TREATMENT OF THYROID CRISIS BY BETA-ADRENERGIC BLOCKADE

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Abstract
Two patients in thyroid crisis were treated with the beta-blocking agents pronethalol and propranalol. Initial specific treatment with iodine and carbimazole and supportive therapy, which included sedation, chlorpromazine and steroids were without effect, and both patients deteriorated. Treatment with pronethalol or propranol was associated with marked symptomatic improvement; the pulse, temperature and respiratory rates falling rapidly, while hyper excitability, restlessness and tremor subsided. In one patient cardiac arrhythmia was controlled. Crisis was associated with a marked elevation of plasma free fatty acids, the levels of which fell abruptly with treatment. Beta-adrenergic blocking agents may be of value in the management of crisis until specific anti-thyroid therapy becomes effective.