Clinical Study on Early Changes in Thyroid Function of Hyperthyroidism Treated with Propylthiouracil and a Relatively Small Dose of Iodide
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概要
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In order to compare the acute effects of three kinds of antithyroid agents of iodide (I<SUP>-</SUP>), propylthiouracil (PTU) and PTU combined with iodide (PTU+I<SUP>-</SUP>) on thyroid function in hyperthyroid patients with diffuse goiter, serum concentrations of thyroxine (T<SUB>4</SUB>), triiodothyronine (T<SUB>3</SUB>), T<SUB>3</SUB>-resin sponge uptake (T<SUB>3</SUB>-RU) and free thyroxine index (FT<SUB>4</SUB>I) were employed as thyroid function parameters. In the group given iodine (1mg/day) as iodinated-lecithine, the initial values of T<SUB>4</SUB>, T<SUB>3</SUB>, T<SUB>3</SUB>-RU and FT<SUB>4</SUB>I were 20.9±1.6μg/100ml (T<SUB>4</SUB>), >740 ng/100m<I>l</I> (T<SUB>3</SUB>), 49.5±2.3%(T<SUB>3</SUB>-RU) and 14.7±1.8 (FTA<SUB>4</SUB>I). At the end of one week of theranv, they decreased clearly to 15.6±2.2 μg/100m<I>l</I>, 457±87ng/100m<I>l</I>, 42.2±4.0% and 9.7±2.4. Theso-called “escapephenomenon” from iodide inhibition was observed in serum T<SUB>4</SUB>, T<SUB>3</SUB>-Ru ana FT<SUB>4</SUB>I values at the end of two weeks of iodide therapy, while serum T<SUB>3</SUB> continued to decrease but the value of T<SUB>3</SUB> was far outside of the normal range. In the PTU group (300 mg/day), thyroid function parameters were 22.5±0.8μg/100 m<I>l</I> (T<I>4</I>), >592ng/100m<I>l</I> (T<SUB>3</SUB>), 54.9±1.0%(T<SUB>3</SUB>-RU) and 18.7±1.0 (FT<SUB>4</SUB>I) before treatment. Theydecreased continually week by week. At the end of four-week treatment with PTU, the value of eacn thyroid function parameter was 11.1±1.9 μg/100m<I>l</I>, 229±56 ng/100m<I>l</I>, 36.6±4.4% and 5.7±1.7. In the group of hyperthyroidism simultaneously given both PTU and iodide (300mg/PTU and mg/iodine), these thyroid function parameters decreased as well as in the group treated with PTU alone for more than two weeks. More rapid or significant decrease of T<SUB>4</SUB>, T<SUB>3</SUB>, T<SUB>3</SUB>-RU and FT<SUB>4</SUB>I in PTU+I<SUP>-</SUP> group than in PTU group was observed in the present study.<BR>These results suggested strongly that iodide alone was not an adequate therapy for hyperthyroidism as well known and they were also compatible with the idea that the concomitant administration of PTU and iodide was more effective in the early phase of therapy of hyperthyroidism than PTU alone.
- 社団法人 日本内分泌学会の論文
著者
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KASAI Kikuo
Department of Endocrinology
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SHIMODA Shin-ichi
Department of Endocrinology
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Ieiri Tamio
Department Of Clinical Laboratory Medicine Dokkyo University School Of Medicine
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Suzuki Hitoshi
Department Of Animal Science Faculty Of Agriculture Tohoku University
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KIKUCHI TOSHINORI
Department of Endocrinology, Internal Medicine
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TAKEMURA YOSHIHIRO
Department of Endocrinology, Internal Medicine
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SUZUKI HITOSHI
Department of Endocrinology, Internal Medicine, Dokkyo University School of Medicine
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KIKUCHI TOSHINORI
Department of Endocrinology, Internal Medicine, Dokkyo University School of Medicine
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TAKEMURA YOSHIHIRO
Department of Endocrinology, Internal Medicine, Dokkyo University School of Medicine
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SHIMODA SHIN-ICHI
Department of Endocrinology, Internal Medicine, Dokkyo University School of Medicine
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