Management of thirotoxicosis

university hospital experience

Abstract

Objectives: to classify patients with thyrotoxicosis as the etiology and to evaluate demographic data and treatment effectiveness of patients with Graves’ Disease (GD). Methods: Retrospective study of patients with thyrotoxicosis of the Hospital das Clínicas of the Universidade Federal de Goiás (HC-UFG) with demographic data collection, clinical characteristics, exams, treatments and outcomes. Results: 170 patients were classified, with the main etiologies GD (68.24%) and multinodular goiter toxic-MNGT (9.41%). The initial treatment modalities used in patients with GD were antithyroid drugs (ATD) in 89.66%, radioiodine ablation (RIA) in 6.9% and thyroidectomy (CX) in 1.72%. The rate of remission with ATD was 38.88% and that of relapse, 14.28%. The remission rate with RIA and CX was 100%, with no cases of relapse. Second treatment option was required in 59.48%, third option in 21.74% and fourth in 16.67%. Adverse events occurred in 20.18% of the ATD treated patients, more associated with methimazole, and the most common were epigastralgia and neutropenia. Complications associated with RIA and CX were reported in 11.86% and 57.14%, mainly cervical pain (5.08%) and hypoparathyroidism (28.57%). Conclusions: The main etiologies of thyrotoxicosis were GD and MNGT. ATD was the first choice, showing the importance of this approach in our environment and the need to use it properly. It is necessary to review the orientation of the proposed treatment to the patient and to reinforce adherence. Treatment with RIA or CX was more effective. No factors associated with remission and relapse were identified, and prospective studies are required.