Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:13

Hyperthyroidism Hypertriglyceridemia 773

complications and prognosis

Complications

■Thyroid storm: rare; requires intensive care

■Hypothyroidism: treated with levothyroxine and occurs in most GD

patients treated with I-131

■Agranulocytosis: occurs in 0.3% of patients treated with PTU or MTZ;

discontinue drug; treat patient with antibiotics, isolation, and IV G-

CSF

Prognosis

■GD: I-131 usually causes hypothyroidism, requiring life-long

levothyroxine; permanent cure uncommon (∼20%) in U. S. after

antithyroid drugs;∼80% require life-long MTZ or PTU

■MNTG and toxic adenoma: usually cured by I-131 or surgery

■Subacute thyroiditis: resolves spontaneously within 3–12 mo

Hypertriglyceridemia.................................

FREDRIC B. KRAEMER, MD

history & physical

History

■diabetes

■obesity

■pancreatitis

■myocardial infarction

■stroke

■peripheral vascular disease

■hypertension

■smoking

■alcohol use

■estrogen or steroid use

■family history of diabetes

■family history of hypertriglyceridemia or hypercholesterolemia

■family history of myocardial infarction

■family history of stroke

■family history of peripheral vascular disease

Signs & Symptoms

■may be asymptomatic