Treating Hyperthyroidism in the Critically Ill Patient with Rectal Methimazole

Treating Hyperthyroidism in the Critically Ill Patient with Rectal Methimazole:

Abstract

Graves’ disease is the most common cause of hyperthyroidism and is typically managed on an outpatient basis with one of anti‐thyroid drugs, radioactive iodine or thyroidectomy. We report a case of Graves’ disease in a critically ill patient following duodenal repair managed with per rectum (PR) methimazole. Nabil et al demonstrated similar blood concentrations of methimazole whether given PO (per os) or PR in six euthyroid volunteers, however there is limited documentation of PR methimazole in the critically ill patient with confirmation of efficacy.