Polypharmacy as a cause of low adherence to treatment for diffuse toxic goiter (case report)

Merzlova P.Ya., Bulgakova S.V., Sharonova L.A., Dolgikh Yu.A., Kosareva O.V., Treneva E.V.

Samara State Medical University, Department of Endocrinology and Geriatrics, Samara, Russia

This article describes a clinical case of a patient with diffuse toxic goiter and thyrotoxicosis syndrome who voluntarily discontinued thiamazole, considering the medication load excessive despite symptomatic therapy prescribed for her associated complaints. Discontinuation of the pathogenetic treatment led to disease progression: the development of resistant arterial hypertension, hypertensive crisis, and a significant deterioration in quality of life, despite continued symptomatic medication. Treatment of the crisis and standard antihypertensive therapy proved ineffective. Only resumption of thiamazole therapy led to rapid stabilization of blood pressure, allowing the patient to discontinue antihypertensive medications. Subsequently, thiamazole dosage adjustment was required due to the development of iatrogenic hypothyroidism, followed by a subsequent increase in thyroid hormone levels, which ultimately led to stable euthyroidism. This case highlights the key importance of antithyroid therapy for thyrotoxicosis and the importance of adhering to doctor’s orders to prevent, primarily, cardiovascular complications.

For citations: Merzlova P.Ya., Bulgakova S.V., Sharonova L.A., Dolgikh Yu.A., Kosareva O.V., Treneva E.V. Polypharmacy as a cause of low adherence to treatment for diffuse toxic goiter (case report). Pharmateca. 2026;33(2):140-145. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.2.140-145

Authors’ contribution: Concept of work – Bulgakova S.V. Data collection – Merzlova P.Ya., Dolgikh Yu.A. Analysis and interpretation of data – Merzlova P.Ya., Sharonova L.A., Kosareva O.V., Treneva E.V. Writing the text of the article - Merzlova P.Ya., Sharonova L.A. Editing the article – Dolgikh Yu.A., Kosareva O.V., Treneva E.V. Final approval of the version for publication - Bulgakova S.V.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: The patients provided an informed consent for the publication of their data.

Keywords

About the Authors

Polina Ya. Merzlova, Teaching Assistant, Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0009-0004-6243-6528
Svetlana V. Bulgakova, Dr. Sci. (Med.), Associate Professor, Head of the Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0000-0003-0027-1786
Lyudmila A. Sharonova, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0000-0001-8827-4919 (corresponding author)
Yulia A. Dolgikh, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0000-0001-6678-6411
Olga V. Kosareva, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0009-0006-4531-9682
Ekaterina V. Treneva, Cand. Sci. (Med.), Associate Professor, Department of Endocrinology and Geriatrics, Samara State Medical University, Samara, Russia; ORCID: https://orcid.org/0000-0003-0097-7252

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