Thyrotoxicosis

Disease-a-Month

Volumn 43, Issue 9, 1997, Pages 606-677

  Kannan, C R ^a,b,c   Seshadri, Krishna ^a,c,d,e,f  

^a Jr Hospital of Cook County   (United States)

^b RUSH MEDICAL COLLEGE   (United States)

^c MADRAS MEDICAL COLLEGE   (India)

^d SRI RAMACHANDRA UNIVERSITY   (India)

^e UNIVERSITY OF ILLINOIS   (United States)

^f ADVOCATE ILLINOIS MASONIC MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

RADIOACTIVE IODINE; THIONAMIDE DERIVATIVE;

CLINICAL EXAMINATION; DIFFERENTIAL DIAGNOSIS; DRUG USE; GRAVES DISEASE; HUMAN; HYPERTHYROIDISM; ORBIT DISEASE; PATHOGENESIS; REVIEW; SKIN DISEASE; THYROID ADENOMA; THYROID SURGERY; THYROID TUMOR; THYROTOXICOSIS; TOXIC GOITER; TROPHOBLASTIC TUMOR;

EID: 84866477325     PISSN: 00115029     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (144)

1. Woeber KA. Thyrotoxicosis and the heart. N Engl J Med 1992;327:94-7.
2. Oppenheimer JH. Thyroid hormone action at the molecular level. In: Braverman L, Utiger R, editors. Werner and Ingbar's the thyroid. 6th ed. Philadelphia: JB Lippincott; 1991. p 204-24.
3. Ching GW, Franklin JA, Stallard TJ, Daykin J, et al. Cardiac hypertrophy as a consequence of long term thyroxine therapy and thyrotoxicosis. Heart 1996;75:363-8.
4. Thomas MR, McGregor AM, Jewitt DE. Left ventricular filling abnormalities prior to and following treatment of thyrotoxicosis: is diastolic dysfunction implicated in thyrotoxic cardiomyopathy? Eur Heart J 1993;14:662-8.
5. Ebisawa K, Ikeda U, Murata M, Skiguchi H, et al. Irreversible cardiomyopathy due to thyrotoxicosis. Cardiology 1994;84:274-7.
6. Sandier G, Wilson GM. The nature and prognosis of heart disease in thyrotoxicosis. QJM 1959;28:347-69.
7. Likoff WB, Levine SA. Thyrotoxicosis as the sole cause of heart failure. Am J Med 1943;206:425-34.
8. Featherstone HJ, Stewart DK. Angina in thyrotoxicosis. Arch Intern Med 1983;143: 554-5.
9. Reynolds JL, Woody HB. Thyrotoxic mitral regurgitation: a probable form of papillary muscle dysfunction. Am J Dis Child 1971;122:544-8.
10. Channick BJ, Adlin EV, Marks AD, et al. Hyperthyroidism and mitral valve prolapse. N Engl J Med 1981;305:499-500.
11. Somerville W, Levine SA. Angina pectoris and thyrotoxicosis. Br Heart J 1950;12: 245-57.
12. Mariotti S, Francechi C, Cossarizza A, Pinchera A. The aging thyroid. Endocr Rev 1995;16:686-714.
13. Dillman W. The cardiovascular system in thyrotoxicosis. In: Braverman L, Utiger R, editors. Werner and Ingbar's the thyroid. 6th ed. Philadelphia: JB Lippincott; 1991. p 759-70.
14. Montereggi A, Marconi P, Olivotto I, et al. Signal-averaged P-wave duration and the risk of paroxysmal atrial fibrillation in hyperthyroidism. Am J Cardiol 1996;77:266-9.
15. Forfar JC, Caldwell GC. Hyperthyroid heart disease. Clin Endocrinol Metab 1985;14:491-508.
16. Smith CD, Ain KB, Ryan S, Ngai BC. Systemic embolism in thyrotoxicosis without cardiac arrhythmia. Thyroid 1994;4:209-11.
17. Culp KS, Piziak VK. Thyrotoxicosis presenting with secretory diarrhea. Ann Intern Med 1986;105:216-7.
18. Sellin RV, Sellin JH. The gastrointestinal tract in thyrotoxicosis. In: Braverman L, Utiger R, editors. Werner and Ingbar's the thyroid. 6th ed. Philadelphia: JB Lippincott: 1991. p 780-4.
19. Yao JC, Gross JB, Ludwig J, Prunell DC. Cholestatic jaundice in hyperthyroidism. Am J Med 1989;86:619-20.
20. Freedberg IM, Volgel LN. The skin in thyrotoxicosis In: Braverman L, Utiger R, editors. Werner and Ingbar's the thyroid. 6th ed. Philadelphia: JB Lippincott; 1991. p 731-3.
21. Ramsay ID. Muscle dysfunction in hyperthyroidism. Lancet 1966;2:931-5.
22. Bradley WG, Walton JN. Neurologic manifestations of thyroid disease. Postgrad Med 1971;50:118-21.
23. Ramsay ID. Electromyography in thyrotoxicosis. QJM 1965;34:255-67.
24. Ghosh D, Trivedi N, Mithal A. Hyperkalemic periodic paralysis associated with thyrotoxicosis. J Assoc Physicians India 1993;41:239-40.
25. Ober P. Thyrotoxic periodic paralysis in the United States. Medicine 1972;71:109-20.
26. Swanson J W, Kelly JJ. Neurologic aspects of thyroid dysfunction. Mayo Clin Proc 1981;56:504-12.
27. Skanse B, Nyman GE. Thyrotoxicosis as a cause of cerebral dysrhythmias and convulsive seizures. Acta Endocrinol 1956;22:246-63.
28. Jabbari B, Huott AD. Seizures in thyrotoxicosis. Epilepsia 1980;21:91-6.
29. Yang CY, Lam HC, Lee HC, Wei YH, et al. MELAS syndrome associated with diabetes mellitus and hyperthyroidism. Clin Endocrinol (Oxf) 1995;43:235-9.
30. Trzepacz PT, Levey GS. The psychiatric manifestations of Graves' disease. Hosp Med 1989;June:64-70.
31. 1 on vasopressin activation of renal adenyl cyclase. J Clin Invest 1970;50:1613-20.
32. Meema HE, Schatz DL. Simple radiologic demonstration of cortical bone loss in thyrotoxicosis. Radiology 1970;97:9-15.
33. Grant DJ, McMurdo ME, Mole PA, et al. Is previous hyperthyroidism a risk factor for osteoporosis in postmenopausal women? Clin Endocrinol (Oxf) 1995;43:339-45.
34. Franklyn JA, Betteridge J, Holder R, Sheppard MC. Effect of estrogen replacement therapy upon bone mineral density in thyroxine treated women with a past history of thyrotoxicosis. Thyroid 1995;5:359-63.
35. Kung AW, Pang RW, Lauder I, et al. Changes in serum lipoprotein (A) and lipids during treatment of hyperthyroidism. Clin Chem 1995;41:226-31.
36. Moller N, Neislen S, Nyhlm B, Porksen N, et al. Glucose turnover, fuel oxidation and forearm substrate exchange in patients with thyrotoxicosis before and after treatment. Clin Endocrinol (Oxf) 1996;44:453-9.
37. O'Meara NM, Blackman JD, Sturis J, et al. Alterations in the kinetics of C-peptide and insulin secretion in hyperthyroidism. J Clin Endocrinol Metab 1993;76:79-84.
38. Krass GE, Pontikides N, Kaltas T, et al. Menstrual disturbances in thyrotoxicosis. Clin Endocrinol (Oxf) 1994;40:641-4.
39. Gordon DL, Brown JL, Emanelle NV, et al. Gynecomastia as the initial manifestation of hyperthyroidism. Endocr Pract 1997;3:80-1.
40. Whishaw R. The diagnosis of thyrotoxicosis with special reference to the masked types. Med J Aust 1939;1:785-92.
41. Lahey F. Nonactivated (apathetic) type of hyperthyroidism. N Engl J Med 1931;204: 747-8.
42. McCullagh EP. Atypical hyperthyroidism. Med Clin North Am 1936;19:1733-42.
43. Greenwood RM, Daly JG, Himsworth RL. Hyperthyroidism and the impalpable thyroid gland. Clin Endocrinol 1985;22:583-7.
44. Dreyfuss A. Protracted epigastric pain and vomiting as a presentation of thyrotoxicosis. J Clin Gastroenterol 1984;6:435-6.
45. Coe N, Page D, Friedman P, Haag BL. Apathetic thyrotoxicosis presenting as an abdominal emergency. South Med J 1982;75:175-8.
46. Lahey FH. Apathetic thyroidism. Ann Surg 1931;93:1026-30.
47. Charpman EM, Maloof F. Bizarre clinical manifestations of hyperthyroidism. N Engl J Med 1956;254:1-5.
48. Dhar SK, Nair CPV. Choreoathetosis and thyrotoxicosis. Ann Intern Med 1974;80: 426-7.
49. Emanulle MA, Brooks MH, Gordon DL, Braithwaite SS. Agoraphobia and hyperthyroidism. Am J Med 1989;86:484.
50. Becker CB, Trock DH. Thyrotoxicosis resembles Lyme disease. Ann Intern Med 1991;114:914-5.
51. Thomas F, Mazzaferri EL, Skillman TG. Apathetic thyrotoxicosis: a distinctive clinical and laboratory entity. Ann Intern Med 1970;72:679-85.
52. Apathetic thyrotoxicosis [editorial]. Lancet 1970;2:809-10.
53. Bayer MF. Effective laboratory evaluation of thyroid status. Med Clin North Am 1991;75:1-26.
54. Spencer CA, LoPresti JS, Patel A, Guttler RB, Eigen A, et al. Applications of a new chemilumiometric assay to subnormal assessment. J Clin Endocrinol Metab 1990;70: 453-60.
55. Nicoloff JT, Spencer CA. The use and misuse of the sensitive thyrotropin assays. J Clin Endocrinol Metab 1990;71:553-8.
56. Hay ID, Bayer MF, Kaplan MM, et al. American Thyroid Association assessment of current free thyroid hormone and thyrotropin measurements and guidelines for future clinical assays. Clin Chem 1991;37:2002-8.
57. Same DH, Refetoff S. Thyroid function tests. In: DeGroot LJ, et al., editors. Endocrinology. 3rd ed. Philadelphia: WB Saunders; 1991. p. 617-64.
58. Hennessey JV, Burg LA, Ibrahim MA, et al. Evaluation of early (5 to 6 hours) iodine 123 uptake for diagnosis and treatment planning in Graves' disease. Arch Intern Med 1995;155:621-4.
59. Ashcraft MW, Van Herle AJ. Management of thyroid nodules, II: scanning techniques, thyroid suppressive therapy and fine needle aspiration. Head Neck Surg 1981;3:297-300.
60. 99mTc pertechnetate flow study for evaluation of cold thyroid nodules. Radiology 1972;102:705-6.
61. McKenzie JM, Zakarija M. The clinical use of thyrotropin receptor antibody measurements. J Clin Endocrinol Metab 1989;69:1093-6.
62. Grove AS Jr. Evaluation of exophthalmos. N Engl J Med 1975;292:1005-13.
63. Schneider AB, Pervos R. Radioimmunoassay of human thyroglobulin: effect of antithyroglobulin antibodies. J Clin Endocrinol Metab 1978;47:126-37.
64. Graves RJ. Clinical lectures. London Med Surg 1835;7:516.
65. Fisfalen MF, DeGroot LJ. Graves' disease and autoimmune thyroiditis. In: Weintraub BD, editor. Molecular endocrinology: basic concepts and clinical correlates. New York: Raven; 1995. p 319-70.
66. Adams DD, Purves HD. Abnormal responses in the assay of thyrotropin. Otago Med School Proc 1956;34:11.
67. DeGroot LJ, Quintans J. The causes of autoimmune thyroid disease. Endocr Rev 1989;10:537-62.
68. Hirota Y, Tamai H, Hayashi Y, et al. Thyroid function and histology in forty five patients with hyperthyroid Graves' disease in clinical remission more than ten years after thionamide drug treatment. J Clin Endocrinol Metab 1986;62:165-9.
69. Livadas D, Psarras A, Koutras A. Malignant cold thyroid nodules and hyperthyroidism. Br J Surg 1976;33:726-8.
70. Wartofsky L, Glinoer D, Solomon B, et al. Differences and similarities in the treatment of Graves' disease in Europe, Japan and the United States. Thyroid 1991;1:129-35.
71. Greer MA. Treating Graves' disease, Endocrinologist 1994;4:69-78.
72. Sugrue D, Mc Evoy M, Feely J, Drury MI. Hyperthyroidism in the land of Graves: results of treatment by surgery, radio-iodine and carbimazole in 837 cases. QJM 1980;49:51-61.
73. Wartofsky L. Low remission after therapy of Graves' disease: possible relation of dietary iodine with antithyroid therapy results. JAMA 1973;226:1083-88.
74. Howard JE. Treatment of thyrotoxicosis. JAMA 1967;202:706-9.
75. Hashizume K, Ichikawa K, Sakurai A, et al. Administration of thyroxine in treated Graves' disease: effects of the level of antibodies to thyroid-stimulating hormone receptors and on the risk of recurrence of hyperthyroidism. N Engl J Med 1991;324: 947-53.
76. Landsberg L. Catecholamines and hyperthyroidism. Clin Endocrinol Metab 1977;6: 697-718.
77. Bahouth S, Malbon C. Genetic regulation of G protein linked receptor expression. In: Silbey E, Houslay R, editors. Regulation of cellular signal transduction. New York: Wiley; 1994. p 361-71.
78. Ventrella SM, Klein I. Beta-adrenergic blocking drugs in the management of hyperthyroidism. Endocrinologist 1994;4:391-9.
79. Rubenfeld S, Silverman VE, Welch KMA, et al. Variable plasma propranolol levels in thyrotoxicosis. N Engl J Med 1979;300:353-4.
80. Cooper DS. Treatment of thyrotoxicosis. In: Braverman LE, Utiger RD, editors. Werner and Ingbar's the thyroid. Philadelphia: JB Lippincott; 1991. p 897-918.
81. Feely J, Peden N. Use of β-adrenoreceptor blocking drugs in hyperthyroidism. Drugs 1984;27:425-46.
82. Hertz S, Roberts A. Application of radioactive iodine in the therapy of Graves' disease. J Clin Invest 1942;21:64.
83. Beierwaltes WH. The treatment of hyperthyroidism with iodine-131. Semin Nucl Med 1978;8:95-103.
84. Jarlov AE, Hegedus L, Kristensen LO, et al. Is calculation of the dose in radioiodine therapy of hyperthyroidism worthwhile? Clin Endocrinol 1995;43:325-30.
85. Vormittag W, Ring F, Kunze-Muhl E, et al. Structural chromosomal aberrations before and after administration of 20ci of iodine-131. Mutat Res 1982;105:333-6.
86. Bliddal H, Hansen JM, Rogwski P, et al. 131 I treatment of diffuse and nodular toxic goiter with or without antithyroid agent. Acta Endocrinol (Copenh) 1982;99:517-21.
87. McDermott MT, Kidd GS, Dodson LE, et al. Radioiodine induced thyroid storm: case reports and literature review. Am J Med 1983;75:353-9.
88. Althaus B, Staub JJ, Neri TM, et al. HLA-DR3 and DRw6: prognostic factors for the incidence of hypothyroidism in Graves' disease after radioiodine treatment. Acta Endocrinol 1986;113:323-8.
89. Cunnien AJ, Hay ID, Gorman CA, et al. Radioiodine induced hypothyroidism in Graves' disease: factors associated with increased incidence. J Nucl Med 1982;23: 978-82.
90. Klementschitsch P, Shen K, Kaplan EL. Reemergence of thyroidectomy as treatment for Graves' disease. Surg Clin North Am 1979;59:35-44.
91. Gorman CA. Temporal relationship between onset of Graves' ophthalmopathy and the diagnosis of thyrotoxicosis. Mayo Clin Proc 1983;58:515-9.
92. Tamai H, Nagakwa T, Ohsako N, et al. Changes in thyroid functions in patients with euthyroid Graves' disease. J Clin Endocrinol Metab 1980;50:108-12.
93. Gorman CA. Pathogenesis of Graves' ophthalmopathy. Thyroid 1994;4:379-83.
94. Garrity JA. Graves' ophthalmology: an ophthalmologist's perspective. Thyroid Today 1992;15:1-9.
95. Burch HB, Wartofsky L. Graves' ophthalmopathy : current concepts regarding pathogenesis and management. Endocr Rev 1993;14:747-94.
96. Gilbard JP, Farris RL. Ocular surface drying and tear film osmolarity in thyroid eye disease. Acta Ophthalmol (Copenh) 1983;61:108-16.
97. Werner SC. Classification of the eye changes of Graves' disease. J Clin Endocrinol Metab 1969;29:982-4.
98. Tallstedt L, Lundell G, Torring O, et al. Occurrence of ophthalmopathy after treatment of Graves' hyperthyroidism. N Engl J Med 1992;326:1733-8.
99. Bartalena L, Marocci C, Bogazzi F, et al. Use of corticosteroids to prevent progression of Graves' ophthalmopathy after radioiodine therapy for hyperthyroidism. N Engl J Med 1989;321:1349-52.
100. Smith TJ, Bahn RS, German GA. Connective tissue, glycosaminoglycans and diseases of the thyroid. Endocr Rev 1989;10:366-91.
101. Morris JC III, Hay ID, Nelson RE, et al. Clinical utility of thyrotropin receptor antibody assays: comparison of radioreceptor and bioassay methods. Mayo Clin Proc 1988;63:707-17.
102. Cairns RJ. Pretibial myxedema. In: Rook A, Wilkinson DS, Ebling FJG, editors. Textbook of dermatology, vol 10. 2nd ed. Oxford: Blackwell Scientific; 1972. p 1867-80.
103. King LR, Braunstein H, Chambers D, et al. A case study of peculiar soft-tissue and bony changes in association with thyroid disease. J Clin Endocrinol Metab 1959;19:1323-30.
104. Plummer HS. The clinical and pathologic relationships of hyperplastic and non-hyperplastic goiter. JAMA 1913;61:650-1.
105. Farid NR, Yufei S, Zou M. Molecular basis of thyroid cancer. Endocr Rev 1994;15:202-19.
106. Hamburger JI. The autonomously functioning thyroid nodule: Goetsch's disease. Endocr Rev 1987;8:439-47.
107. Bech K, Nerup J, Thomsen M, et al. Subacute thyroiditis de Quervain: a disease associated with HLA B antigen. Acta Endocrinol 1977;86:504-7.
108. Lio S, Pontecorvi A, Caruso M, et al. Transitory subclinical and permanent hypothyroidism in the course of subacute thyroiditis (De Quervain). Acta Endocrinol 1984;106:67-70.
109. Nikolai TF, Brosseau J, Kettrick MA, et al. Lymphocytic thyroiditis with spontaneously resolving hyperthyroidism (silent thyroiditis). Arch Intern Med 1980;140:478-82.
110. Roberton HEW. Lassitude, coldness and hair changes following pregnancy and their response to treatment with thyroid extract. Br Med J 1948;2S:93-4.
111. Gerstein HC. Incidence of postpartum thyroid dysfunction in patients with type I diabetes mellitus. Ann Intern Med 1993;118:419-23.
112. Jansson R, Dahlberg, PA, Karlsson F. Postpartum thyroiditis. Baillieres Clin Endocrinol Metab 1988;2:619-35.
113. Hay ID. Thyroiditis: a clinical update. Mayo Clin Proc 1985;60:836-43.
114. Kourides IA, Ridgway EC, Weintraub BD, Bigos ST, et al. Thyrotropin induced hyperthyroidism: use of alpha and beta subunits to identify patients with pituitary tumors. J Clin Endocrinol Metab 1977;45:534-43.
115. Bouillon R, Naesens M, van Asche FA, et al. Thyroid function in patients with hyperemesis gravidarum. Am J Obstet Gynecol 1982;148:922-96.
116. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992;167:648-52.
117. Goodwin TM, Montoro M, Mestman JH. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab 1992;75:1333-7.
118. Galton VA, Ingbar SH, Jimenez-Fonseca J, et al. Alterations in thyroid hormone economy in patients with hydatidiform mole. J Clin Invest 1971;50:1345-54.
119. Brennan MD, Erickson DZ, Carney JA, Bahn RS. Non-goitrous (Type I) amiodarone associated thyrotoxicosis: evidence of follicular disruption in vitro and in vivo. Thyroid 1995;5:177-83.
120. Aghini-Lombardi F, Mariotti S, Fosella PV, Grasso L, et al. Treatment of amiodarone iodine induced thyrotoxicosis with plasmapheresis and methimazole. J Endocrinol Invest 1993;16:823-6.
121. Cavalleri RR, Gerard SK. Unusual types of thyrotoxicosis. Adv Intern Med 1992;91:271-86.
122. Stange WF, Henske JA. Accidental ingestion of poisons. J Pediatr 1955;47:470-4.
123. Cohen III JH, Ingbar SH, Braverman LE. Thyrotoxicosis due to ingestion of excess thyroid hormone. Endocr Rev 1989;10:113-23.
124. Braunstein GD, Koblin R, Sugawara M, et al. Unintentional thyrotoxicosis factitia due to a diet pill. West J Med 1986;145:388-90.
125. Ohno F, Miyoshi K. Clinical observations on thyroidismus medicamentosus due to weight reducing pills in Japan. Endocrinol Jpn 1971;18:321-4.
126. Hedberg CW, Fishbein DB, Jannsen RS, et al. An outbreak of thyrotoxicosis caused by the consumption of bovine thyroid gland in ground beef. N Engl J Med 1987;316:993-8.
127. Mariotti S, Martino E, Cupin C, et al. Low serum thyroglobulin as a clue to the diagnosis of thyrotoxicosis factitia. N Engl J Med 1982;307:410-3.
128. Greer MA. Thyrotoxicosis of extra-thyroid origin. In: Braverman LE, Utiger RD. Werner and Ingbar's the thyroid. 6th ed. Philadelphia: JB Lippincott; 1991. p 728-30.
129. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Endocrinol Metab Clin North Am 1993;22:263-77.
130. Annaise E, Tohme JF. Reserpine in propranolol-resistant thyroid storm. Arch Intern Med 1985;145:2248-9.
131. Ingbar SH. Management of emergencies: thyroid storm. N Engl J Med 1966;274:1252-4.
132. Seely BL, Burrow GN. Thyrotoxicosis in pregnancy. Endocrinologist 1991;1:409-17.
133. Gilnoer D, De Nayer P, Bourodox P, et al. Regulation of maternal thyroid during pregnancy. J Clin Endocrinol Metab 1990;71:276-87.
134. Becks GP, Burrow GN. Thyroid disease and pregnancy. Med Clin North Am 1991;75:121-50.
135. Davis LE, Lucas MJ, Hankins GDV, et al. Thyrotoxicosis complicating pregnancy. Am J Obstet Gynecol 1989;160:63-70.
136. 4. Clin Endocrinol 1983;18:73-85.
137. Hollingsworth DR, Marby CM, Eckerd JM. Hereditary aspects of Graves' disease in infancy and childhood. J Pediatr 1972;81:446-59.
138. Harve P, Francis HH. Pregnancy and thyrotoxicosis. Br Med J 1962;2:817-22.
139. Zakarija M, McKenzie JM. Pregnancy-associated change in thyroid stimulating antibody of Graves' disease and the relationship to neonatal hyperthyroidism. J Clin Endocrinol Metab 1983;57:1036-40.
140. Delange F. Effects of maternal thyroid function during pregnancy on fetal development. In: Becker C, Reinwein D, editors. The Thyroid and Pregnancy. Stuttgart: Schattauer; 1991. p 7-28.
141. Edmonds CJ, Tellez M. Treatment of Graves' disease by carbimazole: high dose with thyroxine compared to titration dose. Eur J Endocrinol 1994;131:120-4.
142. Kuo SW, Huang WS, Hu CA, et al. Effect of thyroxine administration on serum thyrotropin receptor antibody and thyroglobulin levels in patients with Graves' hyperthyroidism during and after therapy. Eur J Endocrinol 1994;131:125-30.
143. Tamai H, Ikuo H, Keisuke H, et al. Lack of effect of thyroxine administration on elevated thyroid stimulating hormone receptor antibody levels in treated Graves' disease patients. J Clin Endocrinol Metab 1995;80:1481-4.
144. McIver B, Rae P, Beckett G, et al. Lack of effect of thyroxine in patients with Graves' hyperthyroidism who are treated with an antithyroid drug. N Engl J Med 1996;334:220-4.