title: [Shortened preoperative preparation in diffuse hyperthyroid goiter: experience in 34 patients].
abstract: Conventional preparation of goitrous hyperthyroid patients using lugol and propranolol may take 2 weeks. This period may be shortened using sodium iopodate and dexamethasone. We used 500 mg of sodium iopodate and 1 mg dexamethasone for 4 days in 34 hyperthyroid patients. Surgical indication derived from failure to medical treatment (68%), large goiter (27%) or adverse reaction to PTU (6%). Clinical euthyroidism was achieved after 4 days in all patients. T3 levels decreased from 482 +/- 26.2 to 137.6 +/- 3.7 ng/dl and T4 from 20.6 +/- 1.04 to 15.2 +/- 0.5 micrograms/dl (p < 0.005). Surgery was uneventful in 33 patients, one subject developed supraventricular tachycardia responsive to verapamil. Electron microscopy of the removed thyroid tissue revealed marked decrease of superficial villi and large phagosomes. Thus, sodium iopodate and dexamethasone are effective and safe for preoperative preparation of hyperthyroid patients.
authors.affiliation: Instituto de Cirugía, Medicina Interna y Anatomía Patológica, Facultad de Medicina, Universidad Austral de Chile.
authors.forename: J A
authors.initials: JA
authors.lastname: Pérez
authors.forename: R
authors.initials: R
authors.lastname: Silva
authors.forename: L
authors.initials: L
authors.lastname: Norambuena
authors.forename: B
authors.initials: B
authors.lastname: López
authors.forename: V
authors.initials: V
authors.lastname: Valencia
authors.forename: C
authors.initials: C
authors.lastname: Kinast
authors.forename: O
authors.initials: O
authors.lastname: Iribarren
mesh_terms: D000293:Adolescent; D000328:Adult; D003907:Dexamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006042:Goiter / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D007487:Ipodate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013965:Thyroidectomy; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D014284:Triiodothyronine; D003907:Dexamethasone; D007487:Ipodate; D013974:Thyroxine
vernacular_title: Preparación preoperatoria abreviada en los bocios difusos hipertiroídeos. Experiencia en 34 pacientes.