Simple clinical and paraclinical factors may predict outcome of treatment for Graves' hyperthyroidism
Sorina Martin1,2, Gheorghe Adrian Tatucu2, Elena Roxana Smadeanu2, Suzana Florea1 & Simona Fica1,2
Objective: The aim of this study was to assess the value of some clinical and paraclinical factors in an attempt to predict outcome following antithyroid drug therapy.
Methodology: We performed a retrospective audit of 101 new patients, aged 1685, separated into two groups: 59 patients with Graves disease (GD) and control group of 42 patients with other ethyologic forms of hyperthyroidism, admitted to our clinic between 2003 and 2008. Data were collected at diagnosis, before initiation of treatment, and then patients were followed up at least until TSH became unsuppressed (>0.45 mUI/l).
Results: In the GD group, mean age at diagnosis (47.09 years) was negatively correlated with the time needed until TSH become unsuppressed (P=0.002) and with TT3 levels (P=0.010). The heart rate was positively correlated with time needed until TSH become unsuppressed (P=0.034). Total cholesterol and triglycerides were negatively correlated with the time needed until TSH become unsuppressed (P=0.04). The GD patients with large goiters (P=0.034), family history of thyroid disease (P=0.008) or personal history of autoimmune disease needed more time until TSH become unsuppressed. Graves ophthalmopathy developed more frequently in older patients, mean age 49.17 years (P=0.01). In the GD patients who could be followed after the cessation of treatment the total dose of antithyroid drugs was positively correlated with remission period after stopping the treatment (P=0.023). These correlations were not found in the control group.
Conclusion: Our study suggests that, in GD patients age at diagnosis, heart rate, lipid profile, goiter size, personal/family history and dose of antithyroid drugs may predict outcome of treatment for Graves hyperthyroidism.