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EFFECT OF THE COMBINATION OF DEXAMETHASONE AND SODIUM IPODATE ON SERUM THYROID HORMONES IN GRAVES' DISEASE
Author(s) -
ARTEAGA E.,
LÓPEZ J. M.,
RODRÍGUEZ J. A.,
MICHAUD P.,
LÓPEZ G.
Publication year - 1983
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.1983.tb00040.x
Subject(s) - medicine , endocrinology , dexamethasone , hormone , sodium , triiodothyronine , thyroid , thyroid hormones , chemistry , organic chemistry
SUMMARY To investigate the effect of the combination of dexamethasone (Dex) and sodium ipodate (SI) on hyperthyroidism, we studied 24 patients with typical GRAVES' disease, divided into four groups of six persons each. Three groups (Study I) were studied acutely (24 h) to determine the effects of Dex (5 mg every 12 h intramuscularly), SI (one oral dose of 3 g) and both drugs at the same doses, upon T4, T3, and rT3 at 0900 h before therapy was started and 24 h later. The group on Dex and that on SI had a similar T3 decrement of 25·9±4·0% and 35·8±5·0%, respectively, ( P < 0·05), whereas the effect of both drugs combined was greater (64·2±3·6%; P <0·01, Dex, and P <0·01, SI, respectively). The increment of rT3 was markedly greater in those patients on SI than in those on Dex (561·3±149·2% and 58·9±11%, respectively, P <0·025). A fourth group (Study II) was studied for seven days while receiving both Dex (1 mg orally three times per day) and SI (500 mg orally three times per day). Both T4 (from 18·8 ± 1·1 to 13·1 ± 1·1 μg/dl, P < 0·02) and T3 (from 593 · 41 to 136·3 ± 12·7 ng/dl, P < 0·001) decreased at day 8. The initial brisk increment of rT3 at 24 h (808 ± 149%, P < 0·005) then diminished concomitantly with the fall of its precursor, T4. The pulse rate correlated with plasma T3 concentration ( r = 0·67, P < 0·001) and varied from 104·7 ± 3·9 on day 1 to 77·3 ± 3·0 beats/min ( P < 0·001) on day 4 and then remained stable. These results show that Dex and SI have potent inhibitory effects at the level of peripheral conversion of T4 and on the thyroid gland itself and that the combined use of these drugs significantly increases these effects. Considering the rapid clinical improvement of thyrotoxicosis achieved with both drugs, this regimen may be valuable in the initial treatment of some patients.