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Sürekli Ayaktan Periton Diyalizi Uygulanan Üç Olguda Tirotoksikoz

Thyrotoxicosis in Three Patients on Continuous Ambulatory Peritoneal Dialysis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Uremia affects thyroid functions and hypothyroidism occurs in end-stage renal disease (ESRD) patients. However, thyrotoxicosis occurs in ESRD patients rarely. Most of the published reports abo¬ ut thyrotoxicosis in ESRD patients are related with thyroid cancer and maintenance on hemodialysis. Therefore we wanted to share our experience about therapy and outcomes of three thyrotoxic peritoneal dialysis (PD) patients without thyroid cancer. Clinical manifestations were nonspecific because uremia masked thyrotoxic symptoms. Hyperthyroidism was due to Basedow- Graves disease in two patients and toxic nodular goiter in one pati¬ ent. All patients were treated with both anti-thyroid drugs (propylthiouracil and propranolol) and radioactive-iodine (RAI) therapy. No si¬ de-effects were seen due to anti-thyroid drugs but hypothyroidism developed after radioactive iodine therapy in all patients. Clinical manifestations of thyrotoxicosis may be masked in ESRD patients. Therefore thyrotoxicosis need to be thoroughly investigated. Anti-thyroid drugs may be used safely in PD patients. But if RAI therapy is used, patients must be evaluated for hypothyroidism after RAI therapy. We speculate that a uremic toxin with poor peritoneal clearance may affect thyroid functions and cause thyrotoxicosis in PD patients.
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Abstract (Original Language): 
Üremi tiroid fonksiyonlarını etkilemekte ve son dönem böbrek yetmezliği (SDBY) hastalarında hipotiroidizm gelişmektedir. Bununla birlikte tirotoksikoz SDBY hastalarında nadirdir. SDBY hastalarında bildirilen çoğu tirotoksikoz olguları tiroid kanseri olan ve hemodiyalize giren hastalardır. Bu nedenle tiroid kanse¬ ri olmayan üç periton diyalizi (PD) hastasındaki tedavi deneyimimizi ve sonuçlarını paylaşmak istedik. Klinik bulgular üreminin tirotoksikoz semptomlarını maskelemesi nedeniyle nonspesifikti. Hipertiroidizmin nedeni iki hastada Basedow-Graves ve bir hastada toksik nodüler guatr idi. Tüm hastalar her iki anti-tiroid ilaç ile (propiltiyourasil ve propranolol) ve radyoaktif iyot (RAI) ile tedavi edildi. Anti-tiroid ilaçlara bağlı bir yan etki tespit edilmedi, fakat tüm hastalarda radyoaktif iyot tedavisi sonrası hipotiroidi gelişti. Tirotoksikozun klinik bulguları SDBY hastalarında maskele¬ nebilir. Bu nedenle tirotoksikoz daha fazla araştırılmalıdır. Anti-tiroid ilaçlar PD hastalarında güvenle kullanılabilir. Fakat eğer RAI tedavisi kullanılırsa, hastalar RAI tedavisi sonrası hipotiroidizm için değerlendirilmelidir. Biz peritoneal klirensi zayıf olan bir toksinin tiroid fonksiyonları üzerine etki edebileceğini ve PD hastalarında tirotoksikoza neden olabileceğini düşünüyoruz.
FULL TEXT (PDF): 
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  • 1
52-55
  • Turkish

REFERENCES

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