Medical Treatment of Hyperthyroidism: State of the Art

Abstract

Methimazole (MMI) and propylthiouracil (PTU) are the main antithyroid drugs used for hyperthyroidism. They inhibit the synthesis of thyroid hormone at various levels and are used as the primary treatment for hyperthyroidism or as a preparation before radioiodine therapy or thyroidectomy. MMI is the drug of choice because of its widespread availability, longer half-life and small number of severe side effects. Drugs of second choice are potassium perchlorate, beta blockers, iodine, lithium carbonate and glucocorticoids. Rituximab, a monoclonal antibody directed against human CD20, was recently proposed as a biological therapy for cases of Graves' disease unresponsive to traditional drugs.

Hematologic Changes in Patients with Graves’ disease in Gorgan During 2014-2015

“…Hyperthyroidism (Graves' disease) is an endocrine disorder with about 2% prevalence in females and 0.2% in males (1-3) and an estimated annual incidence rate of 20 per 100,000 population (2,3). However, in regions without iodine deficiency, Graves' disease is the most common cause of hyperthyroidism, constitutes about 80% of hyperthyroidism cases, while hyperfunctioning autonomous adenomas are the most common cause in regions facing iodine deficiency (2,3).…”

“…However, in regions without iodine deficiency, Graves' disease is the most common cause of hyperthyroidism, constitutes about 80% of hyperthyroidism cases, while hyperfunctioning autonomous adenomas are the most common cause in regions facing iodine deficiency (2,3). Thyroid function disorders are among the most common endocrine diseases (4,5).…”

Aspergiloma pulmonar secundaria a neutropenia inducida por metimazol: reporte de un caso

“…Los fármacos antitiroideos son la base del tratamiento del hipertiroidismo, especialmente en mujeres jóvenes con enfermedad de Graves (EG) (1) . En nuestro país, de este grupo de medicamentos, solo se dispone del metimazol (MMI), el cual está asociado a diversos eventos adversos, la mayoría de los cuales son leves, transitorios y dependientes de la dosis utilizada.…”

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“…Shergy WJ et al reported a case of a patient with polymyositis and high CK levels after PTU treatment for hyperthyroidism but the authors failed to distinguish if the elevation CK was related to drug effect of PTU or polymyositis. The patients symptoms resolved after withdrawal of PTU and treatment with prednisone and metotrexate [2]. Suzuki et al reported 4 cases of adult patients with Graves' disease and an abnormal increase in serum CK concentrations during treatment with thionamides.…”

“…Minor side efects can resolve spontaneously; in case of persistence, the administered thionamide can be replaced by another available drug. Major side effects are agranulocytosis, hepatotoxicity, aplastic anemia and vasculitis, and occur in approximately 0.2-0.5 % of the cases [2]. Myalgia is a rare side effect these drugs.…”