Heart failure is one of the most known complications of hyperthyroidism, more commonly high-output heart failure, but some patients may develop dilated cardiomyopathy with low ejection fraction. We report a 35-year-old man, with hyperthyroidism, atrial fibrillation, and severe heart failure with 43% of ejection fraction. After the definitive treatment of the hyperthyroidism with radioiodine, heart failure was reverted, with symptomatic improvement and echocardiographic normalization including a normal ejection fraction (69%). There are several cases of reversion of heart failure due […]

OBJECTIVE: To determine the consumption of slimming pills (SP) and its association with TSH levels. RESEARCH METHODS AND PROCEDURES: A survey was carried out in Rio de Janeiro (about 5 million inhabitants), Brazil, from June 2004 to April 2005. Households (1,500) were selected using three-stage probability sampling. Women were asked about use of SP, and blood sample was collected. Women were classified as users of SP any time in life, but not in previous two months (n = 293), current […]

The treatment options for the hyperthyroidism of Graves’ disease are antithyroid drugs, surgery and radioiodine, none of which is considered ideal, as they do not act directly on the etiopathogenesis of the disease. Radioiodine has been increasingly used as the treatment of choice because it is a safe and definitive therapy whose administration is very easy. Some authors prefer to administer higher doses in order to deliberately induce hypothyroidism, while others recommend lower doses that result in a lower incidence […]

In this study, we set out to evaluate the costs and effectiveness of the 2 most used therapies in our region, ATD or RAI. 23 patients, 6 men and 16 women, with a mean age of 35.4 years, treated with ATD, and 35 patients, 5 men and 30 women, mean age of 39.4 years, treated with RAI, were studied. After 2 years receiving ATD, 21 patients achieved euthyroidism and 2 remained hyperthyroid. In the RAI group, 21 patients presented hypothyroidism […]

Granuloma annulare (GA) is a begin dermatosis characterized, in general, for papular lesions with annular configuration. Its clinical forms comprehend localized GA, generalized GA, perforating GA and subcutaneous GA. With unknown etiology many factors have been responsible, including autoimmune diseases. We describe a case of a 45-year-old man, with characteristic dermatological injuries of localized GA, associated to systemic alterations, compatible with hyperthyroidism (Graves’ disease). The patient was submitted to an endocrine and dermatological treatment with control of the clinical state. […]

Amiodarone, used in the treatment of cardiac arrhythmias, is associated with thyroid dysfunction. No reports exist on its frequency in southern Brazil, nor studies evaluating the usefulness of clinical scores to diagnose thyroid abnormalities in these patients. This study aimed at determining the prevalence of amiodarone-induced thyroid dysfunction in a representative sample from a tertiary center, to study the conditions associated to this dysfunction and to evaluate the reliability of clinical scores of hypo and hyperthyroidism. One hundred ninety-five amiodarone […]

The aim of the present study was to evaluate a new proposal for increasing compliance to the clinical management of patients with Graves’ disease (GD) in a large and public University Hospital. The patients were carefully selected (no previous GD treatment, goiter volume less than 6mL must be living in the metro area of São Paulo), received medication at no cost, were contacted frequently by the social worker and alerted for the date of consultation and only referred to a […]

OBJECTIVE: To evaluate thyroid function and morphology in all diabetic outpatients from our institution. METHODS: From 1996 to 1998, all diabetic patients were submitted to thyroid ultrasonography (US) and serum measurement of free T4, TSH, TPOAB, and TRAb. The control group, encompassing outpatients of the same hospital without diabetes and thyroid diseases, was submitted to the same evaluation. A patient was shown to have thyroid disorder when two or more measurements were altered, or when the US was abnormal. RESULTS: […]

The relationship between thyroid, gonads and bone morphology was investigated in 5 month-old Wistar rats, castrated and kept in hyperthyroid or euthyroid state for periods of 30, 60 and 90 days. A non-castrated control group was maintained in the same condition. At the end of each period, plasma concentrations of free T4, progesterone and estradiol were measured. The bones from each group were submitted to radiological and histological analysis. Hyperthyroidism in intact rats caused variation in bone morphology throughout the […]

Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare hyperthyroidism complication much more frequent in Asians and Caucasians. We present 3 cases of THPP occurring in Brazilian male patients with 28 years old (y) (Case 1), 29 y (Case 2) and 60 y (Case 3), respectively. They were admitted following an episode of flacid paralysis of extremities. Whereas case 1 reported recurring episodes of paralysis crises, cases 2 and 3 reported only one episode. Signs and symptoms of thyrotoxicosis, such as […]

During development, thyroid hormone deficiency results in delayed skeletal maturation and epiphyseal dysgenesis, resulting in reduced growth and skeletal abnormalities. Thyroid hormone also has effects on bones of adults. Thyrotoxicosis is frequently associated with increased bone turnover and decreased bone mass. However, the mechanisms that mediate its effects on bone tissue are poorly understood. Thyroid hormone acts indirectly in the skeleton, by increasing the secretion of growth hormone and insulin-like growth factor-1; or directly, by modulating target genes via specific […]

Subclinical hypothyroidism (SHT) and subclinical hyperthyroidism (SCH) are defined as normal serum free T4 and T3 levels associated with elevated (SHT) or subnormal (SCH) serum TSH levels, respectively. Symptoms and signs of thyroid dysfunction are scarce. The prevalence is low. In SHT, total cholesterol and LDL-C are modestly elevated and levothyroxine may influence the lipids levels. There is decreased cardiac contractility and increased peripheral vascular resistance that improve with treatment. SCH is associated with atrial fibrillation, increased cardiac contractility and […]