The Treatment of 26 Thyrotoxic Patients with Thiouracil and a Review of Toxic Reactions in All (135) Reported Cases

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Abstract
Eighteen patients with hyperplastic and eight with nodular goitres were treated with thiouracil for periods varying from 6 days-9 mos. Each showed an improvement in the toxic condition as shown by relief of subjective symptoms, a decrease in the systolic and pulse pressures, a slowing of the pulse rate, an increase in wt., a decrease in the size of the thyroid gland, an increase in the value for total blood cholesterol, and a lowering of the BMR. The ester fraction of blood cholesterol was not percentually disturbed. Blood Na, K and Cl levels were unaffected. Creatinuria was decreased. Glucose tolerance was not appreciably changed. Various tests for liver function yielded uniformly normal results. Under thiouracil therapy, there was a transient intensification of the lymphocytosis usually seen in thyrotoxicosis. Two patients showed severe reactions; one with the picture of an agranulocytic angina; the other with an urticarial rash and fever. Sixteen toxic reactions have been observed up to and including the present report; these were briefly reviewed. They included agranulocytic angina, urticaria, fever, diarrhoea, hematuria, peripheral edema, and leuko-penia.