While the diagnosis of Graves’ disease in childhood and adolescence is relatively straightforward, its treatment remains controversial. The first choice therapy is the use of anti-thyroid drugs, although side effects are more frequent than in adults and remission is low. Surgery is not usually indicated as initial treatment. Instead, it is generally recommended after recidive of the disease or due to side effects of medical treatment. The use of radioiodine therapy is increasing in this age group, especially in North […]

Graves’ disease is the most frequent cause of hyperthyroidism. Clinical thyrotoxicosis is directly caused by autoantibodies that activate the TSH receptor. The etiology is multifactorial, with genetic and nongenetic factors involveld. Current treatment options are antithyroid drugs (ATD), radioiodine (131I) and surgery. Radioactive iodine is increasingly being used as definitive therapy, because it long has proven to be a safe, nonexpensive and effective treatment. Recent publications have discussed the use of 131I associated with ATD as well as the identification […]

Thyroid hormone action has profound consequences for the heart, ranging from atrial fibrillation to hemodynamic collapse. It has long been known that the cardiovascular signs and symptoms seen in thyrotoxicosis resemble those seen in states of catecholamine excess. However, measured concentrations of serum catecholamines in patients with thyrotoxicosis are typically normal or even low, suggesting an increase in the adrenergic responsiveness of the thyrotoxic heart. In spite of several decades of work, the question of whether thyroid hormone increases cardiac […]

OBJECTIVE: To examine the factors associated with persistence or recurrence of hyperthyroidism following an initial therapy dose of 131 I. METHODS: Retrospective case-note review of all patients with hyperthyroidism treated with a fixed dose of 400 MBq 131 I at a single reference centre (1992 to 1997). From the 104 patients treated during that period, six had a multinodular goitre and one, a toxic adenoma; 96 were taking thionamide preparations, which were discontinued 7 days prior to radioiodine administration. RESULTS: […]

Despite the incessant dedication of the researchers to the study of osteoporosis, a lot still needs to be elucidated. The deficiency of sexual steroids, mainly of estrogen, is considered the main cause of osteoporosis, although a number of other factors are involved. Hyperthyroidism, for instance, is considered a risk factor for induction or aggravation of osteoporosis and has risen the interest in the study of the effects of T3 and T4 on osseous metabolism. Although hypothyroidism and gonadic dysfunction are […]

Thionamides are drugs frequently used for the treatment of hyperthyroidism in Basedow-Graves’ disease (BGD), both as primary therapy and for the preparation of patients undergoing surgery or radioiodine therapy. Adverse reactions related to these drugs affect 3-12% of patients, varying from minor and transient reactions, more frequently, to uncommon, severe and potentially fatal ones. We describe a patient diagnosed with hyperthyroidism due to BGD, who developed polyarthralgia followed by ulcer-necrotizing cutaneous lesions in the distal extremities of the legs, after […]

The purpose of this article is to review aspects of skeletal muscle dysfunction and body composition in hyperthyroidism. Hyperthyroidism is associated with general muscle weakness, which is part of the initial clinical manifestation of about 80% of patients, compromising their daily activities and quality of life. A factor that contributes for strength reduction is muscle atrophy, which usually tends to affect proximal muscle groups. In addition, hyperthyroidism is accompanied by weight loss due to consumption of muscle mass and adipose […]

Since the first reports in the medical literature describing the clinical presentation of hypo and hyperthyroidism, very little has changed on the semiologic scenario of these entities and even in their therapeutic approach. The changing trends refer much more to the tools used to diagnose thyroid disease. In parallel with these developments, we understand much better about the factors that interfere in the interpretation of thyroid function tests in the diagnosis of hyper and hypothyroidism. In this article, we analyzed […]