjustments-the-control-he-study
#2
Frank R Ernst, Peri Barr, Riad Elmor, Walter Sandulli, Lionel Thevathasan, Arnold B Sterman, Jessica Goldenberg, Kevin Vora
BACKGROUND: In general, hypothyroidism can be adequately treated with a consistent daily dose of levothyroxine. However, the need for levothyroxine dose adjustments is frequent in clinical practice. The extent to which levothyroxine dose adjustments increase the utilization of healthcare resources has not previously been described in the clinical literature. OBJECTIVE: The primary objective of our study was to measure the effect of levothyroxine dose adjustments in terms of their utilization of healthcare resources including direct and indirect costs...
October 31, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27793241/seizure-due-to-multiple-drugs-intoxication-a-case-report
#3
Handan Gulec, Munire Babayigit, Aysun Kurtay, Mehmet Sahap, Fatma Ulus, Zehra Tutal, Eyup Horasanli
The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2h, the patient had a generalized tonic-clonic seizure...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27785940/therapeutic-effects-of-blue-honeysuckle-on-lesions-of-hyperthyroidism-in-rats
#4
Sang-In Park, Young Joon Lee, Seong Hun Choi, Soo Jin Park, Chang-Hyun Song, Sae-Kwang Ku
Hyperthyroidism is a hypermetabolic syndrome characterized by an overproduction of thyroid hormones, which enhances the hormone-induced oxidative stress responsible for some complications in the liver, heart and muscle. Blue honeysuckle (BH) is an edible berry, rich in polyphenols, especially flavonoids or anthocyanins, known as strong antioxidants. The chemo-protective activities of the berry have been connected to the improvement of symptoms in cancer, diabetes mellitus, tumor or cardiovascular diseases. Therefore, the therapeutic effects of BH were examined in hyperthyroidism rat model...
2016: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/27779557/variable-linezolid-exposure-in-icu-patients-possible-role-of-drug-drug-interactions
#5
Christoph Töpper, Cathérine Louise Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. ICU patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. PATIENTS AND METHODS: Plasma concentrations of linezolid were determined by HPLC in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily. Ultrafiltration applying physiological conditions (pH 7...
October 24, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27774323/syndrome-of-reduced-sensitivity-to-thyroid-hormones-two-case-reports-and-a-literature-review
#6
Anastasios Anyfantakis, Dimitrios Anyfantakis, Irene Vourliotaki
Resistance to thyroid hormone (RTH) is an extremely rare dominantly inherited condition of impaired tissue responsiveness to thyroid hormone (TH). Most patients with RTH have mutations in the gene that encodes the β isoform of the receptor of thyroid hormone (THR-β gene). Mutant receptors are unable to activate or repress target genes. The majority of them are asymptomatic or rarely have hypo- or hyperthyroidism. RTH is suspected by the finding of persistent elevation of serum levels of free T3 (FT3) and free T4 (FT4) and nonsuppressed TSH...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27766119/study-of-optimal-replacement-of-thyroxine-in-the-elderly-sorted-results-from-the-feasibility-randomised-controlled-trial
#7
Salman Razvi, Lorna Ingoe, Vicky Ryan, Simon H S Pearce, Scott Wilkes
BACKGROUND: Hypothyroidism is a common condition, particularly in the older population. Thyroid hormone requirements change with age and serum TSH levels also alter, especially in older patients. However, in practice laboratory reference ranges for thyroid function are not age-specific and treatment in older patients aims to achieve a similar target thyroid function level as younger age groups. METHODS: A dual centre, single blind, randomised controlled trial was conducted to determine the feasibility of a future definitive RCT in hypothyroid individuals aged 80 years or older who were treated with levothyroxine...
2016: Thyroid Research
https://www.readbyqxmd.com/read/27759634/delayed-diagnosis-with-autoimmune-polyglandular-syndrome-type-2-causing-acute-adrenal-crisis-a-case-report
#8
Xiaojing Wang, Fan Ping, Cuijuan Qi, Xinhua Xiao
BACKGROUND: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. METHODS: Here we reported a case of 38-year-old female patient who presented with 2 years' history of Hashimoto's thyroiditis and received levothyroxine replacement...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27749579/drug-drug-interactions-with-imatinib-an-observational-study
#9
Isabelle Récoché, Vanessa Rousseau, Robert Bourrel, Maryse Lapeyre-Mestre, Leila Chebane, Fabien Despas, Jean-Louis Montastruc, Emmanuelle Bondon-Guitton
Many patients treated with imatinib, used in cancer treatment, are using several other drugs that could interact with imatinib. Our aim was to study all the drug-drug interactions (DDIs) observed in patients treated with imatinib.We performed 2 observational studies, between the 1st January 2012 and the 31st August 2015 in the Midi-Pyrénées area (South Western France), using the French health insurance reimbursement database and then the French Pharmacovigilance Database (FPVD).A total of 544 patients received at least 1 reimbursement for imatinib...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27741547/overview-of-hypothyroidism-in-pregnancy
#10
Jeffrey M Kroopnick, Caroline S Kim
Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27718637/new-levothyroxine-formulation-meeting-95-105-specification-over-the-whole-shelf-life-results-from-two-pharmacokinetic-trials
#11
Ulrike Gottwald-Hostalek, Wolfgang Uhl, Peter Wolna, George J Kahaly
OBJECTIVE: Small levothyroxine (L-T4) dose changes can lead to significant clinical effects. To ensure thyroid hormone levels are safely maintained, authorities are increasingly adopting stricter potency specifications for L-T4, the most stringent of these being 95-105% of the labeled dose over the whole shelf-life. Levothyroxine sodium (Euthyrox®, Eutirox®, Lévothyrox®) has been reformulated, and two studies performed to ensure bioequivalence to the currently marketed formulation and dosage form proportionality of the new formulation...
October 8, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27700539/is-a-normal-tsh-synonymous-with-euthyroidism-in-levothyroxine-monotherapy
#12
Sarah J Peterson, Elizabeth A McAninch, Antonio C Bianco
CONTEXT: Levothyroxine (LT4) monotherapy is the standard of care for hypothyroidism. OBJECTIVE: To determine whether LT4 at doses that normalize the serum TSH is associated with normal markers of thyroid status. DESIGN: Cross-sectional data from the US National Health and Nutrition Examination Survey (2001-2012) was used to evaluate 52 clinical parameters. LT4-users were compared to healthy controls and controls matched for age, sex, race, and serum TSH...
October 4, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27633516/thyroid-stimulating-hormone-in-thyroid-cancer-does-it-matter
#13
Hannah Rachael Nieto, Kristien Boelaert
Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours is critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer and whilst there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid stimulating hormone (TSH) is raised in patients with malignant thyroid nodules compared to those with benign disease, and TSH is proportionally higher in more aggressive tumours...
September 15, 2016: Endocrine-related Cancer
https://www.readbyqxmd.com/read/27631464/variable-linezolid-exposure-in-intensive-care-unit-patients-possible-role-of-drug-drug-interactions
#14
Christoph Töpper, Cathérine L Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. Intensive care unit (ICU) patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. METHODS: Plasma concentrations of linezolid were determined by high-performance liquid chromatography in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily...
October 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27631398/myxedema-coma-secondary-to-central-hypothyroidism-a-rare-but-real-cause-of-altered-mental-status-in-pediatrics
#15
Michael D Thompson, Rohan K Henry
BACKGROUND: Myxedema coma (MC), a medical emergency defined as severe hypothyroidism leading to altered mental status, is more common in older women with hypothyroidism. METHODS/RESULTS: A 7-year-old Caucasian male with chromosome 1q deletion presented with altered mental status preceded by milestone regression. His presenting labs results were: thyroid-stimulating hormone (TSH) 0.501 μIU/ml and free thyroxine (T4) <0.5 ng/dl. His morning cortisol level was 8...
September 16, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27560633/newly-diagnosed-primary-hypothyroidism-applicant-with-massive-pericardial-effusion-and-acute-renal-failure
#16
I Ates, M Kaplan, N Yilmaz
OBJECTIVE: While non-symptomatic pericardial effusion is seen in primary hypothyroidism, massive pericardial effusion is a very rare finding. In the literature, newly diagnosed primary hypothyroidism cases presenting with massive pericardial effusion or acute renal failure are present, but we did not encounter any case first presenting with combination of two signs. In this case report, primary hypothyroidism case that presenting with massive pericardial effusion and acute renal failure will be discussed...
January 2016: Endocrine Regulations
https://www.readbyqxmd.com/read/27546693/the-effect-of-metformin-on-tsh-levels-in-euthyroid-and-hypothyroid-newly-diagnosed-diabetes-mellitus-type-2-patients
#17
D Dimic, M Velojic Golubovic, S Radenkovic, D Radojkovic, M Pesic
INTRODUCTION: Metformin is the first-line oral hypoglycemic agent in the treatment of type 2 diabetes mellitus with a number of positive effects. The aim of the study was to determine the effect of metformin on TSH levels in euthyroid and hypothyroid newly diagnosed diabetes mellitus type 2 patients. MATERIAL AND METHODS: The study included 255 newly diagnosed diabetes mellitus type 2 drug naive patients, 170 euthyroid patinets, group A, 85 hypothiroid patients, group B, and 80 euthyroid DM type 2 patients on metformin therapy for more than 5 years, group C...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27542000/serum-thyroglobulin-in-the-monitoring-of-differentiated-thyroid-cancer
#18
Carol Evans, Sarah Tennant, Petros Perros
Patients with differentiated thyroid cancer (DTC) usually have an excellent prognosis. Following surgical and radioiodine treatment to remove the cancer cells and suppressive doses of levothyroxine, long-term follow-up, including measurement of serum thyroglobulin (Tg) using a sensitive assay is required to detect recurrence. To interpret Tg results clinicians need to know the corresponding serum TSH concentration, have an appreciation of the clearance of Tg from patient serum following various interventions and the limitations of its measurement...
2016: Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum
https://www.readbyqxmd.com/read/27540557/severe-tsh-elevation-and-pituitary-enlargement-after-changing-thyroid-replacement-to-compounded-t4-t3-therapy
#19
Adlai L Pappy, Nelson Oyesiku, Adriana Ioachimescu
We present the first case of iatrogenic hypothyroidism as a result of compounded thyroid hormone (T4/T3) therapy. The thyroid replacement was changed from 175 µg levothyroxine (LT4) to 57/13.5 µg compounded T4/T3 daily in order to improve the T3 level, despite normal thyroid-stimulating hormone (TSH). This resulted in clinical manifestations of hypothyroidism and high TSH level (150 µIU/mL). Six months later, the patient was referred to our clinic for abnormal pituitary magnetic resonance imaging. On reinitiating a physiologic dose of LT4, clinical and biochemical abnormalities resolved and the pituitary gland size decreased...
July 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/27538922/unexpected-elevated-free-thyroid-hormones-in-pregnancy
#20
Claudia Teti, Elena Nazzari, Marina Raffaella Galletti, Mattia Grazia Mandolfino, Francesca Pupo, Giampaola Pesce, Flavia Lillo, Marcello Bagnasco, Salvatore Benvenga
BACKGROUND: The use of thyrotropin and free thyroid hormone assays to evaluate thyroid function is widespread, but in some situations the results are inconsistent with the patient's thyroid status. SUMMARY: A 35-year-old woman with a known diagnosis of chronic autoimmune thyroiditis was referred to the authors' clinic at week 26 of her second pregnancy. The patient was clinically euthyroid. Consistent with this, her serum thyrotropin (TSH) was normal (0.79 mIU/L), but she had elevated free thyroid hormones-free triiodothyronine (fT3) and free thyroxine (fT4)-as determined by a one-step chemiluminescent assay...
November 2016: Thyroid: Official Journal of the American Thyroid Association
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