Displaying publications 41 - 60 of 79 in total

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  1. Fulltext Endoscopic orbital decompression for Graves' ophthalmopathy
    Tang IP, Prepageran N, Shashinder S
    Med J Malaysia, 2008 Mar;63(1):67-8.
    PMID: 18935740
    We report a male patient of Graves' Disease with bilateral exophthalmos who had undergone bilateral transnasal endoscopic orbital decompression with subsequent improvement of 3 mm in orbital proptosis bilaterally without any complications. Transnasal endoscopic orbital decompression is recommended as an alternative to traditional decompression techniques especially for purely cosmetic reasons.
    Matched MeSH terms: Hyperthyroidism*
  2. Fulltext Thyrotoxic neuropathy- an under diagnosed condition
    Sahni V, Gupta N, Anuradha S, Tatke M, Kar P
    Med J Malaysia, 2007 Mar;62(1):76-7.
    PMID: 17682580
    Many neurological diseases like myopathy, periodic paralysis, ophthalmoplegia, and myasthenia gravis are known associations of thyrotoxicosis. However the association of neuropathy with thyrotoxicosis is not frequently recognized. First described by Charcot in 1889, thyrotoxic neuropathy or 'Basedow's Paraplegia' is a rarely reported entity. We describe here a case of a young woman with subacute distal neuropathy as the presenting manifestation of thyrotoxicosis. The neuropathy improved on antithyroid treatment. A careful literature search leads us to believe that peripheral neuropathy in thyrotoxicosis is under recognised. Thyroid function tests can be helpful in the diagnosis of this treatable neuropathy and should be included in the routine work up.
    Matched MeSH terms: Hyperthyroidism*
  3. Fulltext Transient hyperthyroidism following L-asparaginase therapy for acute lymphoblastic leukemia
    Fadilah SAW, Faridah I, Cheong SK
    Med J Malaysia, 2000 Dec;55(4):513-5.
    PMID: 11221167
    The effect of L-asparaginase on the thyroid gland has not been well documented. We report the first two cases of hyperthyroidism associated with thyroid nodule following L-asparaginase therapy for acute lymphoblastic leukemia (ALL). The thyroid function abnormalities were not severe, short-lived and did not require specific therapy.
    Matched MeSH terms: Hyperthyroidism/chemically induced*
  4. Fulltext Comparison of the efficacy of single and multiple regimens of carbimazole in the treatment of thyrotoxicosis
    Mafauzy M, Wan Mohamad WB, Zahary MK, Mustafa BE
    Med J Malaysia, 1993 Mar;48(1):71-5.
    PMID: 8341175
    Carbimazole, in 3 divided daily doses, is commonly prescribed for the treatment of thyrotoxicosis. However, based on its long intra-thyroid half-life, the drug may be effective when used as a single or twice daily dose. This study was undertaken to determine the effect of once, twice or thrice daily doses of carbimazole on thyroid function in patients with thyrotoxicosis. Seventy previously untreated thyrotoxic patients were randomly allocated to receive carbimazole 30 mg once (group 1), 15 mg twice (group 2) and 10 mg thrice (group 3) daily. All patients were also prescribed propranolol 20 mg thrice daily for the first 4 weeks. Blood was taken for total T3, T4, TSH, blood counts and liver enzymes determinations at the beginning and at 6 weeks of treatment. Only 48 (68.6%) patients were included in the analysis, as the rest defaulted follow-up (20.0%) or blood samples were not available at review (11.4%). Of the 48 patients, 17 were in group 1, 16 in group 2 and 15 in group 3. Following 6 weeks of treatment, there was no significant difference in the mean serum levels of total T3 and T4 between the 3 groups. However, there was a significant decrease in the mean serum levels of total T3 and T4 as compared to the start of the treatment. Four patients (23.5%) in group 1, 4 patients (25%) in group 2 and 3 patients (20%) in group 3 were still thyrotoxic at 6 weeks of treatment, whilst 10 patients (58.8%) in group 1, 6 patients (37.5%) in group 2 and 3 (20%) in group 3 were biochemically hypothyroid.(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Hyperthyroidism*
  5. Fulltext Lethargy in a patient with cirrhosis
    Chuah SY, Wong NW, Goh KL
    Postgrad Med J, 1997 Mar;73(857):177-9.
    PMID: 9135840 DOI: 10.1136/pgmj.73.857.177
    Matched MeSH terms: Hyperthyroidism/complications*
  6. Fulltext Results of long-term follow-up after compensated fixed-dose therapy for thyrotoxicosis
    Zaini A, Khir A, Doi SA, Chan SP, Paramsothy M, Khoo BH
    J Int Med Res, 1992 Jun;20(3):279-88.
    PMID: 1397673
    To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.
    Matched MeSH terms: Hyperthyroidism*
  7. Fulltext Psychoses associated with thyrotoxicosis: a retrospective study of twenty cases
    Tan CK
    Med J Malaysia, 1985 Sep;40(3):247-51.
    PMID: 3842721
    A total of 23 patients with psychoses associated with thyrotoxicosis were admitted to the psychiatric unit of a University Hospital over a 13-year period, of which 20 patients were included in this retrospective study. It was found that a parallel relationship between thyrotoxicosis and psychosis appears to exist in six patients, while in the remaining 14 patients, the course of the two disease processes were largely independent of each other. Paranoid delusions and auditory hallucinations were the most prominent psychiatric symptoms. Depression was commonly seen even in patients who were not having an affective illness. In four patients, a mixed schizo-affective psychosis was seen, suggesting that the diagnostic distinction between the affective and schizophrenic reactions are often blurred in psychosis associated with thyrotoxicosis.
    Matched MeSH terms: Hyperthyroidism*
  8. Fulltext Dysphagia as a primary manifestation of thyrotoxicosis: a case report
    Ramanathan M
    Med J Malaysia, 1989 Mar;44(1):83-6.
    PMID: 2626117
    This report deals with a middle aged man in whom the presenting symptom of the disorder was dysphagia. The clinical approach to the final diagnosis of thyrotoxic myopathy causing dysphagia is outlined and the pathophysiology of dysphagia then discussed. The need to include thyrotoxicosis in the differential diagnosis of an otherwise unexplained case of dysphagia is stressed.
    Matched MeSH terms: Hyperthyroidism*
  9. Optimization of nuclear medicine procedures for the diagnosis and management of thyroid disorders: report of a research coordination meeting held in Vienna, 15-17 December 1986 under the auspices of the International Atomic Energy Agency
    Ganatra R, Gembicki M, Nofal M
    Nucl Med Commun, 1988 Feb;9(2):131-9.
    PMID: 3386976
    The third and final meeting of a coordinated research programme on the diagnosis and management of thyroid disorders was held in Vienna from 15 to 17 December 1986. The participants were from Czechoslovakia, Egypt, Israel, Malaysia and Thailand. Each participant had studied between 500 and 1000 patients for thyroid function evaluation by performing T3, T4 and TSH radioimmunoassays. Each had also used the newly available supersensitive immunoradiometric (IRMA) assay in a group of patients to compare the efficiency of the new assay with that of the conventional assay. A microcomputer was provided to each participant for data analysis. Internal quality control was studied by establishing precision profiles and external quality control was on the basis of pooled standard sera in different ranges. Recommendation for the strategy suggested T4 RIA as the test of first choice in each category of thyroid function. IRMA TSH was suggested as a second test in borderline cases.
    Matched MeSH terms: Hyperthyroidism/diagnosis
  10. Cyclic adenosine 3',5'-monophosphate content and bronchial smooth muscle contractility of hyper- and hypothyroid lungs
    Nabishah BM, Morat PB, Alias AK, Kadir BA, Khalid BA
    Clin Exp Pharmacol Physiol, 1992 Dec;19(12):839-42.
    PMID: 1335381
    1. Male Sprague-Dawley rats were made either hyper- or hypothyroid with thyroxine or 4-methyl-2-thiouracil, respectively. Bronchial smooth muscle (BSM) contractility and lung cyclic adenosine 3',5'-monophosphate (cAMP) content were measured in both conditions. 2. Bronchial smooth muscle contractility was significantly weaker in hyperthyroid rats, while the BSM contractility of hypothyroid rats was the same as controls. 3. The cAMP content of hyperthyroid rat lungs was similar to controls but was decreased in hypothyroid rats. 4. These studies demonstrated that both the hyper- and hypothyroid states affect respiration, although the mechanisms involved with different for each condition.
    Matched MeSH terms: Hyperthyroidism/physiopathology*
  11. Thyroid autoantibodies and associated complications during pregnancy
    Nor Azlin MI, Bakin YD, Mustafa N, Wahab NA, Johari MJ, Kamarudin NA, et al.
    J Obstet Gynaecol, 2010;30(7):675-8.
    PMID: 20925608 DOI: 10.3109/01443615.2010.503908
    This study was undertaken to determine the presence of thyroid autoantibodies and associated pregnancy complications from 49 pregnant women with thyroid disease. There were 31 (63%) women with Graves' disease (GD) and 18 (37%) with primary hypothyroidism (PHT). A total of 26 (53.1%) women, 19 (61%) with GD and seven (39%) with PHT, had positive antibodies. Six had thyroid peroxidase antibodies (TPO), one with thyroglobulin antibody (TG) and eight had TSH receptor antibodies (TR). Two had a mixture of antibodies involving TG/TPO (one GD vs one PHT), four with TG/TPO/TR (all had GD) and five with TPO/TR (four with GD vs one with PHT). There were associations in women with positive thyroid antibodies and pre-eclampsia (15.4%), abruptio placenta (4%), caesarean deliveries (31%), postpartum thyroiditis (19.2%) and abnormal neonatal thyroid function (15.4%). Women with positive thyroid antibodies in pregnancy need close care during and after pregnancy, as they can develop complications affecting both mother and fetus.
    Matched MeSH terms: Hyperthyroidism/immunology*; Hyperthyroidism/epidemiology
  12. Slow carbamazepine clearance in a nonadherent Malay woman with epilepsy and thyrotoxicosis
    Yeap LL, Lim KS, Ng CC, Hui-Ping Khor A, Lo YL
    Ther Drug Monit, 2014 Feb;36(1):3-9.
    PMID: 24342894 DOI: 10.1097/FTD.0000000000000024
    The authors describe a case of a 37-year-old Malay lady with an unusually slow carbamazepine clearance, which may be related to genetic polymorphisms of drug metabolizing enzymes and transporters. When given a small daily dose of 200 mg immediate-release carbamazepine, this patient experienced drowsiness. Subsequently, she reduced her carbamazepine dose to 200 mg twice a week (on Mondays and Fridays), resulting in poor seizure control. At the same time, the patient was diagnosed with hyperthyroidism and was given carbimazole and propranolol. Hyperthyroidism and the concurrent use of these antihyperthyroid agents may have further slowed down the metabolism of carbamazepine. Therapeutic drug monitoring of carbamazepine was carried out, and a slow carbamazepine clearance of 1.45 L·h⁻¹ per 70 kg was observed. Genotyping of selected genetic variants in CYP3A4, CYP3A5, EPHX1, ABCB1, and ABCC2 revealed that she has CYP3A5*3/*3 and ABCB1 3435-CC genotypes. Both genotypes have been shown to be associated with higher adjusted mean serum carbamazepine concentration in Chinese and Korean patients with epilepsy. Physicians should be vigilant about the risk of adverse effects among patients with a slow carbamazepine clearance, especially in Malays. Simulations of carbamazepine dosing regimen based on the pharmacokinetic parameters of this patient were performed to allow individualization of drug therapy.
    Matched MeSH terms: Hyperthyroidism/drug therapy; Hyperthyroidism/physiopathology
  13. Fulltext Autoimmune thyroid disease in a cohort of Malaysian SLE patients: frequency, clinical and immunological associations
    Ong SG, Choy CH
    Lupus, 2016 Jan;25(1):67-74.
    PMID: 26113361 DOI: 10.1177/0961203315593164
    Autoimmune thyroid disease (ATD) has been associated with other systemic autoimmune diseases. To date, there is limited data on thyroid disorders and autoimmune thyroid disease in Malaysia. The frequency of ATD among 189 systemic lupus erythematosus (SLE) patients was 6.3%, with 2.6% in the hyperthyroid group and 3.7% in the hypothyroid group. Hypothyroidism developed at a much younger mean age (24.3 years), suggesting that SLE might be a predisposing factor for the development of Hashimoto's thyroiditis. There was a higher rate of thyroid peroxidase antibody (TPO) positivity compared with anti-thyroglobulin antibody (Tg) in the hyperthyroid subgroup. This study also demonstrated a greater proportion of ATD patients who demonstrated high titres (≥ 1:6400) of TPO compared with high titres of Tg. Although there was an association between ATD and the presence of anti-Ro/SSA and/or anti-La/SSB antibodies, the absence of sicca symptoms and negative Schirmer's tests suggest a lack of association with secondary Sjogren's syndrome. A novel association between ATD and antiphospholipid syndrome (APS) was detected in our cohort. Hence we propose that patients affected by APS be routinely screened for ATD.
    Matched MeSH terms: Hyperthyroidism
  14. Fulltext Hypothyroidism and its associated factors after radioactive iodine therapy among patients with hyperthyroidism in the Northeast Coast State of Malaysia
    Wan Mohamed WMI, Sayuti SC, Draman N
    J Taibah Univ Med Sci, 2018 Oct;13(5):432-437.
    PMID: 31435358 DOI: 10.1016/j.jtumed.2018.06.004
    Objectives: The aim of this study was to determine the incidence of hypothyroidism and its associated factors within one-year post radioactive iodine (RAI) therapy.

    Methods: A retrospective study was conducted among patients with hyperthyroidism who received RAI therapy at Nuclear Medicine Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan. Data regarding patients' demographics, gender, aetiology of hyperthyroidism, presence of autoantibodies, dose of RAI used and usage of antithyroid drug post RAI therapy were included in the analysis.

    Results: Of a total of 167 screened patients, 137 subjects were eligible for this study. The incidence of hypothyroidism within one year of RAI therapy was 32.9%. Women were found to be less likely to develop hypothyroidism post RAI therapy (adjusted odds ratio, 0.406; 95% confidence interval: 0.181-0.908; p = 0.028). The usage of antithyroid drug post RAI was significantly associated with a lower incidence of hypothyroidism post RAI therapy (adjusted odds ratio, 0.188; 95% confidence interval: 0.081-0.438; p<0.001).

    Conclusion: This study showed a high incidence of hypothyroidism within one-year post RAI therapy. Gender and usage of antithyroid drug post RAI therapy are significantly associated with the development of hypothyroidism.

    Matched MeSH terms: Hyperthyroidism
  15. Fulltext High prevalence of thyroid antibodies in urban population of Peninsular Malaysia
    MA, Shahar, Ahmad Marzuki Omar, N, AB Wahab, N, Sukor, NA, Kamaruddin
    IIUM Medical Journal Malaysia, 2020;19(2):3-12.
    MyJurnal
    INTRODUCTION: Thyroid antibodies are closely related to autoimmune thyroid disorders. To date, there
    are no data on the prevalence of these antibodies among the Malaysian population. This study aimed to
    determine the prevalence of thyroid antibodies; and the factors associated with thyroid antibodies in the
    Malaysian adult population. MATERIALS AND METHODS: A cross-sectional study was performed in 5 preassigned regions in Peninsular Malaysia. Participants’ sociodemographic profile and medical history were
    recorded. Physical examinations were done looking for abnormalities of the thyroid gland and signs of thyroid
    dysfunctions. Fifteen mils of blood were withdrawn and analysed for thyroid function, anti-thyroperoxidase
    (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies at a central laboratory. RESULTS: Among the total of
    2190 respondents, the overall prevalence of positive anti-TPO and anti-TG antibodies were 12.2% and 12.1%,
    respectively; mainly found in urban and coastal areas. Only 7% to 9% of those with positive anti-TPO or antiTG antibodies had either hypo- or hyperthyroidism. The predictors for positive anti-TPO antibody were
    female [adjusted OR 1.7 (95%CI: 1.2–2.4); p=0.001], Indian [adjusted OR 1.9 (95%CI: 1.1–3.1); p=0.020], and
    having a goitre [adjusted OR 1.8 (95%CI: 1.2–2.8), p=0.004]. The predictors of positive anti-TG antibody was
    female [adjusted OR 2.3 (95%CI: 1.6–3.3); p
    Matched MeSH terms: Hyperthyroidism
  16. Fulltext Thyroid associated ophthalmopathy - a review
    Mallika PS, Tan AK, Aziz S, Syed Alwi SAR, Chong MS, Vanitha R, et al.
    Malays Fam Physician, 2009;4(1):8-14.
    PMID: 25606151 MyJurnal
    Thyroid associated ophthalmopathy is an autoimmune disorder affecting the orbital and periorbital tissues. Hyperthyroidism is commonly associated with thyroid associated ophthalmopathy, however in 5% to 10% of cases it is euthyroid. Genetic, environmental and endogenous factors play a role in the initiation of the thyroid ophthalmopathy. Smoking has been identified as the strongest risk factor for the development of the disorder. The pathogenesis involves activation of both humoral and cell mediated immunity with subsequent production of gycoaminoglycans, hyaluronic acid resulting in oedema formation, increase extraocular mass and adipogenesis in the orbit. The natural history of the disease progresses from active to inactive fibrotic stage over a period of years. Diagnosis is mainly clinical and almost all patients with ophthalmopathy exhibit some form of thyroid abnormality on further testing. Treatment is based on the clinical severity of the disease. Non-severe cases are managed by supportive measures to reduce the symptomatology and severe cases are treated by either medical or surgical decompression. Rehabilitative surgery is done for quiescent disease to reduce diplopia and improve cosmesis.
    Matched MeSH terms: Hyperthyroidism
  17. Fulltext Subclinical hypothyroidism among patients with depressive disorders
    Siti Yazmin Zahari Sham, Nor Aini Umar, Zarida Hambali, Rosdinom Razali, Mohd Rizal Abdul Manaf
    Malaysian Journal of Medicine and Health Sciences, 2014;10(2):71-78.
    MyJurnal
    Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.
    Matched MeSH terms: Hyperthyroidism
  18. Hyperthyroidism in pregnancy
    Zainuddin Z, Shaker AAH
    Family Physician, 2005;13(3):2-4.
    MyJurnal
    Thyroid diseases are common in women, including at the time of pregnancies. Many typical features of hyperthyroidism are common in normal pregnancies and this may delay or mask the diagnosis. Uncontrolled thyrotoxicosis increases the rate of miscarriage, intrauterine growth restriction (IUGR), premature labour and perinatal mortality. Multi-disciplinary efforts are required to achieve optimal control of thyrotoxicosis. Anti-thyroid drugs are safe and should be used with the lowest possible doses. Radioiodine treatment is contraindicated during pregnancy and lactation. Indications of surgery include: compression symptoms, thyroid malignancy, non-compliance to medications or when the patient develop drugs side effects
    Matched MeSH terms: Hyperthyroidism
  19. Fulltext Carbimazole-induced aplastic anaemia - a case report
    Vijay AP, Lim SS, Tan ATB, Rokiah P, Chan SP
    JUMMEC, 2009;12(2):92-95.
    MyJurnal
    Antithyroid drugs have been used for more than 50 years for the management of hyperthyroidism. Most patients tolerate treatment well, but some may develop rare life threatening side effects such as agranulocytosis and aplastic anaemia. Clinical experience with the latter condition is extremely limited. We report on a case of carbimazole-induced aplastic anaemia caused by hypocellular bone marrow and associated plasmacytosis in a thyrotoxic patient chronically treated with carbimazole. This resolved after substitution with propylthiouracil. The clinical course was complicated by neutropaenic septicaemia and atrial fibrillation.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hyperthyroidism
  20. Fulltext Clinical value of a rapid fully automated thyroid autoantibody assay in the diagnosis and management of graves disease
    Hanita, O., Azura, N.R., Faizal, M.M.Z.
    Medicine & Health, 2012;7(1):24-31.
    MyJurnal
    The most common cause of hyperthyroidism is Graves disease (GD) which is characterised by the presence of autoantibodies which binds to the TSH receptor (TRAb). Recently, a rapid, fully automated electrochemiluminescent immunoassay ElecsysAnti-TSHR for detection of autoantibodies to TSH receptor was made available for routine clinical use. The objective of this study is to evaluate this assay and to determine the sensitivity, specificity and cut-off value. Interassay and total imprecision (CV) were determined at 3.78-7.02 IU/L and 13.5-21.2 IU/L respectively. A total of 124 samples which comprised of 46 GD, seven Hashimoto thyroiditis (HD), 11 non autoimmune nodular goitre (NAG), 2 thyroid cancers (Ca) and 58 normal controls were retrospectively analysed to determine the sensitivity, specificity and cut-off value. Inter-assay CV’s were 2.4% at a concentration of 3.90 IU/L (range: 3.78-7.02 IU/l) and 0.8% at 20.80 IU/L (range:13.5-21.2 IU/l). Total imprecision was 3.8% at a concentration of 3.80 IU/L (range:13.5-21.2 IU/l) and 1.0% at 20.8 IU/L (range:13.5-21.2 IU/l). The ROC analysis of patients with GD, other thyroid disorders and normal controls revealed that the highest sensitivity (94%) and specificity (98%) were seen at cut-off value of 1.69 IU/L. Positive predictive value (PPV) and negative predictive value (NPV) was 95% and 94% respectively. At this derived cut-off value of 1.69 IU/L, we found that the sensitivity of TRAb positivity within the group of 29 newly diagnosed GD patients was 94%. Our results demonstrate that this fully automated assay with testing time of 27 minutes has high sensitivity in detecting GD and high specificity for discriminating other thyroid disease and represent major improvement in the diagnosis and management of patients with thyroid diseases.
    Matched MeSH terms: Hyperthyroidism
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