Clinical Profile and Long-Term Remission in Patients with Graves’ Disease: The Tripoli Medical Centre Experience - Abstract
Background: Graves’ disease (GD) is an autoimmune disease characterized by goiter hyperthyroidism and ophthalmopathy. Treatment options include anti-thyroid drugs (ATD), radioactive iodine (RAI), and surgery.
Objective: To determine the clinical features at presentation, mode of treatment, and longterm outcome of GD in our region and to determine the whether the duration of ATD treatment, patient gender, and age at presentation can predict the long-term response rate.
Methods: Retrospective review of medical records of 145 consecutive Libyan patients with GD who were treated at the endocrine clinic of the Tripoli Medical Center (TMC) during the period between June 2005 and April 2007. Demographic data, presenting clinical features, and the results of thyroid function test at the time of the first presentation were obtained. Mode of treatment and the long-term outcome were recorded
Results: A total of 145 patients were reviewed, 71.7% were female and 28.3% were males. Mean age was 36.7±11.8 years (Range 16-70) and mean duration of follow up was 5.7±3.9 years (Range 1-12) years. Tremor (64.8%), weight loss (54.5%), and palpitation (53.1%) were the most common clinical manifestations. 76.6% were treated only with antithyroid drugs (ATD), 16.6% received radioactive iodine (RAI), and 6.9% underwent surgery. Long-term remission rates for ATD, surgery, and RAI were 59.1%, 88.9%, and 87% respectively.
Conclusion: Clinical manifestations of GD in our patients were comparable with those reported in the literature. There was an underuse of second-line treatment, namely surgery, and RAI therapy