Graves’ Disease and the Manifestations of Thyrotoxicosis
DeGroot LJ.
ncbi.nlm.nih.gov/books/NBK2...
RESPIRATORY SYSTEM
Except for dyspnea, which may or may not represent abnormal respiratory function, symptoms deriving from the lungs are not prominent. Nevertheless, measurements show some reduction in vital capacity, expiratory reserve volume, pulmonary compliance, airway resistance, and weakness in both expiratory and inspiratory muscles [323,324]. Minute volume response to exercise is excessive for the amount of oxygen consumed [325]. Dyspnea on effort is present in a large majority of the patients. Pulmonary function in patients without coincident congestive heart failure has demonstrated reduction in vital capacity, decreased pulmonary compliance, weakness of the respiratory muscles, increase in respiratory dead space ventilation, and normal diffusion capacity. A combination of the four abnormalities may produce dyspnea [326]. Amelioration of intractable bronchial asthma has been reported after treatment of coincident thyrotoxicosis [209].
RETICULOENDOTHELIAL AND LYMPHATIC SYSTEMS
The reticuloendothelial and lymphocytic systems undergo hyperplasia. There may be generalized lymphadenopathy, and the thymus may be enlarged. Occasionally the thymus presents as an anterior mediastinal mass, but diminishes to normal size with control of the thyrotoxicosis [370]. Some authors have reported that the spleen tip can be felt in 20% of patients, but in our experience this finding is not common. The autoimmune responses in these patients have been detailed above. Several markers of augmented immune activity are elevated, including soluble CD30, a molecule released by T helper 2 cells, and IL-6 [371].
\"breakthrough thyrotoxicosis\" Anyone else experienced this?
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Urgent - Help me understand the role of hydrocortisone during thyrotoxicosis
