Graves'-Basedow's disease--asthma association. Presentation of five cases

Thyroid hormones have a non-selective permissive action on adrenergic receptors (including beta 2). Asthma is an immune disease in which some pathological pathways include beta 2 adrenergic receptor blockade. In theoretical terms, that would mean that in hyperthyroidism asthma would ameliorate. In 5 cases with Graves-Basedow's disease--asthma association this phenomenon has not appeared. The similar clinical features and follow-up of these patients suggest a narrow etiopathogenic group. In all cases, asthma has occurred previous to Graves-Basedow's disease, and the thyroid disease has been suspected because of paradoxical aggravation of asthma crises. In all cases the immune thyroid disease appeared in women over 40 years of age (two over 60 yrs). The thyromegaly was diffuse but small (and absent in one case), thyroid hormone levels have been expectedly high (T3 slightly higher than in other cases). No eye proptosis over Werner's 3rd degree has been recorded. The therapeutical problems have been as follows: contraindication of non-selective antitachycardia beta-blockers (we have administered reserpine), contraindication of non-selective adrenergic bronchodilatory agents (we have administered very low doses of aminophylline), early radical antithyroid therapy (we have administered 111-185 MBq of 131I). Thyroid function after 6 mos to 7 years follow-up have been within normal range (except one case who became hypothyroid). The asthma ameliorated early after 131I administration.