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TSH before the administration of weekly T4 was higher (weekly, 6.61 mIU/mL; daily, 3.92 mlU/mL; p = 0.0001), and mean FT4 (weekly, 0.98 ng/dL; daily, 1.35 ng/dL; p = 0.01) and FT3 (weekly, 208 pg/dL; daily, 242 pg/dL; p = 0.01) were lower. Apart
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her medication was explained. Treatment failure would call for supervised weekly administration of levothyroxine 1,000 μg. A beneficial evolution of fT 4 to 38.6 pmol/L was noted with a suppressed TSH using daily intake. It was even necessary to
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causes associated with malabsorption of LT4 should be evaluated [ 1 , 4 ]. Since LT4 malabsorption is infrequent, we present a clinical case with a diagnosis of LT4 malabsorption that raised the need for alternatives to oral administration. Case
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pathways. What Do These Case Reports Add to Current Knowledge? • These well-documented clinical cases of reactivation of GO after administration of rhTSH for incidental thyroid cancer support the hypothesis of the role of the TSHR in GO. Indeed the
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methylprednisolone from start to conclusion was 4,500 mg, corresponding to a mean daily dose of about 60 mg, which probably illustrates that intermittent weekly glucocorticoid administration implicates far less perturbation of the HPA axis compared to daily doses. On
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medical therapy and correlates well with disease severity and extra thyroidal manifestations, i.e., thyroid eye disease [ 6 , 10 - 14 ]. Various attempts have been made to model human GD in mice, i.e., by administration of plasmid TSHR DNA via
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, Karavitaki N , Weetman AP , et al. A thyroxine absorption test followed by weekly thyroxine administration: a method to assess non-adherence to treatment . Eur J Endocrinol . 2013 May ; 168 ( 6 ): 913 – 7 . 10.1530/EJE-12-1035 23554450 0804
Department of Medicine I, Johannes Gutenberg University Medical Center, Mainz, Germany
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Trials and Therapeutic Applications. In a nonrandomized pilot study [ 14 ], 20 GH patients were rendered euthyroid after about 4 months of methimazole and then assigned to RTX (375 mg/m 2 weekly for four doses) or observation alone. Four of 10 patients
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furosemide 40 mg 6 h later. Corticosteroids were started on day 4; 500 mg methylprednisolone was administered on alternate days (day 4, day 6, and day 8), followed by 500 mg methylprednisolone weekly for 3 weeks and 250 mg methylprednisolone for 6 weeks. The
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Food and Drug Administration (FDA) approved the use of several multikinase inhibitors (MKIs) based on recent clinical trials showing their ability to limit disease progression [ 6 , 7 , 8 , 9 , 10 , 11 ]. It is not known, however, whether the
