Asthma and hyperthyroidism

doi:10.1016/0091-6749(72)90133-9

Journal of Allergy and Clinical Immunology

Volume 49, Issue 6, June 1972, Pages 348-355

https://doi.org/10.1016/0091-6749(72)90133-9 Get rights and content

Abstract

Case histories of five patients with severe, intractable asthma, who were later found to have concomitant hyperthyroidism, are presented. Although the frequency of these two diseases in the same individual appears to be small, diagnosis and therapy of the hyperthyroid state provided dramatic amelioration of the asthma.

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Citation Excerpt :
A reduction in vital capacity and decreased lung compliance can occur. Several case reports have described worsening airway reactivity in patients with asthma, which improved only after treatment of thyrotoxicosis was begun [24]. Other studies, however, contradict this assertion and maintain that a consistent relationship between asthma and thyrotoxicosis does not exist [25,26].
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Carefully matching the severity of the asthma with the therapeutic protocols provides an organized approach to asthma treatment. Avoiding triggers of asthma and controlling the environmental exposure to potential triggers leads to lower medication requirements and less lability. Offering the family written instructions to cope with changes in the child's condition, based on assessment of clinical and PEFR observations, allows them more autonomy and comfort in the day-to-day care of the asthmatic child.
Asthma and chronic obstructive lung disease: A pharmacologic approach
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Changing concepts are emerging that should improve our ability to adequately treat asthma. This volume of Disease-a-Month reviews the triggers and the role of inflammation in asthma, and outlines the treatment of acute asthma as well as the chronic management of reversible obstructive airways disease. There is general agreement that sympathomimetics are the treatment of choice for acute severe asthma. The role of theophylline for acute symptoms has been downplayed, and the role of corticosteroids continues to be debated. However, most authorities agree that patients with severe asthma will benefit from the addition of corticosteroids to the program. For the chronic management of asthma, appreciation that inflammation is a perpetuating feature suggests that treatment should generally be directed toward the inflammation. Corticosteroid aerosols have taken on greater prominence and have been advocated as the first line of approach. New concepts regarding the role of allergy in the perpetuation of asthma and the role of immunotherapy in its amelioration also have emerged. Medications not previously thought to be beneficial are being actively investigated. They include gold, methotrexate, and even intravenous gamma globulin.
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We studied the effect of increased thyroid function on airway reactivity. Carbachol challenge was performed to assess airway reactivity according to a standardized method. Measurements of forced expiratory volume-1 second (FEV₁), specific airway conductance (SGaw), the provocative dose of carbachol for a 20 percent decrease in FEV, (PD-20) and that for a 35 percent decrease in SGaw (PD-35) were established upon entry when each subject was hyperthyroid, and subsequently, after the subjects had returned to the euthyroid state. It was concluded that hyperthyroidism reduced the severity of carbachol-induced changes in airway reactivity as measured by SGaw.

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Asthma and hyperthyroidism

Abstract

J. Allergy

J. Allergy

Lancet

The relationship of thyroid disease and the atopic state

Ann. Allergy