Document Detail


The evolution of Graves' ophthalmopathy during treatment with antithyroid drug alone and combined with triiodothyronine.
MedLine Citation:
PMID:  1624679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We analyzed the evolution of the ophthalmopathy associated with Graves' hyperthyroidism in 45 patients treated with two different antithyroid drug regimens. Group A patients (n = 31) received either methimazole (40-100 mg daily) or propylthiouracil (400-900 mg daily) combined with T3 daily throughout treatment. Group B patients (n = 14) were treated with conventional regimen with lower doses of either methimazole (5-25 mg daily) or propylthiouracil (50-300 mg daily) and no T3 addition. Eye signs and proptosis measurement were evaluated just before the beginning of the treatment and compared with the results after antithyroid drug withdrawal. Improvement of the eye signs considered on grounds of the NOSPECS classification was greater in group A than group B (p less than 0.01). Also, the decrease in proptosis measurement was greater (p less than 0.01) in patients treated with combined regimen (21.5 +/- 2.4 mm to 20.4 +/- 2.3 mm) than in patients receiving conventional therapy (20.4 +/- 1.6 mm to 20.0 +/- 1.7 mm). Serum thyroglobulin concentrations did not correlate with either the severity or the evolution of the ophthalmopathy. Negative serum antithyroglobulin antibody (TgAb) was associated with the improvement of the ophthalmopathy that was noted in 24 out of 27 patients (Chi-Square = 5.84; p less than 0.001). Thus, serum TgAb levels might have some connection with progression of eye signs but serum Tg concentration does not. Our study suggests that in most patients the transition from hyperthyroidism to euthyroidism induced by antithyroid drug therapy is associated with the improvement of the Graves' ophthalmopathy. However, no marked difference can be drawn between the two treatment regimens.
Authors:
N Bromberg; J H Romaldini; R S Werner; J A Sgarbi; M C Werner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  15     ISSN:  0391-4097     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-08-11     Completed Date:  1992-08-11     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  191-5     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Hospital Servidor Publico Estadual de Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Autoantibodies / blood
Drug Therapy, Combination
Eye Diseases / blood,  drug therapy*,  etiology
Female
Graves Disease / blood,  complications,  drug therapy*
Humans
Male
Methimazole / administration & dosage*
Middle Aged
Propylthiouracil / administration & dosage*
Thyroglobulin / blood,  immunology
Triiodothyronine / administration & dosage*
Chemical
Reg. No./Substance:
0/Autoantibodies; 51-52-5/Propylthiouracil; 60-56-0/Methimazole; 6893-02-3/Triiodothyronine; 9010-34-8/Thyroglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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