Pulmonary Function in Hyperthyroidism*

Stein, Martin H.; Kimbel, Philip; Johnson, Robert L.

doi:10.1172/jci104262

Cited by 51 publications

(23 citation statements)

References 40 publications

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“…Red cell transit times can be unequal without gross regional differences in blood flow or diffusing capacity. For instance, pulsatile blood flow may carry some red cells through the capillary bed faster than others (29). Also the pulmonary capillary bed, a labyrinth of interconnecting capillaries, presents many alternative paths of different length from artery to vein requiring different times for red cell transit.…”

Section: Methodsmentioning

confidence: 99%

Functional Significance of a Low Pulmonary Diffusing Capacity for Carbon Monoxide*

Johnson¹,

Taylor²,

DeGraff³

1965

J. Clin. Invest.

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Diffusing capacity of the lungs imposes a theoretical limit to oxygen consumption, causing oxygen saturation of arterial blood to fall sharply if this limit is approached (1). The diffusing surface of the normal lung is so large, however, that at sea level oxygen capacity of the blood and the cardiac output rather than diffusing capacity create the major bottleneck to oxygen transport (2). Diffusion becomes an important limit only at high altitudes (3) or when diffusing capacity is reduced sufficiently by disease to cause alveolar capillary block (4).Diffusing capacity of the lungs usually is measured with respect to CO (DLco) rather than oxygen (DLO2 and oxygen transfer into pulmonary capillary blood. The red cell as well as the pulmonary membrane offers resistance to CO and oxygen transfer into blood (5, 6); the total resistance (1/DL) is the sum of the membrane and red cell resistances:

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Section: Methodsmentioning

confidence: 99%

Functional Significance of a Low Pulmonary Diffusing Capacity for Carbon Monoxide*

Johnson¹,

Taylor²,

DeGraff³

1965

J. Clin. Invest.

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“…As these values for 0 were derived for blood of normal O. capacity (or hemoglobin concentration), a correction had to be applied in the case of polycythemic blood. This could be done either by changing 0 in direct proportion to the 02 capacity (2), or by calculating Dm and Vc using e as given and then multiplying calculated Vc by 20/02 capacity of patient's blood at the time of study (18). The latter method is simpler in practice and gives the same result as the former.…”

mentioning

confidence: 99%

Pulmonary Diffusing Capacity and Its Subdivisions in Polycythemia Vera

Burgess¹,

Bishop²

1963

J. Clin. Invest.

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1Polycythemia vera is characterized by a greatly increased red cell mass, and patients with the disease have an increase of both hemoglobin concentration and total blood volume. The purpose of the present study was to observe the effect of these two variables, and their changes with treatment, on pulmonary diffusion.The rate of chemical reaction with hemoglobin is an important factor in the over-all rate of gas uptake from the lung. Roughton and Forster (1) proposed the equation 1/DL = 1/DE + 1/1Vc (Equation 1) and showed that by its use it was possible to subdivide the total diffusing capacity of the lung. DL is the total pulmonary diffusing capacity for CO from the alveolus to the interior of the red cell. Dm is the membrane diffusing capacity and relates to the movement of gas from the alveolus to the surface of the red cell. 9, often referred to as the rate of uptake of CO by the red cells, is actually the product of the rate at which CO replaces 02 in oxyhemoglobin and the concentration of hemoglobin (2). Vc is the pulmonary capillary blood volume at any instant. McNeill, Rankin, and Forster (3) have related these parameters in terms of resistances. 1/DL may be considered as the total resistance to gas uptake, which is composed of the sum of 1/DM, the membrane resistance,and l/OVc, the red cell resistance.In polycythemia vera one would expect the increased hemoglobin concentration to result in an increase in 0, thus lowering the red cell resistance and so producing an increase in DL. Previous observers, however, have not found an abnormally high DL in this disease. Ratto, Briscoe, Morton, and Comroe (5) reported a normal CO uptake in four patients. Rankin, McNeill, and Forster (6), and Forster (7), briefly mentioned that DL, DM, and Vc were normal in polycythemia vera. Fishman (8), quoting work from his laboratory with a steady state CO technique, concluded that diffusion was normal. Newman, Feltman, and Devlin (9) report a normal A-a (alveolar to arterial) difference for oxygen in four out of five patients with polycythemia vera.People acclimatized to high altitude show features similar to polycythemia vera, as they have both an increased red cell mass and total blood volume (10). Barcroft and his colleagues (11) in 1920 measured DL by Krogh's technique and found slightly but not significantly higher values for 13 newly acclimatized subjects, as compared with values at sea level. They noted that the natives permanently resident at high altitudes had significantly higher values for DL than those of the party.There have been several studies of 02 transfer in the lungs in acclimatized subjects. Houston and Riley (12) found a decrease in the A-a difference in 02 tension under conditions of prolonged simulated altitude and calculated that the DL for 02 was increased. Velasquez (13) re-ported that the maximal DL for 02 during exercise was greater than normal in subjects acclimatized to an altitude of 4,540 m.The plan of the present study was to measure 997

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“…It was shown that CoQ10 and thyroid hormones are inversely correlated [44]. The level of CoQ10 in hypothyroidism (even in subclinical cases) is elevated [36], while CoQ10 level in patients with hyperthyroidism is reduced [44]. In the cited study, significantly higher values of CoQ10 in a group of COPD patients with low fT3 levels were observed, compared to COPD patients with normal fT3 levels [44].…”

Section: Hypermetabolism In Copdmentioning

confidence: 76%

“…In patients with COPD and hyperthyroidism, muscle weakness may also appear, and may result from increased catabolism [33,35]. The loss of muscle mass and muscle strength in patients with thyrotoxicosis has been confirmed [36]. Similarly to hypothyroidism, loss of muscle mass may be responsible for decreased lung function.…”

Section: Hyperthyroidismmentioning

confidence: 98%

Thyroid Gland in Chronic Obstructive Pulmonary Disease

Miłkowska-Dymanowska

Białas

Laskowska

et al. 2017

Advances in Respiratory Medicine

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The risk of chronic obstructive pulmonary disease (COPD), as well as thyroid diseases increases with age. COPD is a common systemic disease associated with chronic inflammation. Many endocrinological disorders, including thyroid gland diseases are related to systemic inflammation. Epidemiological studies suggest that patients with COPD are at higher risk of thyroid disorders. These associations are not well-studied and thyroid gland diseases are not included on the broadly acknowledged list of COPD comorbidities. They may seriously handicap quality of life of COPD patients. Unfortunately, the diagnosis may be difficult, as many signs are masked by the symptoms of the index disease. The comprehension of the correlation between thyroid gland disorders and COPD may contribute to better care of patients. In this review, we attempt to revise available literature describing existing links between COPD and thyroid diseases.

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Pulmonary Function in Hyperthyroidism*

Cited by 51 publications

References 40 publications

Functional Significance of a Low Pulmonary Diffusing Capacity for Carbon Monoxide*

Functional Significance of a Low Pulmonary Diffusing Capacity for Carbon Monoxide*

Pulmonary Diffusing Capacity and Its Subdivisions in Polycythemia Vera

Thyroid Gland in Chronic Obstructive Pulmonary Disease

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