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Hyperthyreosis factitia acuta — Geringe klinische Symptome bei drei Fällen unter β-Blocker-Behandlung

Acute factitial thyrotoxicosis — Moderate clinical symptoms in three patients receiving β-adrenergic blockade

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Summary

The clinical and laboratory findings are described in three patients who ingested large amounts ofl-thyroxine (two cases) andl-thyroxine together withl-triiodothyronine and who were treated with propranolol. Serum concentrations of thyroxine (maximum values 75 µg/dl, 64 µg/dl, and 20 µg/dl, respectively; normal range 4–12 µg/dl), triiodothyronine (maximum values 837 ng/dl, 453 ng/dl, and 566 ng/dl, resp.; normal range 80–180 ng/dl), reverse triiodothyronine (maximum values 235 ng/dl, 190 ng/dl, and 65 ng/dl, resp.; normal range 10–40 ng/dl) as well as free thyroxine equivalent and free triiodothyronine equivalent were monitored daily until they reached the normal range. Statistical analysis of the kinetics of these parameters indicated that the extreme thyroxine conversion was directed toward reverse triiodothyronine, partly due to the treatment with the β-adrenergic blocker propranolol. The striking discrepancy between the high concentrations of the active hormones and the moderate clinical symptoms was most likely caused by peripheral effects of propranolol.

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Abbreviations

d:

Tag

dl:

Deziliter

e:

Eulersche Zahl

EKG:

Elektrokardiogramm

f:

Frequenz

FT3E:

free triiodothyronine equivalent

FT4E:

free thyroxine equivalent

GOT:

Glutamat-Oxalacetat-Transaminase

GPT:

Glutamat-Pyruvat-Transaminase

γ-GT:

γ-Glutamyl-Transferase

°C:

Grad Celsius

kg:

Kilogramm

L:

levo-

ln:

natürlicher Logarithmus

m:

männlich

mg:

Milligramm

µg:

Mikrogramm

min:

MInute

mmHg:

Millimeter Quecksilbersäule

NWG:

Nachweisgrenze

PBI:

protein bound iodine

p.o.:

per os

PTT:

Partielle Thromboplastinzeit

r:

Korrelations-koeffizient

rT3 :

reverse T3

Std.:

Stunde(n)

T:

Temperatur

T3 :

Trijodthyronin

T4 :

Tetrajodthyronin=Thyroxin

Tbl.:

Tabletten

Tg:

Thyreoglobulin

TSH:

Thyreotropin

w:

weiblich

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Authors and Affiliations

  1. Abteilung Innere Medizin I, Universität Ulm, Germany

    F. S. Keck, U. Loos, L. Duntas & E. F. Pfeiffer

Authors
  1. F. S. Keck
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  2. U. Loos
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  3. L. Duntas
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  4. E. F. Pfeiffer
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Additional information

Daten teilweise dargestellt auf dem 28. Symposium der Deutschen Gesellschaft für Endokrinologie, 1984, Heidelberg.

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft, Bonn-Bad Godesberg (SFB 87/Hl)

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Keck, F.S., Loos, U., Duntas, L. et al. Hyperthyreosis factitia acuta — Geringe klinische Symptome bei drei Fällen unter β-Blocker-Behandlung. Klin Wochenschr 64, 319–326 (1986). https://doi.org/10.1007/BF01711950

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  • DOI: https://doi.org/10.1007/BF01711950

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