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Mikura K, Yoshimura Noh J, Watanabe N, Aida A, Yoshimura R, Kinoshita A, Suzuki A, Suzuki N, Fukushita M, Matsumoto M, Yoshihara A, Sugino K, Ito K. Radioiodine uptake after monotherapy with potassium iodide in patients with Graves' disease. Endocr J 2023; 70:541-549. [PMID: 36843112 DOI: 10.1507/endocrj.ej22-0505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023] Open
Abstract
The effect of potassium iodide (KI) on radioiodine uptake (RAIU) before radioisotope therapy in Graves' disease (GD) patients was investigated. A total of 82 patients who had been treated with KI monotherapy before 24-hour RAIU (24 h RAIU) were evaluated and 354 of those who had been treated with thiamazole (MMI) monotherapy were extracted from the 1,130 GD patients who were identified as having had appropriate iodine restriction based on urinary iodine excretion. Urinary iodine excretion (UIE) <200 μg/day was confirmed in all subjects. Propensity score-matching was performed to identify the difference in 24 h RAIU between the KI group and the MMI group. In addition, multiple regression analysis was performed to evaluate related to 24 h RAIU. Propensity score-matching resulted in 57 matched patients in each group. After matching, 24 h RAIU was still significantly lower in the KI group than in the MMI group (median 53% (interquartile range 47-61%) vs. 63% (56-66%); p = 0.001). In addition, KI monotherapy was weakly negatively correlated with 24 h RAIU, whereas the female sex and FT3 were very weakly positively correlated on multiple regression analysis. The results suggest that KI monotherapy likely suppressed 24 h RAIU more than MMI monotherapy in GD patients with appropriate iodine restriction, given the difference in the mechanism of hormone suppression.
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Affiliation(s)
- Kentaro Mikura
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | | | - Natsuko Watanabe
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Azusa Aida
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Ran Yoshimura
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Aya Kinoshita
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Ai Suzuki
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Nami Suzuki
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Miho Fukushita
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Masako Matsumoto
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | - Ai Yoshihara
- Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan
| | | | - Koichi Ito
- Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
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Watanabe N, Yoshimura Noh J, Akamizu T, Yamada M. Survey of the actual administration of thiamazole for hyperthyroidism in Japan by the Japan Thyroid Association. Endocr J 2022; 69:35-43. [PMID: 34321366 DOI: 10.1507/endocrj.ej21-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To clarify the actual administration of thiamazole (MMI), the first choice of antithyroid drugs, the actual therapy provided by the Japan Thyroid Association (JTA) members for the following conditions was surveyed. The subjects included adult patients, pregnant women, and pediatric patients with Graves' disease who visited each medical institution from September 2019 to February 2020. Initial doses, frequency of administration, maintenance doses, maximum doses, consultation intervals for pregnant women, and dosages administrated to breastfeeding mothers were surveyed. The total number of cases collected was 11,663. Administration of 15 mg once a day was the most common initial therapy, constituted 74.4% (2,526/3,397 cases) of adults, 33.8% (44/130) of pregnant women, and 50.8% (61/120) of children. The maintenance dose before discontinuation was equivalent to 2.5 mg/day in 52.3% (3,147/6,015). The most common maximum dose for adults and children was 30 mg/day, administrated to 57.5% of adults (223/388) and 59.6% (28/47) of children; for pregnant women, it was 15 mg/day, administrated to 71.1% (27/38). The most common consultation interval for pregnant women was every four weeks (32.1%, 341/1,063). In lactating mothers, the dose was 10 mg/day or less in 366 of 465 cases (78.7%). Breastfeeding was also allowed 4-6 hours after the administration of 15-20 mg/day in 69 patients (14.8%). Breastfeeding was prohibited in 26 patients (5.6%). In conclusion, initial MMI therapy was started with 15 mg once a day in most patients, and MMI was also administrated to lactating mothers following the Graves' disease treatment guidelines by the JTA.
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Moniwa N, Shioya Y, Gocho Y, Takahashi S, Tanaka M, Furuhashi M, Kuroda S, Hama T, Shima Y, Ogawa Y, Miura T. A case of membranous nephropathy secondary to asymptomatic Graves' disease. CEN Case Rep 2022; 11:309-313. [PMID: 34988884 DOI: 10.1007/s13730-021-00672-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/27/2021] [Indexed: 11/29/2022] Open
Abstract
Although cases of secondary membranous nephropathy associated with autoimmune thyroid disease (AITD) have been reported, most of them, if not all, present with symptomatic thyroid disease. Here we report an asymptomatic case of AITD complicated with secondary membranous nephropathy. A 16-year-old girl was referred to our institute because of proteinuria found by an annual medical checkup. Urinalysis showed a urinary protein creatinine ratio (UPCR) of 3.0 g/gCre. Blood examination revealed that she had Graves' disease, although she did not have any symptoms of hyperthyroidism such as weight loss, anxiety, tremor, tachycardia, or eye symptoms. In a kidney biopsy, periodic acid silver-methenamine staining showed spike formation in the basement membrane. Electron microscopy showed electron-dense deposits on the epithelial side of the glomerular basement membrane. Immunofluorescent staining showed co-localization of thyroid peroxidase and IgG deposition along the glomerular capillary walls. A diagnosis of membranous nephropathy secondary to asymptomatic Graves' disease was made on the basis of results of the examinations. Treatment with thiamazole added to enalapril improved proteinuria (reduction of UPCR to 0.83 g/gCr) and hypoalbuminemia. Consideration should be given to the possibility of AITD in differential diagnosis of etiologies of membranous nephropathy even when typical symptoms of AITD are lacking.
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Affiliation(s)
- Norihito Moniwa
- Department of Nephrology, Teine Keijinkai Hospital, 1-40, 1 jo 12 chome Maeda Teine-ku, Sapporo, 006-8555, Japan. .,Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
| | - Yu Shioya
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yufu Gocho
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoko Takahashi
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Setsuko Kuroda
- Department of Nephrology, Kyoritsu Gorinbashi Hospital, Sapporo, Japan
| | | | - Yuko Shima
- Department of Pediatrics, Wakayama Medical University, Wakayama, Japan
| | - Yayoi Ogawa
- Hokkaido Renal Pathology Center, Sapporo, Japan
| | - Tetsuji Miura
- Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.,Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
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Charfi O, Daldoul M, Lakhoua G, Aouinti I, Daghfous R, Kastalli S, El Aidli S. Leukocytoclastic vasculitis mimicking photosensitivity induced by thiamazole. Therapie 2021; 77:611-612. [PMID: 34454743 DOI: 10.1016/j.therap.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Ons Charfi
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia.
| | - Mouna Daldoul
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
| | - Ghozlane Lakhoua
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
| | - Imen Aouinti
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
| | - Riadh Daghfous
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
| | - Sarrah Kastalli
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
| | - Sihem El Aidli
- Centre national de pharmacovigilance, 1006 Tunis, Tunisia; Unité de recherche: UR17ES12, La Rabta, faculté de médecine, université Tunis-El-Manar, 1007 Tunis, Tunisia
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Pelewicz K, Wolny R, Bednarczuk T, Miśkiewicz P. Prevention of Iodinated Contrast Media-Induced Hyperthyroidism in Patients with Euthyroid Goiter. Eur Thyroid J 2021; 10:306-313. [PMID: 34395302 PMCID: PMC8314765 DOI: 10.1159/000515126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 02/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Iodinated contrast media (ICM)-induced hyperthyroidism is an underestimated, potentially severe condition; however, its prevention has not been sufficiently investigated. The aim of this study was to evaluate the influence of ICM on thyroid status, the advantages of prophylactic therapy for iodine-induced hyperthyroidism (IIH) in patients with euthyroid goiter and cardiovascular comorbidities, and the association between the incidence of IIH and thyroid volume. METHODS Thirty-six euthyroid patients undergoing procedures involving ICM administration were divided into 2 groups: the first group (n = 13) received prophylactic treatment with thiamazole or thiamazole combined with sodium perchlorate during ICM exposure; the second group (n = 23) did not receive prophylaxis. Thyroid-stimulating hormone levels were evaluated before and after ICM, and thyroid hormone levels were assessed after ICM at different points in time. The morphology of the thyroid was evaluated by ultrasonography. RESULTS Twenty-one patients (58%) developed hyperthyroidism after ICM. Hyperthyroidism was observed more frequently in the group without prophylactic treatment than in the group with prophylaxis (65 vs. 15%, respectively; p = 0.006). No cases of overt hyperthyroidism were observed in the group receiving thiamazole with sodium perchlorate. IIH persisted for a median time of 52.5 days. Larger thyroid volume was associated with a significantly higher occurrence of ICM-induced hyperthyroidism (p = 0.04). CONCLUSIONS Patients with euthyroid goiter receiving ICM are at risk of developing hyperthyroidism. The occurrence of hyperthyroidism after ICM in euthyroid patients with goiter is higher in those with larger thyroid volume. The frequency of ICM-induced hyperthyroidism in euthyroid patients with goiter is lower in those receiving prophylactic therapy with thiamazole in monotherapy or in combination with sodium perchlorate than in those not receiving prophylactic treatment.
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Affiliation(s)
- Katarzyna Pelewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Wolny
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Tomasz Bednarczuk
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Miśkiewicz
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
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Feng J, Hao Z, Zhang X, Li M, zhong W, Zhang C, Gharawi A, Alrashood ST, Khan HA. Effect of thiamazole on kainic acid-induced seizures in mice. Saudi J Biol Sci 2021; 28:1840-1846. [PMID: 33732070 PMCID: PMC7938111 DOI: 10.1016/j.sjbs.2020.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 02/08/2023] Open
Abstract
Kainic acid (KA) induced epileptic seizures in mice is a commonly used experimental model of epilepsy. Previous studies have suggested the roles of various neurotransmitters and oxidative stress in KA-induced seizures. An important role of hypothyroidism has also been suggested in epilepsy. Thiamazole (TZ) is an anti-hyperthyroid drug with antioxidant property. This study reports the effect of TZ on KA-induced epileptic seizures in mice, produced by intraperitoneal (IP) injection of KA (18 mg/kg). Prior to KA injection, the animals were treated with TZ (12.5, 25 and 50 mg/kg IP). Our results showed that in KA alone group, about half of the animals developed seizures. Pre-treatment of mice with TZ significantly increased the frequency of seizures in dose-dependent manner. Administration of TZ significantly reduced the latency time and aggravated the severity of seizures. TZ also increased the mortality in KA-treated mice. Striatal dopamine and serotonin levels were markedly increased in KA alone treated mice, which were not significantly affected by TZ treatment. Among the indices of oxidative stress, we observed a significant reduction in cerebral vitamin E whereas the levels of cerebral malondialdehyde and conjugated dienes were significantly increased in animals with high severity of seizures. In conclusion, TZ potentiated the frequency and severity of experimental seizure in mice. There is a possibility of altered metabolism of KA in presence of TZ that might have potentiated the toxicity of KA. These findings suggest a caution while administering anti-hyperthyroid drugs in epileptic seizures.
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Affiliation(s)
- Jigao Feng
- Department of Neurosurgery, Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 571199, China
| | - Zheng Hao
- Department of Neurosurgery, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xian Zhang
- Department of ICU, The First People's Hospital of Huaihua City, Huaihua, Hunan 418000, China
| | - Mingxia Li
- Department of Neurology, The First People's Hospital of Huaihua City, Huaihua, Hunan 418000, China
| | - Wuzhao zhong
- Department of Neurosurgery, Nanchang 334 Hospital, Nanchang, Jiangxi 330024, China
| | - Caicai Zhang
- Department of Physiology, Hainan Medical University (Joint Laboratory for Neuroscience, Hainan Medical University), Haikou, Hainan 570311, China
- Corresponding author at: Department of Physiology, Hainan Medical University (Joint Laboratory for Neuroscience, Hainan Medical University), Haikou, Hainan 570311, China.
| | - Ali Gharawi
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
| | - Sara T. Alrashood
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Haseeb A. Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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Mao L, Wang Q, Luo Y, Gao Y. Detection of Ag + ions via an anti-aggregation mechanism using unmodified gold nanoparticles in the presence of thiamazole. Talanta 2021; 222:121506. [PMID: 33167219 DOI: 10.1016/j.talanta.2020.121506] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 12/01/2022]
Abstract
The present study proposed a novel and highly selective and sensitive method for Ag+ ion detection based on gold nanoparticles (AuNPs) anti-aggregation. Thiamazole can induce AuNPs aggregation due to electrostatic interactions, which result in color transitions in the AuNPs solution from red to blue. However, the presence of Ag+ ions results in the preferential combination of the pyridinic nitrogen of thiamazole with the Ag+ ions. In addition, the Ag+ ions oxidize the sulfhydryl groups(-SH), which inhibit AuNPs aggregation and prompt a color change from blue to red. As a result, the present study established a method for Ag+ ion determination by AuNPs-thiamazole colorimetric probe based on the aforementioned anti-aggregation mechanism. The probe dynamic range was easily tuned via adjustments of the thiamazole amount. The relationship between the Ag+ concentration and AuNPs aggregation was monitored by ultraviolet-visible light (UV-Vis) spectroscopy at a dynamic range of 0.1 nM-9 μM and at a detection limit of 0.042 nM. The river water and tap water recovery analysis validated the successful operation of this colorimetric sensor in environmental monitoring.
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Affiliation(s)
- Lihui Mao
- College of Science and Technology, Xinyang College, Xinyang, 464000, China.
| | - Qianqian Wang
- College of Science and Technology, Xinyang College, Xinyang, 464000, China
| | - Yuhao Luo
- College of Science and Technology, Xinyang College, Xinyang, 464000, China
| | - Yongping Gao
- College of Science and Technology, Xinyang College, Xinyang, 464000, China
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Brinkman A, Schneider U, Buttgereit F, Burmester G, Krusche M. [ Thiamazole-induced arthritis]. Z Rheumatol 2021; 80:180-3. [PMID: 33196862 DOI: 10.1007/s00393-020-00921-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 11/24/2022]
Abstract
Wir berichten über den Fall eines 42-jährigen Patienten mit akuter asymmetrischer Polyarthritis der großen und mittelgroßen Gelenke sowie Fieber und erhöhten serologischen Entzündungszeichen. Die Symptomatik begann kurz nach Beginn einer Thiamazol-Therapie bei neu diagnostiziertem Morbus Basedow. Eine durch Thionamide ausgelöste Arthritis wird auch als „antithyroid arthritis syndrome“ (AAS) bezeichnet und ist eine seltene unerwünschte medikamentöse Nebenwirkung. Klinisch kann sich das Krankheitsbild mit Myalgien, Arthralgien, Fieber, Hautausschlag und Polyarthritis präsentieren. Bei Verdacht auf ein AAS sollte die Thionamid-Medikation in Rücksprache mit dem Endokrinologen nach Möglichkeit zeitnah abgesetzt oder umgestellt werden. In einigen Fällen ist eine antiinflammatorische Therapie mit NSAR oder Glukokortikoiden zur Symptomkontrolle nötig.
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Eilsberger F, Luster M, Feldkamp J. [Iodine-induced thyroid dysfunction]. Med Klin Intensivmed Notfmed 2020; 116:307-311. [PMID: 32583035 DOI: 10.1007/s00063-020-00699-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/03/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Iodine-induced thyroid dysfunctions are, despite their rare occurrence, important clinical syndromes. Their immediate recognition can avoid serious consequences. Important triggers can be iodine-containing contrast agents, amiodarone or iodine-containing disinfectants. Iodine-induced hypothyroidism and hyperthyroidism need to be distinguished, whereby the former is usually self-limiting. OBJECTIVES The aim of this article is to present current knowledge on the pathogenesis, therapy, and prophylaxis of iodine-induced thyroid dysfunction. MATERIALS AND METHODS We performed a literature search of current publications and linked them to daily clinical experience. RESULTS AND CONCLUSION In iodine-induced hyperthyroidism, antithyroid drugs and perchlorate are primarily used to decrease thyroid hormone synthesis and further iodine uptake into the thyroid. For the prophylaxis of x‑ray contrast agent-induced hyperthyroidism, perchlorate can be administered in high-risk settings in combination with antithyroid drugs, if possible starting one day before the iodine exposure.
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Affiliation(s)
- F Eilsberger
- Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Deutschland.
| | - M Luster
- Klinik für Nuklearmedizin, Universitätsklinikum Marburg, Baldingerstraße, 35043, Marburg, Deutschland
| | - J Feldkamp
- Klinik für Allgemeine Innere Medizin, Endokrinologie, Diabetologie, Infektiologie, Klinikum Bielefeld Mitte, Bielefeld, Deutschland
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Abstract
R1 The diagnosis of Graves' disease in children is based on detecting a suppression of serum TSH concentrations and the presence of anti-TSH receptor antibodies. 1/+++. R2 Thyroid ultrasound is unnecessary for diagnosis, but can be useful for assessing the size and homogeneity of the goiter. 2/+. R3. Thyroid scintigraphy is not required for the diagnosis of Graves' disease. 1/+++. R4. The measurement of T4L and T3L levels is not necessary for the diagnosis of Graves' disease in children but can be useful for the management and assessment of prognosis. 1/++. R5. In the absence of TSH receptor autoantibodies, the possibility of genetically inherited hyperthyroidism must be considered. 1/++. R6. Drug therapy is the primary line of treatment for children and consists of imidazole, carbimazole or thiamazole, with an initial dosage of 0.4 to 0.8mg/kg/day (0.3 to 0.6mg/kg/day for thiamazole) depending on the initial severity, up to maximum of 30mg. 1/++. R7. Propylthiouracil is contraindicated for children with Grave's disease. 1/+++. R8. Before starting treatment, it may be useful to perform a CBC in order to assess the degree of neutropenia caused by hyperthyroidism. It is not necessary to perform systematic CBCs during follow-up. 2/+. R9. An emergency CBC should be performed if symptoms include fever or angina. If neutrophil counts are <1000/mm3, synthetic antithyroid therapy should be discontinued or decreased and may be permanently contraindicated in severe (<500) and persistent neutropenia. Otherwise treatment may be resumed. 1/++. R10. Transaminases levels should be measured before initiating treatment. Systematic monitoring of liver function is not consensually validated. 2/+. R11. In cases of jaundice, digestive disorders or pruritus, measuring liver enzymes (AST, ALT), total and conjugated bilirubin and alkaline phosphatases is indicated. 1/++. R12. Patients and parents should be informed of the possible side effects of antithyroid agents. 1/+. R13. Therapeutic education of parents and children is important in ensuring the best possible treatment compliance. 2/++. R14. Given the specificities involved in the treatment of Graves' disease in children, medical care should be provided by a specialist accustomed to treating endocrinopathies in pediatric patients. 2/+. R15. Depending on patient age, the severity of the disease at diagnosis and the persistence of anti-TSH receptor antibodies, the initial course of treatment must take place over an extended period of 3 to 6 years. R16.The anticipated success rates of medical treatment (50% of patients in remission following several years of treatment) should be explained to the family and the child. The possibility that radical treatment may be required in case of failure or intolerance of medical treatment should also be discussed. 1/++. R17.In females with Graves' disease, it is important to explain that they must undergo an assessment by an endocrinologist before planning future pregnancies, from the start of pregnancy and during the course of pregnancy. This is true in all female patients, even those in remission after medical treatment, or those who have undergone radical treatment. R18.Indications for a radical treatment can arise in cases of: 1/+: contraindication to antithyroid agents; poorly controlled hyperthyroidism due to lack of compliance; relapse despite prolonged medical treatment; a request made by the family and child for personal reasons. R19.Surgery is the radical method of treatment used in children under 5 years of age, or in cases of very large, nodular, or compressive goiters. 2/++. R20. The surgeon's experience in dealing with thyroidectomies in children is likely to be the most significant determining factor in limiting the morbidity of the procedure (alongside any collaboration between a pediatric surgeon and an adult surgeon). 1/++. R21 When radical treatment is indicated, I-131 treatment may be discussed after 5 years (but more often after puberty), if the goiter is not too large. Experience from monitoring Graves' disease in North American children is reassuring. 1/++.
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Affiliation(s)
- Juliane Léger
- Department of Pediatric Endocrinology and Diabetology and Reference Center for rare Diseases of Growth and Development, CHU Robert-Debre, 75019 Paris, France
| | - Isabelle Oliver
- Endocrine, Bone Diseases, Genetics, Obesity, and Gynecology Unit, Children's Hospital, University Hospital, 31000 Toulouse, France
| | - Danielle Rodrigue
- Department of Pediatric Endocrinology, CHU Bicêtre, 94275 Le Kremlin-Bicêtre, France
| | - Anne-Sophie Lambert
- Department of Pediatric Endocrinology, CHU Bicêtre, 94275 Le Kremlin-Bicêtre, France
| | - Régis Coutant
- Department of Pediatric Endocrinology and Diabetology and Reference Center for Rare Diseases of Thyroid and Hormone Receptivity, University hospital of Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
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Yang XY, Wei H, Li KB, He Q, Xie JC, Zhang JT. Iodine-enhanced ultrasound degradation of sulfamethazine in water. Ultrason Sonochem 2018; 42:759-767. [PMID: 29429728 DOI: 10.1016/j.ultsonch.2017.12.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/12/2017] [Accepted: 12/22/2017] [Indexed: 06/08/2023]
Abstract
This study investigated sulfamethazine (SMT) ultrasound degradation, enhanced by iodine radicals, generated by potassium iodide (KI) and hydrogen peroxide (H2O2) in situ. The results showed that the ultrasound/H2O2/KI (US/H2O2/KI) combination treatment achieved an 85.10 ± 0.45% SMT removal (%) in 60 min under the following conditions: pH = 3.2, ultrasound power of 195 W, initial SMT concentration of 0.04 mmol·L-1, H2O2 concentration of 120 mmol·L-1, and KI concentration of 2.4 mmol·L-1. UV-Vis spectrophotometric monitoring of molecular iodine (I2) and triiodide (I3-) revealed a correlation between the SMT degradation and the iodine change in the solution. Quenching experiments using methanol, t-butanol and thiamazole as radical scavengers indicated that iodine radicals, such as I and I2-, were more important than hydroxyl radicals (HO) for SMT degradation. SMT degradation under the US/H2O2/KI treatment followed pseudo-first order reaction kinetics. The activation energy (Ea) of SMT degradation was 7.75 ± 0.61 kJ·mol-1, which suggested the reaction was controlled by the diffusion step. Moreover, TOC removal was monitored, and the obtained results revealed that it was not as effective as SMT degradation under the US/H2O2/KI system.
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Affiliation(s)
- Xiao-Yu Yang
- State Key Laboratory of Eco-hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an, China
| | - Hong Wei
- State Key Laboratory of Eco-hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an, China.
| | - Ke-Bin Li
- Key Laboratory of Synthetic and Natural Functional Molecule Chemistry, Ministry of Education, School of Chemistry and Material Science, Northwest University, Xi'an, China
| | - Qiang He
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN, USA
| | - Jian-Cang Xie
- State Key Laboratory of Eco-hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an, China
| | - Jia-Tong Zhang
- State Key Laboratory of Eco-hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an, China
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