Studies on the T<SUB>3</SUB> Suppression Test by the 24-Hour Thyroidal <SUP>131</SUP>I Uptake in Patients with Graves Disease: Comparison of the Effects of Propylthiouracil and Methylmercaptoimidazole

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概要

• 論文の詳細を見る

• The T<SUB>3</SUB> suppression test by the 24-hr thyroidal <SUP>131</SUP>I uptake was reevaluated in patients with Graves desease before and after withdrawal of antithyroid drug. Fifty patients had been treated with propylthiouracil (PTU) or methylmercaptoimidazole (MMI) for 12 to 70 months. They were prescribed a maintenance dose of antithyroid drug (PTU, 50mg/day; MMI, 5mg/day) at the time of investigation and regarded as euthyroid on the basis of serum T<SUB>3</SUB>, T<SUB>4</SUB> and TSH levels. Each patient was given 75mu;g T<SUB>3</SUB> daily for 8 days in conjunction with PTU or MMI. The 24-hr thyroidal <SUP>131</SUP>I uptake was then measured (post T<SUB>3</SUB> uptake). In 30 patients whose post T<SUB>3</SUB> uptake was below 35%, treatment was stopped and the T<SUB>3</SUB> suppression test was repeated at one and 3 months later. During the two-year follow up, 24 remained well, while 6 relapsed within 4 to 12 months.<BR>In patients with sustained remission, the post T<SUB>3</SUB> uptake was significantly lower in the MMI-treated group (13 cases, 7.7±1.0%) than in the PTU-treated group (11 cases, 18.6±1.9%). MMI withdrawal produced a marked rebound in the post T<SUB>3</SUB> uptake, whereas none of the patients showed the rebound after PTU withdrawal. In patients who relapsed later, there was no difference in the post T<SUB>3</SUB> uptake during treatment and the rebound occurred in the both groups following goitrogen withdrawal. Serum T<SUB>3</SUB>, T<SUB>4</SUB> and TSH levels were within normal ranges at one and 3 months after cessation of antithyroid drug.<BR>From the results of the present study, it is concluded that criteria for T<SUB>3</SUB> suppressibility by the 24-hr uptake should be determined by the antithyroid drug employed and by the time of investigation. There is a dissociation in the post T<SUB>3</SUB> uptake values following withdrawal of the two different antithyroid drugs.

• 社団法人 日本内分泌学会の論文

著者

• Kobayashi Isao

  Division of Clinical Endocrinology, Department of Medicine, School of Medicine, Gunma University

• MORI MASATOMO

  Division of Endocrinology, Department of Medicine, Gunma University Hospital

• Kobayashi I

  Gumma Paz College

• Fukuda Hitoshi

  First Department Of Internal Medicine School Of Medicine Gunma University

• MARUTA SAKAE

  Division of Endocrinology, Department of Medicine, Gunma University School of Medicine

• ISHII HIDEKAZU

  First Department of Internal Medicine, Gunma University School of Medicine

• ISHIHARA HIROFUMI

  First Department of Internal Medicine, Gunma University School of Medicine

• IRIUCHIJIMA TOKUJI

  First Department of Internal Medicine, Gunma University School of Medicine

• TAKAHASHI MASAKI

  First Department of Internal Medicine, Gunma University School of Medicine

• SHIMOMURA YOHNOSUKE

  First Department of Internal Medicine, Gunma University School of Medicine

• Kobayashi Isao

  Division Of Clinical Endocrinology Department Of Medicine School Of Medicine Gunma University

• KOBAYASHI ISAO

  Division of Endocrinology, Department of Medicine, Gunma University School of Medicine

• MARUTA SAKAE

  Division of Endocrinology, Department of Medicine, Gunma University Hospital

• FUKUDA HITOSHI

  First Department of Internal Medicine, Gunma University School of Medicine

• MORI MASATOMO

  Division of Endocrinology, Department of Medicine, Gunma University

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