[Skip to Navigation]
June 1972

Sympathetic Blockade in Hyperthyroidism: Preoperative Management Following Toxic Reaction to Antithyroid Drugs

Author Affiliations


From Department of Medicine, Section of Endocrinology and Metabolism, Rush-Presbyterian-St. Luke's Medical Center, Chicago.

Arch Intern Med. 1972;129(6):967-971. doi:10.1001/archinte.1972.00320060115015

The antithyroid drugs propylthiouracil and methimazole are commonly used in the treatment of hyperthyroidism. The incidence of overall toxic drug reactions to these antithyroid drugs have been reported to vary from 6% to 9%1-3; however, the incidence of serious side effects, including agranulocytosis, is approximately 0.3% to 0.6% in a large series.4 Subsequent management of the hyperthyroidism in those patients who develop drug toxic reaction becomes a problem, especially in the younger age group where alternative forms of treatment are limited.

During the past few years sympathetic blocking drugs, including guanethidine sulfate5 and propranolol hydrochloride,6-9 have been advocated as ancillary agents in the treatment of hyperthyroidism. The use of propranolol as a means of preparing hyperthyroid patients for thyroidectomy has also been suggested.10 This report details the course of three hyperthyroid patients who developed toxic reactions to antithyroid drugs and in whom thyroidectomy was successfully