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Unilateral Toxic Multicystic Goiter-Reply

Unilateral Toxic Multicystic Goiter-Reply Abstract In Reply. —Dr Daniels is correct to point out that a low dose of levothyroxine can produce thyrotoxicosis in the presence of autonomous thyroid tissue. As stated in the figure legend in our article, the patient had not been receiving levothyroxine therapy three weeks before the preoperative sodium iodide I 123 thyroid scan. Several weeks later, the patient became clinically mildly hyperthyroid, with a serum thyroxine uptake of 16.0 μg/dL. At that time, she had not received any levothyroxine therapy for six weeks. Nevertheless, the indication for surgery was not the mild hyperthyroidism, but the mass effect of the enlarged left thyroid gland, which was causing a pressure sensation in the patient's neck.Potassium iodide in pharmacologic doses has been used for many years to prepare thyrotoxic patients for surgery. In addition to producing a prompt block to thyroid hormone secretion, iodide decreases vascularity within 14 days,1 making the References 1. Brownlie BEW, Turner JG, Ellwood MA, et al: Thyroid vascularity: Documentation of the iodide effect in thyrotoxicosis. Acta Endocrinol 1977;86:317-322. 2. Fradkin JE, Wolff J: Iodide-induced thyrotoxicosis. Medicine 1983;62:1-20.Crossref 3. Wolff J: Iodide goiter and the pharmacologic effects of excess iodide. Am J Med 1969; 47:101-107.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Unilateral Toxic Multicystic Goiter-Reply

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350110212053
Publisher site
See Article on Publisher Site

Abstract

Abstract In Reply. —Dr Daniels is correct to point out that a low dose of levothyroxine can produce thyrotoxicosis in the presence of autonomous thyroid tissue. As stated in the figure legend in our article, the patient had not been receiving levothyroxine therapy three weeks before the preoperative sodium iodide I 123 thyroid scan. Several weeks later, the patient became clinically mildly hyperthyroid, with a serum thyroxine uptake of 16.0 μg/dL. At that time, she had not received any levothyroxine therapy for six weeks. Nevertheless, the indication for surgery was not the mild hyperthyroidism, but the mass effect of the enlarged left thyroid gland, which was causing a pressure sensation in the patient's neck.Potassium iodide in pharmacologic doses has been used for many years to prepare thyrotoxic patients for surgery. In addition to producing a prompt block to thyroid hormone secretion, iodide decreases vascularity within 14 days,1 making the References 1. Brownlie BEW, Turner JG, Ellwood MA, et al: Thyroid vascularity: Documentation of the iodide effect in thyrotoxicosis. Acta Endocrinol 1977;86:317-322. 2. Fradkin JE, Wolff J: Iodide-induced thyrotoxicosis. Medicine 1983;62:1-20.Crossref 3. Wolff J: Iodide goiter and the pharmacologic effects of excess iodide. Am J Med 1969; 47:101-107.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1983

References