Lithium Carbonate를 사용(使用)한 갑상선기능항진증(甲狀腺機能亢進症)의 치료(治療)

The Effect of Lithium Carbonate in the Treatment of Hyperthyroidism

For the assessment of antithyroid effect of lithium carbonate, it was administered to the 17 hyperthyroid and 5 euthyroid patients, who visited the Seoul National University Hospital from Jan. to Aug., 1977. Thyroid function tests were performed just before the administration of Lithium carbonate, 2 weeks and 2 months after lithium treatment. The results were as follows; 1) In the 5 euthyroid patients, no significant changes in thyroid function tests were obtained before and after lithium treatment. 2) In the 17 hyperthyroid patients, the values of the $T_3RIA$ were $370{\pm}121ng/dl$ 2 weeks after lithium treatment as compared with $506{\pm}121ng/dl$ before the administration, of which the mean percentage fall was 26.9%. $T_3RU$ was varied from $56.8{\pm}8.0%\;to\;47.3{\pm}8.1%$ (16.7% in mean percentage fall), $T_4$ was changed from $24.2{\pm}2.4ug/dl\;to\;22.0{\pm}4.2ug/dl$ (9.1% in mean fall), and $T_7$, from $13.82{\pm}2.25\;to\;10.55{\pm}3.12$ (23.7% in mean fall). 3) In the 5 hyperthyroid patients, serial thyroid function tests were performed 2 weeks and 2 months later. The mean percentage falls of $T_3RIA$ were 36.6 and 61.3%, 2 weeks and 2 months after lithium treatment respectively. Those of $T_3RU$ were 17.5 and 35.1%, those of $T_4$ were 20.4 and 44.0%, $T_7$, 35.0 and 60.7%. 4) Approximately $45{\sim}60%$ of mean fall in thyroid function tests were obtained within the second week. Normal thyroid function tests were observed in 2 among 17 patients within the second week, and 2 among 5 patients within the second month. 18 patients, however, became clinically euthyroid within the 4th week. 5) Single case of hypothyroidism was experienced, and 5 patients (29.4%) complained mild side effects. Lithium salts could be safely administered to hyperthyroid patients who are allergic to thioamides or iodine. Its use is indicated in cases of acute thyrotoxicosis in which it's necessary to reduce hormone levels very rapidly, and lithium-thioamides drug combination is a highly effective and safe means of initial routine control of hyperthyroidism.