Management of hyperthyroidism due to Graves' disease: a retrospective analysis of 1,000 inpatient cards.

ABSTRACT

There are three different modalities to treat hyperthyroidism due to Grave's disease anti-thyroid drugs (ATD), radioiodine and surgery, each of them having its own advantages and disadvantages. The option for one of the three therapeutical approaches has both subjective and objective components. In Europe, a screening on the therapeutical options in Graves' disease was performed at the European Thyroid Association (ETA) initiative, being based on a questionnaire. In the Thyroid Department of the Endocrinology Institute in Bucharest, w analysed the managements of hyperthyroidism due to Graves' disease on 1,000 cards of hyperthyroid patients admitted there during the last five years. In order to diagnose Graves' disease, in vivo tests radioiodine uptake (RIU) at 2 and 24 hrs, 93.39% scintigram (92.93%), thyroid ultrasonography (15%) and reflexogram (98.06%), were carried out. Out of the in vitro tests, PBI (protein bound iodine) was performed prioritarily, while T4, T3 (variable), TSH (13.91%) were performed according to the economic factors. For the patient with moderate hyperthyroidism, antithyroid therapy was alternative with the radioiodine one (51.61% and 48.35%, respectively). The age of the patient played a major role in the decision to take. The frequency of cases treated with radioiodine was considerably higher in the patients with recurrence and in the elderly. The initial dose of antithyroid treatment was high (50-60 mg), and was reduced according to the thyroid function. The therapy duration was not pre-determined. The ATD treatment was prolonged for a time-interval ranging between 2 and 5 years, depending of the clinical status (age, sex, goiter size, exophthalmic syndrome) and the social conditions.(ABSTRACT TRUNCATED AT 250 WORDS)