Endocrine Abstracts

Introduction: Antithyroid drugs (ATD) are usually the first-line treatment for Graves’ disease (GD). It represents an effective treatment with good compliance. This therapeutic modality can be the cause of adverse effects including hematological, cutaneous and hepatic complications. The aim of our study is to evaluate the efficacy of ATD as well as its tolerance in patients with GD.

Methods: It is a retrospective study that included 76 patients, with GD, followed in our department and treated with ATD for at least 2 years. Patients who received ATD to prepare them for radical treatment were eliminated. Remission was defined as the appearance of biological euthyroidism maintained after discontinuation of ATD.

Results: Our study included 29 males (38.2%) and 47 females (61.8%) with a mean age of 33.82 years (8-66 years), The mean duration of treatment was 28.73 months (0.5 - 230 months). Remission was observed in 33 patients (43.4%), with a mean duration of 24.8 months (8-72 months). Relapse was observed in 22 patients (28.9%), 7 cases at the time of degression; 29 cases or 87.8% of the cases having achieved remission; and one case after transition to hypothyroidism despite discontinuation of thyroxine treatment, most likely in the context of Hashitoxicosis. Side effects were observed in 16 patients: one case of agranulocytosis occurring 2 weeks after the Introduction of Basdene*, 6 cases of digestive disorders such as vomiting, 2 cases of hepatic cytolysis, 4 cases of ANCA-positive rash, one case of acute pancreatitis stage A with negative etiological investigation and an improvement upon discontinuation of Basdene*. We noted a case of rapidly progressive ANCA-positive glomerulonephritis in a 50-year-old woman, who presented with hematuria. We also noted a case of segmental and focal hyalinosis in a 15-year-old girl with Graves’ disease since the age of 5 and a history of ANCA vasculitis at the age of 7-year-old.

Conclusion: Our results confirm that the rate of durable remission on ATD is relatively low. The possibility of the occurrence of ANCA vasculitis and the potential severity of these vasculitis require special attention to systemic symptoms (rash, hematuria, proteinuria) and the search for ANCA in the presence of such manifestations.