Treatment of Hyper‐ and Hypothyroidism

McDougall, I. Ross

doi:10.1002/j.1552-4604.1981.tb01782.x

Cited by 5 publications

References 108 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

The antithyroid arthritis syndrome reviewed

Shabtai

Shapiro

Orenstein

et al. 1984

Arthritis & Rheumatism

View full text Add to dashboard Cite

Five hundred patients with clinically evident thyrotoxicosis, confirmed by laboratory evaluation showing elevated free thyroxine index or total T3, were treated initially with either propylthiouracil or methimazole. Eight patients developed rheumatic symptoms of severe arthralgias involving small' and large joints, without swelling or erythema, 2-80 weeks after initiation of treatment. Analgesic or antiinflammatory drugs were required for 1-3 weeks to control pain in 7 of 8 of these patients. Treatment with the alternate antithyroid agent produced an adverse reaction in 4 of 5 patients. Since our experience differs from previous reports, we describe our findings here, focusing on the experience of I patient.Case report. A 25-year-old woman presented to the clinic with tremor, palpitations, and a 13 kg weight loss which had developed over a 2-month period. On examination the pulse rate was 120/minute, the skin was smooth and moist, and the thyroid gland was diffusely enlarged. The serum T4 was 14 pgldl, the T3 Sephadex uptake 62%, and the radioactive iodine uptake 75% at 24 hours. She received methimazole 45 mg daily for a month, tapered to 30 mg daily for 3 weeks. She then noted the onset of pain in her shoulders, knees, calves, ankles, and back; no erythema or swelling was observed. The drug was discontinued. Severe pain continued for 72 hours, however, and analgesic treatment was required for a total of 3 weeks.

show abstract