Search for other papers by Luigi Bartalena in
Google Scholar
PubMed
Search for other papers by Fausto Bogazzi in
Google Scholar
PubMed
Search for other papers by Luca Chiovato in
Google Scholar
PubMed
Search for other papers by Alicja Hubalewska-Dydejczyk in
Google Scholar
PubMed
Search for other papers by Thera P. Links in
Google Scholar
PubMed
Search for other papers by Mark Vanderpump in
Google Scholar
PubMed
initial therapeutic choice. Fig. 2. Algorithm for the management of amiodarone-induced thyrotoxicosis (AIT). AIT 1, type 1 AIT; AIT 2, type 2 AIT. The iodine-replete thyroid gland of AIT patients is less responsive to thionamides, so very
Search for other papers by John H. Lazarus in
Google Scholar
PubMed
recommendation that PTU should only be used for the first trimester. It is preferred in the first trimester to carbimazole or methimazole due to the occurrence of so-called methimazole embryopathy in patients on a thionamide drug in the first trimester during
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, UK
Search for other papers by Claire L Wood in
Google Scholar
PubMed
Search for other papers by Niamh Morrison in
Google Scholar
PubMed
Search for other papers by Michael Cole in
Google Scholar
PubMed
Search for other papers by Malcolm Donaldson in
Google Scholar
PubMed
Wellcome Trust-MRC Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
Search for other papers by David B Dunger in
Google Scholar
PubMed
Search for other papers by Ruth Wood in
Google Scholar
PubMed
Department of Endocrinology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
Search for other papers by Simon H S Pearce in
Google Scholar
PubMed
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, UK
Search for other papers by Timothy D Cheetham in
Google Scholar
PubMed
Introduction Thyrotoxicosis affects around 100 children under the age of 15 years in the UK every year ( 1 ) although the incidence may be increasing ( 2 ). Management typically involves the administration of thionamide anti-thyroid drug (ATD
Search for other papers by Bruno Bouça in
Google Scholar
PubMed
Search for other papers by Ana Cláudia Martins in
Google Scholar
PubMed
Search for other papers by Paula Bogalho in
Google Scholar
PubMed
Search for other papers by Lídia Sousa in
Google Scholar
PubMed
Search for other papers by Tiago Bilhim in
Google Scholar
PubMed
Search for other papers by Filipe Veloso Gomes in
Google Scholar
PubMed
Search for other papers by Élia Coimbra in
Google Scholar
PubMed
Search for other papers by Ana Agapito in
Google Scholar
PubMed
Search for other papers by José Silva-Nunes in
Google Scholar
PubMed
dysfunction ( 5 ). Restoration of euthyroidism is of paramount importance in heart failure (HF) patients; it may be difficult to achieve with medication and it can also be refractory to a combination therapy of thionamides and glucocorticoids, making this a
London School of Hygiene and Tropical Medicine, London
Search for other papers by Peter N. Taylor in
Google Scholar
PubMed
Search for other papers by Bijay Vaidya in
Google Scholar
PubMed
considerations when selecting which ATD to use in pregnancy and in those planning pregnancy. Search Strategy Various combinations of ‘anti-thyroid drugs’, ‘thionamide’, ‘carbimazole’, ‘methimazole’, ‘propylthiouracil’, ‘pregnancy’, ‘side effects
Search for other papers by Megumi Fujikawa in
Google Scholar
PubMed
Search for other papers by Ken Okamura in
Google Scholar
PubMed
Objective: As thionamide is associated with various adverse effects, we reevaluated the practical efficacy of potassium iodide (KI) therapy for Graves’ hyperthyroidism (GD).
Methods: We administered KI (mainly 100 mg/day) to 324 untreated GD patients, and added methimazole (MMI) only to those remaining thyrotoxic even at 200 mg/day. When the patient became hypothyroid, MMI if taken was stopped, then levothyroxine (LT4) was added without reducing the KI dose. Radioactive iodine (RI) therapy or thyroidectomy was performed whenever required. We evaluated the early effects of KI at 2-4 weeks, and followed patients for 2 years.
Results: At 2 weeks, serum thyroid hormone decreased in all 324 patients. At 4 weeks, fT4, fT3, and both fT4 and fT3 levels became normal or low in 74.7%, 50.6%, and 50.6%, respectively. In a cross-sectional survey over 2-years, GD was well-controlled with KI or KI+LT4 (KI-effective) in >50% of patients at all time points. Among 288 patients followed for 2 years, 42.7% remained ‘KI-effective’ throughout 2 years (KI Group), 30.9% were well-controlled with additional MMI given for 1-24 months, and 26.4% were successfully treated with ablative therapy (mainly RI). Among ‘KI-effective’ patients at 4 weeks, 76.5% were classified into KI Group. No patients experienced adverse effects of KI.
Conclusion: KI therapy was useful in the treatment of GD. A sufficient dose of KI was effective in >50% of GD patients from 4 weeks to 2 years, and 42.7% (76.5% of ‘KI effective’ patients at 4 weeks) remained ‘KI-effective’ throughout 2 years.
Search for other papers by Christiaan F. Mooij in
Google Scholar
PubMed
Search for other papers by Nitash Zwaveling-Soonawala in
Google Scholar
PubMed
Search for other papers by Eric Fliers in
Google Scholar
PubMed
Search for other papers by A.S. Paul van Trotsenburg in
Google Scholar
PubMed
. According to current guidelines, preoperative treatment of (refractory) hyperthyroidism consists of the administration of a thionamide (e.g., methimazole), beta-blocker, glucocorticoid, and an iodine-containing preparation [ 1 ]. These treatment protocols
Search for other papers by Annelies Tonnelier in
Google Scholar
PubMed
Search for other papers by Jeroen de Filette in
Google Scholar
PubMed
Search for other papers by Ann De Becker in
Google Scholar
PubMed
Search for other papers by Sophie Deweer in
Google Scholar
PubMed
Search for other papers by Brigitte Velkeniers in
Google Scholar
PubMed
]. Medical treatment consists of thionamide plus potassium perchlorate (type 1) or glucocorticosteroids (type 2) [ 1 , 2 , 3 ]. Worldwide, multiple treatment algorithms have been proposed [ 2 ]. Combination therapy with glucocorticoids and thionamide, with or
Search for other papers by N. Papanikolaou in
Google Scholar
PubMed
Search for other papers by P. Perros in
Google Scholar
PubMed
thyrotoxicosis: report of three cases and a literature review. Dysphagia 2004;19:120–124. 15382800 12 Burch WM Jr: Pseudothyrotoxic myopathy: a complication of thionamide therapy in hyperthyroidism. South Med J 1979;72:1494–1495. 10
Search for other papers by Georgios K. Markantes in
Google Scholar
PubMed
Search for other papers by Marina A. Michalaki in
Google Scholar
PubMed
Search for other papers by George A. Vagenakis in
Google Scholar
PubMed
Search for other papers by Fotini N. Lamari in
Google Scholar
PubMed
Search for other papers by Efthymia Pitsi in
Google Scholar
PubMed
Search for other papers by Maria Eliopoulou in
Google Scholar
PubMed
Search for other papers by Nicholas G. Beratis in
Google Scholar
PubMed
Search for other papers by Kostas B. Markou in
Google Scholar
PubMed
mechanisms contribute to thyroid dysfunction [ 2 ]. Thionamides is the treatment of choice in AIT1, while AIT2 is treated with oral glucocorticoids [ 3 ]. Although the diagnosis of thyrotoxicosis is easy, based on the findings of increased thyroid hormone