A prospective study of the effects of lithium on thyroid function and on the prevalence of antithyroid antibodies
Identifieur interne : 000C41 ( Main/Exploration ); précédent : 000C40; suivant : 000C42A prospective study of the effects of lithium on thyroid function and on the prevalence of antithyroid antibodies
Auteurs : D. H. Myers [Royaume-Uni] ; R. A. Carter [Royaume-Uni] ; B. H. Burns [Royaume-Uni] ; A. Armond [Royaume-Uni] ; S. B. Hussain [Royaume-Uni] ; Vinnie K. Chengapa [Royaume-Uni]Source :
- Psychological Medicine [ 0033-2917 ] ; 1985-02.
Abstract
Tests of thyroid function and pathology were carried out on 133 patients before they were treated with lithium (Li+). Of the 12 patients who subsequently became hypothyroid during treatment with lithium 9 had, before the commencement of treatment, thyroid autoantibodies and/or an exaggerated thyroid stimulating hormone (TSH) response to thyrotropin releasing hormone (TRH), whereas 3 patients had neither of these indicators. Lithium administration was accompanied by a rise in thyroid antibody titre in 20 patients but a fall in only 5, a statistically significant difference. Evidence that it may be an immunostimulant is discussed. Li+-induced thyroid failure cannot be accurately predicted, and may occur suddenly. The best minimum safeguard, therefore, is serial thyroxine (T4) (or free T4) estimation, supplemented if equivocal by a free thyroxine index (FTI), a basal TSH and, if doubt remains, by a TRH test.
Url:
DOI: 10.1017/S0033291700020924
Affiliations:
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<front><div type="abstract">Tests of thyroid function and pathology were carried out on 133 patients before they were treated with lithium (Li+). Of the 12 patients who subsequently became hypothyroid during treatment with lithium 9 had, before the commencement of treatment, thyroid autoantibodies and/or an exaggerated thyroid stimulating hormone (TSH) response to thyrotropin releasing hormone (TRH), whereas 3 patients had neither of these indicators. Lithium administration was accompanied by a rise in thyroid antibody titre in 20 patients but a fall in only 5, a statistically significant difference. Evidence that it may be an immunostimulant is discussed. Li+-induced thyroid failure cannot be accurately predicted, and may occur suddenly. The best minimum safeguard, therefore, is serial thyroxine (T4) (or free T4) estimation, supplemented if equivocal by a free thyroxine index (FTI), a basal TSH and, if doubt remains, by a TRH test.</div>
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