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Graves'-Basedow's disease--asthma association. Presentation of five cases
H I Ursu1, D Pereţianu, T Bulandra
1C.I. Parhon Institute of Endocrinology, Bucharest, Romania.
Romanian Journal of Endocrinology
|January 1, 1993
Summary
In hyperthyroidism, asthma theoretically improves due to thyroid hormones affecting beta 2 receptors. However, this study found asthma did not improve in Graves-Basedow
Area of Science:
- Endocrinology
- Immunology
- Pulmonology
Background:
- Thyroid hormones exert a permissive effect on adrenergic receptors, including beta 2 receptors.
- Asthma involves immune pathways potentially affected by beta 2 adrenergic receptor blockade.
- Theoretical models suggest hyperthyroidism should ameliorate asthma symptoms.
Observation:
- Five patients with Graves-Basedow's disease and asthma association were studied.
- Asthma preceded the onset of Graves-Basedow's disease in all cases.
- Paradoxical worsening of asthma crises often signaled the thyroid disease.
Findings:
- The expected asthma amelioration in hyperthyroidism was not observed.
- Patients were women over 40, with diffuse but small goiters.
- Radioiodine therapy (131I) led to early asthma improvement.
- Thyroid hormone levels were high, with T3 slightly elevated.
Implications:
- The co-occurrence of asthma and Graves-Basedow's disease may represent a distinct etiological group.
- Standard asthma treatments requiring beta-blockers or bronchodilators posed therapeutic challenges.
- Early antithyroid therapy with radioactive iodine appears effective for asthma in this specific patient cohort.