Thyroid Function after Surgical Treatment of Thyrotoxicosis

Toft, A. D.; Irvine, W. J.; Sinclair, Ian; McIntosh, D. J.; Seth, John; Cameron, E.

doi:10.1056/nejm197803232981202

Cited by 116 publications

(20 citation statements)

References 29 publications

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“…Serum TSH was measured by RIA; the between-assay coefficient of variation using anonymous control sera was 5.1% (7). In euthyroid patients attending an Endocrine Clinic, the 95th percentile of TSH concentrations was 5.7 mU/liter, which was therefore regarded as the upper limit of the reference (normal) range, with 5% of patients having concentrations between 5.7-10 mU/liter.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Gray

Borsey

Seth

et al. 1980

The Journal of Clinical Endocrinology & Metabolism

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A study was made of the distribution of primary thyroid failure, indicated by a raised serum TSH concentration, in 605 (294 males and 311 females) insulin-dependent (type I) diabetics, aged 21-84 yr, not previously suspected of having thyroid disease. The prevalence of a raised serum TSH concentration in females of all ages (17%) was significantly greater (P less than 0.0005) than that in males (6.1%) and increased with increasing age at onset of diabetes (P less than 0.05) and age at time of study (P less than 0.001) in females but not in males. There was no significant difference in the duration of diabetes when comparing patients with normal and raised serum TSH concentrations. The prevalence of a raised TSH concentration in late-onset insulin-dependent diabetics was no greater in patients requiring insulin within 3 months of diagnosis of diabetes than in those exhibiting secondary sulfonylurea failure, who required insulin more than 3 months after diagnosis. In type I diabetes, the prevalence of subclinical primary thyroid failure is considerably greater than has previously been suspected, with female late-onset insulin-dependent diabetics being at the greatest risk.

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Section: Methodsmentioning

confidence: 99%

Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Gray

Borsey

Seth

et al. 1980

The Journal of Clinical Endocrinology & Metabolism

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“…This incidence was lower than that reported by Toft et a1., who found that 80% were euthyroid 12 months after surgery [11]. In another series reported by the Noguchi Thyroid Clinic and Hospital Foundation, however, 90.6% became euthyroid after surgery [12].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the low euthyroid rate observed in the present study might have been due to sampling errors independent of the current hypothesis. The presence of 11 censored cases (most of them were considered to be euthyroid), selection of enlarged thyroid glands to obtain enough amount of thyroid tissue for culture study, and the shortness of the observation periods after the surgery [11] might be related to the higher incidence of post-operative hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

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Post-Operative Thyroid Status of Patients with Graves' Disease Is Determined by the Responsiveness of Thyrocyte to TSH under the Present Thyroid Gland Remnant.

et al. 1998

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Abstract.In order to determine whether thyrocyte responsiveness to TSH is correlated with postoperative thyroid status, thyrocytes obtained from 51 patients with Graves' disease were cultured for 3 days. This was followed by culture with 10 mU/mL of TSH (TSH group) or without TSH (control group) for 3 additional days. On the 8th culture day, the amount of thyroglobulin (Tg) secreted into the culture medium was assayed and the Tg ratio (amount of Tg from the stimulated group/amount of TG from the control group) was calculated.Logio (the Tg ratio) was used for the statistic study.

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“…Since propranolol is now commonly used pre-and perioperatively for hyperthyroidism (1)(2)(3)(4)(5), it seems important to keep in mind the propranolol-induced modulations of the cardiovascular responses to stress in the event of various emergencies.…”

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confidence: 99%

Plasma Catecholamines and Cardiovascular Responses to Hypoglycemia in Hyperthyroidism before and during Treatment with Metoprolol or Propranolol*

Nilsson

Karlberg

Söderberg

1980

The Journal of Clinical Endocrinology & Metabolism

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Hypoglycemia normally promotes increases in plasma epinephrine (E) and norepinephrine (NE), tachycardia, and a widened pulse pressure; these responses can be modified by /?-adrenoceptor-blocking agents. We assessed the catecholamine and cardiovascular responses to a standard insulin tolerance test in 18 hyperthyroid patients before and during treatment with selective /?-l (metoprolol; n = 9) or nonselective (propranolol; n = 9) /^-blocking agents. During hypoglycemia, metoprolol as well as propranolol treatment caused an augmented increase in plasma E, while the increase in NE remained unaltered during /8-blockade compared to pretreatment changes. Treatment with metoprolol reduced the supine basal heart rate (HR), although the HR rose significantly during hypoglycemia. Blood pressure (BP) changes were similar to pretreatment values. Propranolol not only lowered basal HR but also totally blocked hypoglycemia-induced tachycardia. Compared to pretreatment, an increase in diastolic BP and a further rise in systolic BP were recorded.Eleven subjects were reexamined when they were made euthyroid by conventional antithyroid therapy. During hypoglycemia, NE concentrations reached a similar maximum value in the hyperthyroid and euthyroid states, although basal concentrations were lower during hyperthyroidism. No differences were seen between plasma levels of E, and the cardiovascular changes were similar in hyper-and euthyroidism, except for lower basal diastolic BP in hyperthyroidism.Our data demonstrate that stress-induced increases in plasma catecholamines are not suppressed in hyperthyroidism. During /S-adrenoceptor blockade, hypoglycemia provokes an enhanced response in plasma E. This increment in plasma E induces changes in the cardiovascular response which are quite different during selective /S-l or nonselective /^-blockade. The difference is probably due to a coexisting and unopposed change in the aadrenergic tone during nonselective /^-blockade. (J Clin Endocrinol Metab 50: 906, 1980)

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Thyroid Function after Surgical Treatment of Thyrotoxicosis

Cited by 116 publications

References 29 publications

Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Prevalence of Subclinical Thyroid Failure in Insulin-Dependent Diabetes

Post-Operative Thyroid Status of Patients with Graves' Disease Is Determined by the Responsiveness of Thyrocyte to TSH under the Present Thyroid Gland Remnant.

Plasma Catecholamines and Cardiovascular Responses to Hypoglycemia in Hyperthyroidism before and during Treatment with Metoprolol or Propranolol*

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