Background and aims: Patients with Graves disease should be rendered euthyroid rapidly and euthyroidism subsequently maintained. Studies have shown this can be achieved at 3 months and maintained for the following 9 months in 90% of patients. The aim of this review was to ascertain whether we were achieving this target within our hospital setting.
Method: We undertook a retrospective analysis of patients with Graves thyrotoxicosis referred to Royal Bournemouth Hospital. Thyroid function test results (TFTs) from referral to 54 weeks were assessed for frequency of testing and thyroid status at 3, 6, 9 and 12 months.
Results: 39 patients with incident Graves thyrotoxicosis (clinical goitre, thyroid orbitopathy or positive TRAb) who presented between 1 January 2015 and 31 December 2016 and were treated with anti-thyroid medication were assessed. Age 47.7 years (range 1989), 2 male. 3 patients were lost to follow-up and were excluded from analysis beyond 3 months. 18/39 (49%) patients had TFTs 6 weekly for the first 3 months and 28/36 (78%) had TFTs every 3 months for the following 9 months.
Summary: Our real-world data achieved euthyroidism in 70% of our patients by 6 months and this was maintained to 12 months.
A nurse-led rapid-access thyrotoxicosis service is being trialled to facilitate more intense early intervention.
|Time from referral||3 months||6 months||9 months||12 months|
|Number of patients||25||27||28||12|