Syrenicz A
Kliniki Endokrynologii i Chorób Przemiany Materii, Instytutu Chorób Wewnetrznych, Pomorskiej Akademii Medycznej.
Ann Acad Med Stetin. 1990;36:133-52.
The performed studies covered 48 subjects, inhabiting the Western Pomerania, therein 40 patients with hyperthyroidism in the course of Graves-Basedow's disease (32 females and 8 males, aged 21-64 years) as well as 8 healthy individuals (5 females and 3 males, aged 23-36 years, with negative anamnesis towards thyroid diseases), who made up the control group at determining the pharmacokinetic parameters after a single oral dose containing 60 mg of thiamazole. On the basis of estimating the time of treatment with "full dose" of thiamazole, indispensable for attaining clinical euthyreosis, according to criteria provided by Crooks et al., the patients with hyperthyroidism during Graves-Basedow's disease were divided into 2 subgroups: 1). Subgroup IA included 22 patients, in whom the clinical state of euthryreosis was obtained in 28 days of therapy with "full dose" of thiamazole. 2). Subgroup IB encompassed 18 patients, in whom euthyreosis appeared after at least 35-day-long treatment with a "full dose" of thiamazole. The differing behavior of thyroid hormones and thiamazole pharmacokinetics+ in both subgroups of patients has furnished the basis for the following conclusions to be drawn: The patients with hyperthyroidism in the course of Graves-Basedow's disease, attaining rapidly the clinical euthyreosis during the treatment with "full dose" of thiamazole, are found to normalize the concentrations of thyroxine and triiodothyronine in serum after shorter time than it is done by patients requiring a longer drug application in a "full dose". In patients achieving euthyreosis both after short and long time of treatment with "full dose" of thiamazole, the normalization in concentrations of thyroid hormones in serum markedly exceeds, by about 2-4 weeks, the establishing of clinical euthyreosis. In patients, who readily attain the clinical euthyreosis, the concentrations of thiamazole in serum, after a single "full dose" as well as during two-month-long treatment, are significantly higher than in patients reaching euthyreosis slowly, in spite of the fact that there were no outstanding differences in absorbing the drug from the alimentary duct in both subgroups being compared. The cause that the clinical effect varies in the compared subgroups of patients with hyperthyroidism during the Graves-Basedow's disease is the difference in thiamazole metabolism in the organism, most likely in the liver.