Outcomes of medical management of thyrotoxicosis in Benin City, Nigeria

Abstract

Objective: The treatment options for thyrotoxicosis include medical, surgical and radioiodine therapy. Many patientswith goiter are reluctant to accept thyroidectomy when euthyroid because they hope the goiter will resolve with antithyroid drugs. Radioiodine therapy is not available in our locality. The aim of this study was to document the outcomes of medical treatment of thyrotoxicosis in our hospital.

Methods: This was a retrospective study of all patients with thyrotoxicosis managed by the Endocrinology Unit of the University of Benin Teaching Hospital over a 3 year period. Their medical records were retrieved. Data extracted included age, gender, presenting complaints, findings on physical examination,thyroid hormone profiles, and treatment outcomes.

Results: Thirty five patients (32 females, 3 males) with thyrotoxicosis were seen giving a female to male ratio of 8:1. Their mean age was 44.3±13.9 years. The peak age range at presentation was 40-49 years. The modes of presentation were: thyrotoxicosis 22(62.86%), Graves’ disease 7(20%), Graves’ ophthalmopathy 2(5.7%), thyrocardiac heart disease 2(5.71%). The frequency of symptoms were anterior neck mass 68.57%, weight loss 60%, palpitation 60%, heat intolerance 37.14%, bulging eyes 31.43%, hyperdefaecation 31.45%, and tremors of the hands 19.99%. Goiter was found in 27(77.14%), proptosis 16 (45.71%) and onycholysis 3(8.57%). Goiters persisted despite medical treatment while 20% of the patients remained hyperthyroid, 74% were euthyroid and 5.71% became hypothyroid

Conclusion: Goiters did not resolve with antithyroid drugs. Therefore, patients seeking resolution of goiter should opt for surgery or radioiodine therapy.

Keywords: thyrotoxicosis, medical management, antithyroid drugs