[Changes in the blood picture in hyperthyroidism]. / Blutbildveränderungen bei Hyperthyreose.

On the basis of a retrospective study about 276 clinically and paraclinically ascertained cases of hyperthyroidism in 34% of the patients above all mild anaemias could be proved which under thyreostatic therapy with thiamazol which after repeated incidence of an euthyroid metabolic situation vastly normalized themselves also without an anaemia-specific additional medication. Leukocytopenias (5.8%) and thrombocytopenias (3.3%) had only a low frequency in untreated hyperthyroidism. Nevertheless an unequivocal parallelity of the haematologic changes was to be observed in erythro-, granulo- and thrombopoiesis. There was a clear correlation between the activity of hyperthyroidism, measured at the T3- or T4 level, and anaemia and haemocytopenia, respectively. Lacking substance deficiency conditions and signs of haemolysis let us first of all think of a causal thyrotoxic bone-marrow damage on account of the dependence of the haematologic changes on the activity of hyperthyroidism and their immediate influencibility by aimed thyrostatic therapy. A relatively low dosed thiamazol therapy has influence on haematopoiesis and peripheral blood picture only at a very small percentage, in which cases the changes mostly are fully reversible. Thereby the initial haematologic situation before the therapy does not provide any predictability for perhaps appearing haematotoxic or allergic side-effects under thyreostatic treatment. The thiamazol therapy does not show any recognizable side-effects in the dosage administered on the investigated leukocytic functions agglomeration, adhesion and phyagocytosis. Only for the adhesion of leukocytes was proved a significant functional disturbance of leukocytes, which was, however, reversible with normalization of metabolism and with high probability was also directly thyreotoxically induced.

EEG changes in untreated hyperthyroidism and under the conditions of thyreostatic treatment.

20 patients with hyperthyroidism were observed with repeated EEG measurements before and during treatment (ObsidanR; MethimazolR). 17 patients, before starting antithyroid therapy, had slight to moderate EEG abnormalities. A prevalence for moderate disturbances occurred for patients with a higher degree of hyperthyroidism. The dominant EEG frequency was higher than in euthyroid controls, but no exact correlation to T3-values could be observed. 16 patients showed abnormal reactivity to photic stimulation. One-week therapy by propranolol produced only a slight synchronizing effect in EEG's, where T3-values decreased. After 4 weeks selective therapy by MethimazolR all patients were euthyroid, but some EEG abnormalities persisted in 12 patients in a lower degree. The dominant EEG frequency decreased to control-group ranges and abnormal photic reactivity was reduced. After 6 months some EEG disturbances re-increased tentiatively, in 3 relapses excessively. These observations confirm the prognostic value of EEG measurements for the recognition of occurrence and persistence of cerebral disturbances in severe metabolic dysfunctions.

[Hyperthyroidism and anemia]. / Hyperthyreose und Anämie.

In a random test of 100 patients with hyperthyroidism with clinical and paraclinical ascertainment of the diagnosis in 38 cases normo-hypochromic, normocytary anaemias of different expression were found. In the patients with anaemia the serum hormone values were statistically significantly higher than in the 62 patients without anaemia. Also cardiotoxic and hepatotoxic findings were more frequently to be proved in patients with anaemia. A causal iron deficiency, deficit of vitamin B12 or folic acid as well as a haemolytic component of the induction of anaemia could vastly be excluded. By means of the treatment of the basic disease and metabolic balance a normalisation of hemoglobin was achieved without additional medication. From the results of the examinations is concluded that above all a thyreotoxic damage is responsible for the development of the anaemia. In cases of oligo-symptomatic hyperthyroidism part from hepatotoxicity and cardiotoxicity also anaemias may become a leading symptom.

[Budd-Chiari syndrome following intake of oral contraceptives (author's transl)]. / Budd-Chiari-Syndrom nach Einnahume von Ovulationshemmern.

Described in this paper are three cases of Budd-Chiari syndrome in young women who had taken oral contraceptives. Not more than 30 cases maximum so far have been reported in international literature, in the context of Budd-Chiari syndrome related to oral contraceptives. However, oral contraceptives have been increasingly considered to cause to disease, over the past ten years.