Endocrine Abstracts

Introduction: Thyrotoxicosis in the elderly may present differently than in younger indeviduals, and with the aging of the worlds’ population it is imperative to obtain data in this age group.

Aim: Our aim was to identify and characterize clinical and biochemical parameters of thyrotoxicosis in the elderly and to compare them to those of younger patients.

Methods: We retrospectively evaluated files of patients older than 40 who were admitted to Rabin Medical Center in the years 2000–2018, and had suppressed TSH levels and increased thyroid hormone levels at admission. Clinical characteristics were compared between those older and younger than 70 years.

Results: After exclusion of 42 patients (7 had non thyroidal illness, and 35 for multiple admissions) our cohort included 277 patients of which 157 were older than 70 (57%, mean 81.2±6.1) with a female predominance. TSH levels, thyroid hormone levels and heart rate at admission were comparable between the groups. Etiology was more likely to be Graves’ disease or thyroiditis among those younger than 70 years, and toxic adenoma/toxic multinodular goiter or amiodarone induced thyrotoxicosis in those older than 70 years. Weight loss, fatigue, apathy, new and chronic fibrillation and goiter were all significantly more common in the elderly. Similar results were obtained when we excluded those who were treated with thyroxine before hospitalization.

Conclusions: Hospitalized elderly individuals with thyrotoxicosis more commonly present with non-classical symptoms and atrial fibrillation, compared to younger patients. Low threshold for evaluation might be appropriate in this age group.