PMC10288288_01
An overview of the clinical course of the patient. Changes in antithyroid drug
dosages and choices are indicated by arrows. The dark gray area indicates the duration
of hospitalization for worsening thyroid symptoms until RAI administration. At time
point 1, intravenous hydrocortisone, oral methimazole, Lugol's solution, and oral
propranolol were added for two days. At time point 2, 10 mCi of RAI was administered.
At time point 3, lithium carbonate was discontinued, and thyroxine replacement was
initiated. RAI, radioactive iodine therapy; CBZ, carbimazole; PTU, propylthiouracil;
Li2CO3, lithium carbonate.
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PMC10288288_01_cpe-32-168-g001.jpg
fig_001
Despite gradually increasing the dosage of CBZ to 40 mg daily and adding oral propranolol (10 mg three times daily), the patient remained thyrotoxic, both clinically and biochemically (Fig. 1).