Long-term outcomes of treatment of hyperthyroidism in Ireland.

Hdl Handle:
http://hdl.handle.net/10147/209160
Title:
Long-term outcomes of treatment of hyperthyroidism in Ireland.
Authors:
Leary, A C; Grealy, G; Higgins, T M; Buckley, N; Barry, D G; Murphy, D; Ferriss, J B
Affiliation:
Department of Medicine, Cork University Hospital.
Citation:
Ir J Med Sci. 1999 Jan-Mar;168(1):47-52.
Journal:
Irish journal of medical science
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209160
PubMed ID:
10098345
Abstract:
We investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Antithyroid Agents/*therapeutic use; Calcium/blood; Chi-Square Distribution; Child; Cholesterol/blood; Female; Follow-Up Studies; Graves Disease/diagnosis/epidemiology/therapy; Humans; Hyperthyroidism/diagnosis/epidemiology/*therapy; Ireland/epidemiology; Male; Middle Aged; Prognosis; Retrospective Studies; Statistics, Nonparametric; Survival Rate; Thyroidectomy/methods; Thyroxine/therapeutic use; Treatment Outcome
ISSN:
0021-1265 (Print); 0021-1265 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorLeary, A Cen_GB
dc.contributor.authorGrealy, Gen_GB
dc.contributor.authorHiggins, T Men_GB
dc.contributor.authorBuckley, Nen_GB
dc.contributor.authorBarry, D Gen_GB
dc.contributor.authorMurphy, Den_GB
dc.contributor.authorFerriss, J Ben_GB
dc.date.accessioned2012-02-03T15:13:51Z-
dc.date.available2012-02-03T15:13:51Z-
dc.date.issued2012-02-03T15:13:51Z-
dc.identifier.citationIr J Med Sci. 1999 Jan-Mar;168(1):47-52.en_GB
dc.identifier.issn0021-1265 (Print)en_GB
dc.identifier.issn0021-1265 (Linking)en_GB
dc.identifier.pmid10098345en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209160-
dc.description.abstractWe investigated the long-term outcome of treatment in 159 patients with hyperthyroidism first seen between 1979 and 1992. Median duration of follow-up was 10 1/2 years. We also inquired into current practice for the follow-up of hyperthyroidism by other endocrinologists in Ireland. Seven cases of unrecognised hyperthyroidism (4 per cent) and one of unrecognised hypothyroidism were identified. Among patients with Graves' disease, of those treated with an antithyroid drug, 28 per cent were in remission, 68 per cent had relapsed and 4 per cent had become hypothyroid. Of those treated by sub-total thyroidectomy, 31 per cent were in remission, 19 per cent had relapsed, 19 per cent were hypothyroid and 31 per cent were sub-clinically hypothyroid. Among patients treated with radioiodine, 19 per cent were euthyroid, 3 per cent were still hyperthyroid and three-quarters had become hypothyroid. In contrast, after radioiodine for toxic nodular goitre, 63 per cent were euthyroid and only 32 per cent had become hypothyroid (Chi Squared v. Graves' disease, P = 0.001). Of 73 patients receiving thyroxine replacement, plasma TSH was normal in only 41 per cent, although 82 per cent of patients had been seen by the family doctor within the previous 12 months. Seven of 17 other endocrinologists undertook long-term follow-up of hyperthyroid patients in their specialist clinics but none was using a computerised system to co-ordinate this. The findings confirm that careful follow-up is required for all hyperthyroid patients. The family doctor is well positioned to undertake this, but education and auditing are required.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAntithyroid Agents/*therapeutic useen_GB
dc.subject.meshCalcium/blooden_GB
dc.subject.meshChi-Square Distributionen_GB
dc.subject.meshChilden_GB
dc.subject.meshCholesterol/blooden_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshGraves Disease/diagnosis/epidemiology/therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHyperthyroidism/diagnosis/epidemiology/*therapyen_GB
dc.subject.meshIreland/epidemiologyen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPrognosisen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshStatistics, Nonparametricen_GB
dc.subject.meshSurvival Rateen_GB
dc.subject.meshThyroidectomy/methodsen_GB
dc.subject.meshThyroxine/therapeutic useen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.titleLong-term outcomes of treatment of hyperthyroidism in Ireland.en_GB
dc.contributor.departmentDepartment of Medicine, Cork University Hospital.en_GB
dc.identifier.journalIrish journal of medical scienceen_GB
dc.description.provinceMunster-

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