ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2003) 5 P279

Outcome of carbimazole, radioactive iodine and subtotal thyroidectomy in the treatment of Graves' disease at Alnour Hospital in Saudi Arabia

AM Karawagh & MM Abdelaziz

Department of Medicine, Endocrinology Section, King Khalid National Guard Hospital, Jeddah, Saudi Arabia.

(i)Background (i): Treatment of Graves' disease involves a choice of several methods such as medical treatment, radioactive iodine and surgery. However, primary treatment of this condition remains controversial and shows considerable geographical variations worldwide.
(i)Objective (i): In this study we examined the rate of complete remission (without relapse), relapse and complications of the different treatment modalities (carbimazole, radioactive iodine and subtotal thyroidectomy) used in the treatment of Graves' disease in Alnour Hospital, Saudi Arabia.
(i) Methods (i): We followed all newly diagnosed patients with Graves' disease (50 patients) attending Al Nour Hospital at Makkah in Saudi Arabia from in 1996 for 5 years. Despite all patients were given the choice of radioactive iodine as a primary treatment, only few individuals considered this modality (8 patients) and most patients opted for carbimazole (37 patients). Surgical treatment was considered in only 4 patients for cosmetic reasons.
(i) Results (i): Although carbimazole was the most commonly used treatment for Graves' disease, patients given this treatment exhibit the lowest rate of complete remission (7/37; 19%) and the highest rate of relapse (30/37, 81%) after 5 years follow up. In contrast radioactive iodine treatment was associated with the highest rate of complete remission (7/8; 88%) and the lowest rate of relapse (1/8; 12%). Complete remission was noticed in 75% (3/4) and relapse was observed in 25% (1/4) of the patients who underwent surgery. However the frequency of hypothyroidism was the highest among patients given radioactive iodine (3/8; 37%) compared with those treated with surgery (2/4; 50%) or carbimazole (2/37; 5%).
(i)Conclusion (i): Radioactive iodine was the most efficacious treatment modality used in the treatment of Graves disease in achieving complete remission without relapse when compared with surgery or carbimazole, though complicated with the highest incidence of hypothyroidism.

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