• Title/Summary/Keyword: Hyperthyroidism

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A Study on the Clinical Diagnosis of Hyperthyroidism (갑상선기능항진증(甲狀腺機能亢進症)의 임상적(臨床的) 진단(診斷)에 관(關)한 연구(硏究))

  • Ku, In-Seo;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.7 no.1
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    • pp.15-29
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    • 1973
  • To attain a simple and reliable method of evaluating the thyroid function the reliability of the clinical manifestation and the conventional thyroid function tests in diagnosing the hyperthyroidism was studied. The subjects included 184 patients with hyperthyroidism and 66 cases with euthyroidism, who were treated at the Thyroid Clinic, Seoul National University Hospital, from July 1971 through August 1972. The observed results were as follows: 1. In the cases of hyperthyroidism, 19% of the patients were male and 81% female; in the cases of euthyroidism, 7.6% of the patients were male and 92.4% female. The majority of the patients were in 2nd to 4th decades of their lives. 2. There were objective signs clearly manifested in hyperthyroidism which were rare or absent in the euthyroid state. These clinical signs included wide pulse pressure, tachycardia, systolic murmur, exophthalmos, tremor, and warm skin. In the hyperthyroid state 91.3% of the cases manifested two or more of the above signs, whereas in the euthyroid state no patients manifested any two of the above signs. 3. The most frequent complaints of the patients with thyroid disease were palpitation, weight loss, increased appetite, heat intolerance, perspiration, hunger feeling; nervousness, exertional dyspnea, etc. There was no clear difference in the incidence of the symptoms between hyperthyroidism and euthyroidism. 4. In the diagnosis of hyperthyroidism, the reliability of thyroid ?unction tests was as follows; $T_7$ was 92.4% reliable, $^{125}IT_3$ resin uptake rate 91.6% reliable, $^{131}I$ thyroid uptake rate in 24 hrs. 89.4% reliable, serum $T_4$ level 85.9% reliable and BMR 75.5% reliable. Therefore the careful observation of the clinical manifestation of the disease is a simple and reliable way of making a correct diagnosis of either hyperthyroidism or euthyroidism. 5. In hyperthyroidism there shows no correlationship between the results of the thyroid function test and clinical signs but a high BMR was associated with both tachycardia and systolic murmur.

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Review of Domestic Experimental Studies of Herbal Medicines for Hyperthyroidism since 2000 (갑상선 기능항진증에 대한 국내 한의약 실험연구 고찰 - 2000년 이후)

  • Lee, Min-hye;Jeon, Chan-yong;Kang, Mi Suk;Choi, You-kyung
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.949-960
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    • 2016
  • Objectives: This study reviewed experimental studies on the effects of herbal medicines in treating hyperthyroidism. Methods: We analyzed the experimental studies of herbal medicines done in Korea to treat hyperthyroidism that have been reported since 2000 by searching 4 Korean databases with the keyword "hyperthyroidism". Results: Two single herbal medicines and 15 complex herbal medicines were used in 15 experimental studies. There was 1 clinical study and 14 nonclinical studies, among them, 2 in vitro experiments and 12 in vivo experiments. It was confirmed that the herbal medicines used have improving effects on hyperthyroidism by inhibiting the oversupplied thyroid hormones and hypermetabolic symptoms. Conclusions: There should be further studies on the antioxidative effects and acting mechanisms of herbal medicines and more clinical studies on hyperthyroidism.

Hyperthyroidism Caused by a Mutation in the Thyrotropin Receptor Gene in Two Brothers (형제에서 발생한 갑상선 자극호르몬 수용체 유전자 돌연변이에 의한 갑상선 항진증 2례)

  • Kim, Jae Hyun;Lee, Sung Soo;Lim, Jung Sup;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.3
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    • pp.337-341
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    • 2005
  • Thyrotropin receptor(TSHR) mutations must be considered when congenital hyperthyroidism has persisted, but there has been no evidence for autoimmunity. TSHR mutations leading to constitutive activation of the thyroid gland were identified as the molecular cause of autosomal dominant nonautoimmune hyperthyroidism and sporadic congenital hyperthyroidism. We report two cases of hyperthyroidism caused by germline TSHR mutation who presented with exessive sweating and no evidence of autoimmune thyroid disease. They were brothers and their mother had undergone thyroidectomy because of hyperthyroidism. Direct sequencing of the polymerase chain reaction-amplified exon 10 of the TSHR genomic DNA revealed a transition of GCT to GTT, resulting in an exchange of alanine 627 to valine in the patients and their mother. This might be a novel mutation or polymorphism, but we did not perform any functional gene study. But considering the clinical profiles, we can conclude that hyperthyroidism of these two brothers might come from the point mutation described above.

The corrected QT (QTc) prolongation in hyperthyroidism and the association of thyroid hormone with the QTc interval

  • Lee, Ye Seung;Choi, Joong Wan;Bae, Eun Ju;Park, Won Il;Lee, Hong Jin;Oh, Phil Soo
    • Clinical and Experimental Pediatrics
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    • v.58 no.7
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    • pp.263-266
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    • 2015
  • Purpose: Ventricular repolarization is assessed using the QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged QTc is associated with an increased risk of arrhythmias and cardiac mortality. As there have been few reports regarding the effects of hyperthyroidism on ventricular repolarization, we studied the association between serum free thyroxine (free T4 [fT4]) and thyroid stimulating hormone (TSH) levels and the QTc interval. Methods: Thirty-eight patients with hyperthyroidism (<30 years old) were included, and we used their clinical records and available ECGs (between August 2003 and August 2011) to evaluate the association between their fT4 and TSH levels and their QTc interval. In addition, we studied the ECGs of 72 age-matched patients with no hyperthyroidism (control group) and compared their data with that from the patients group. Results: The QTc duration in patients with hyperthyroidism was significantly prolonged compared to that in the control subjects (P<0.001). In addition, the number of hyperthyroid patients with abnormal prolonged QTc was significantly higher than that in the control group (P<0.001). Among the patients with hyperthyroidism, patients with prolonged QTc and borderline QTc had higher fT4 levels and there was positive correlation between their fT4 levels and their QTc interval (P<0.05). However, no correlation was observed between their TSH levels and their QTc interval. Conclusion: We report that hyperthyroidism is associated with QTc prolongation. The correlation between the fT4 levels and the QTc interval suggests that thyroid status is associated with QTc values and the risk of cardiac mortality.

Comparison of Effects of Yangkyuksanhwa-tang, Palmulgunja-tang and Cheongpyesagan-tang on the Rat Hyperthyroidism Induced by Levothyroxine (Levothyroxine으로 유발된 갑상선기능항진증 랫트에 대한 양격산화탕, 팔물군자탕 및 청폐사간탕의 효능 비교연구)

  • Kim, Seong-Tae;Choi, Ae-Ryun
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.2
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    • pp.132-146
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    • 2016
  • Objectives This study's object was to observe the comparative effects of Yangkyuksanhwa-tang, Palmulgunja-tang and Cheongpyesagan-tang on the chronic LT4(levothyroxine) induced hyperthyroidism in rats.Methods Six groups, each of 8 rats in group, were used in this study. Saline and distilled water treated rats are intact control group. Hyperthyroidism was induced by daily subcutaneous LT4 300 μg/kg treatment for 27 days(LT4 control). Since 12th LT4 treatment PTU(propylthiouracil) 10 mg/kg was intraperitoneal injected(PTU group) and aqueous extracts of Yangkyuksanhwa-tang, Palmulgunja-tang and Cheongpyesagan-tang(YS, PG and CS) 500 mg/kg were orally administrated(YS, PG, CS group), once a day for 15 days. The differences in the body, thyroid gland and epididymal fat pad weights, serum T3(tri-iodothyronine), T4(thyroxine), TSH(thyroid-stimulating hormone), thyroid gland and epididymal fat pad histopathology, liver weight, AST(asparte aminotransferase), ALT(alanine aminotransferase) concentrations, hepatic lipid peroxidation, GSH(glutathione), SOD(superoxide dismutase), CAT(catalase) activities, liver histopathology were observed to evaluate effects on hyperthyroidism, liver damages and antioxidant effects.Results As results of LT4 treatment, hyperthyroidism and related liver damages such as lower body, thyroid weights, higher serum T3, T4, AST, ALT levels, thinner follicular lining epithelium in thyroid glands were observed. However, these symptoms were inhibited by oral treatment of YS, PG and CS. As compared with PTU treatment, these herbal prescriptions showed lower overall efficacy on the hyperthyroidism, but YS showed more favorable effects on the hepatic antioxidant defense systems.Conclusions This results suggest that YS, PG and CS favorably control the LT4 induced hyperthyroidism and related liver damages in rats through modulation of the hepatic antioxidative defense systems.

A Case Study of Soyangin Hyperthyroidism Patient (소양인(少陽人) 갑상선기능항진증 환자 1례에 대한 임상보고)

  • Yi, Jin-Wook;Choi, Jae-Song;Jang, Moon-Hee;Ahn, Taek-Won
    • Journal of Haehwa Medicine
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    • v.21 no.2
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    • pp.149-156
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    • 2013
  • 1. Objectives This study is about a "Soyangin" hyperthyroidism patient with palpitation, facial flushing, fatigue, hand tremor and vertigo etc. In this case, we evaluated the effect of Oriental medicine treatment for hyperthyroidism. 2. Methods This patient was treated by Sasang constitutional herbal medication based on "Donguisusebowon". Acupuncture and west medications were used together. We evaluated the clinical progress through two method, Blood Test(T3, Free T4, TSH) and VAS(Visual Analogue Scale). 3. Results During 2months treatment, chief complaints, symptoms and blood test results(T3, Free T4, TSH) of this patient were improved. 4. Conclusion This study shows that Yangkyuksanhwa-tang is an effective treatment for "Soyangin" hyperthyroidism patient.

Current Opinions on the Radioiodine Treatment of Graves' Hyperthyroidism (Graves병 갑상선 기능항진증에서 방사성 옥소 치료의 지견)

  • Lee, Sang-Woo;Lee, Jae-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.6
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    • pp.341-354
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    • 2003
  • Radioactive iodine therapy using I-131 for hyperthyroidism has been used for more than 50 years, and generally considered safe and devoid of major side effects. Appropriate patient selection criteria and clinical judgement concerning patient preparation should be employed for its optimal use. It has not been possible to resolve the trade-off between efficient definite cure of hyperthyroidism and the high incidence of post-therapy hypothyroidism. The dose of the I-131 needed to maintain euthyroid state remains an area of uncertainity and debate. Early side effects are uncommon and readily managable. Other than the need for long-term monitoring and, in most cases, lifelong thyroid hormone treatment for late adverse consequences of this treatment remains only conjectural. We have reviewed general principles and recent advances in radioiodine treatment for Graves' hyperthyroidism, specially regarding to several controversies.

Recent Research Trends in Korean Medicine Treatment of Hyperthyroidism: A Review of Literature Focusing on Domestic Articles from 2000 to 2018 (갑상선 기능 항진증의 한의학적 치료에 대한 최신 연구 동향 : 2000년부터 2018년까지 국내 학술논문을 중심으로 한 문헌고찰)

  • Choi, Yu-jin;Jung, Nu-ri;Song, Kwang-chan;Kim, Gi-tae;Ko, Heung;Shin, Seon-mi
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1116-1135
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    • 2018
  • Objective: This study was performed to research Korean medical treatment methods for hyperthyroidism by summarizing domestic clinical studies. Methods: The study was based on 14 papers published in Korea since 2000, on Korean medicine treatments for hyperthyroidism. Papers were searched on four domestic electronic databases. Results: 1. This paper analyzed 14 studies on the subject of clinical research on hyperthyroidism in Korea. 12 of them reported cases while two of them reported on clinical research. 2. The average age of the subjects was 39 years, 71.3% of women, 20-60 years of age accounted for 92%, and the average duration of disease was 22 months. 3. Of the 115 subjects, 102 had experienced Western medical treatment. So most of them chose Western medical treatment as the first treatment method, of which 24 experienced side effects. 4. Eumhuhwadong (陰虛火動) and Gieumyanghu (氣陰兩虛) appeared 3 times respectively. 5. The Korean herbal medicine, Ahnjeonbaekho-tang was the most frequent herbal medicine used to treat hyperthyroidism, with the next most frequent being Yanggyuksanhwa-tang. 6. The study, which was performed using herbal medicine alone, showed a marked improvement in clinical symptoms and thyroid function test, compared with administration of antithyroid drugs and herbal medicines. Conclusions: Large-scale studies and randomized controlled trials will be needed to evaluate the validity of Korean medical treatment for hyperthyroidism.

Nonautoimmune congenital hyperthyroidism due to p.Asp633Glu mutation in the TSHR gene

  • Cho, Won Kyoung;Ahn, Moon-Bae;Jang, Woori;Chae, Hyojin;Kim, Myungshin;Suh, Byung-Kyu
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.4
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    • pp.235-239
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    • 2018
  • Most cases of congenital hyperthyroidism are autoimmune forms caused by maternal thyroid stimulating antibodies. Nonautoimmune forms of congenital hyperthyroidism caused by activating mutations of the thyrotropin receptor (TSHR) gene are rare. A woman gave birth to a boy during an emergency cesarean section at 33 weeks of gestation due to fetal tachycardia. On the 24th day of life, thyroid function tests were performed due to persistent tachycardia, and hyperthyroidism was confirmed. Auto-antibodies to TSHR, thyroid peroxidase, and thyroglobulin were not found. The patient was treated with propylthiouracil and propranolol, but hyperthyroidism was not well controlled. At 3 months of age, the patient had craniosynostosis and hydrocephalus, and underwent a ventriculoperitoneal shunt operation. Direct sequencing of the TSHR gene showed a heterozygous mutation of c.1899C>A (p.Asp633Glu) in exon 10. No mutations were discovered in any of the parents in a familial genetic study. We have reported a case of sporadic nonautoimmune congenital hyperthyroidism, by a missense mutation of the TSHR gene, for the first time in South Korea.

Thyroid imaging in 53 cats with hyperthyroidism using technetium-99m as pertechnetate

  • Lee, Young-won
    • Korean Journal of Veterinary Research
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    • v.39 no.2
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    • pp.394-397
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    • 1999
  • Thyroid imaging was performed in 53 hyperthyroid cats with technetium-99m as pertechnetate($^{99m}TcO_{4}$). Increased radionuclide accumulation was found in all cats. Thirty-four cats had bilateral enlargements of the thyroid glands and 14 cats had unilateral enlargements. Five cats had multi-focal accumulation of $^{99m}TcO_{4}$ in the ventral neck or mediastinum. Conclusively, nuclear thyroid image is useful method in diagnosis of feline hyperthyroidism.

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