Endocrine Abstracts

In order to assess the frequency and timing of recurrence in a group of patients with Graves’ disease and the predictors of recurrence, 197 patients were sampled, who were first seen in the OCDEM clinic in either 2001 or 2002 and put on anti-thyroid medication. Graves’ disease was diagnosed by the presence of low TSH levels ± symmetrical goitre ± uniform radioactive iodine uptake ± eye disease ± high levels of thyroid hormones. Patients with <18 months of treatment, those for whom the outcome was unknown and those for whom this was a relapse were excluded, leaving 62 patients overall; of which 10 were male. This cohort was followed up for on average 10.2 months ± 1.75 months (range 0–41 months). During this time 24 people relapsed, on average 8.8 months ± 1.2 months (range 2–18 months) after ending treatment. The overall relapse rate was 39%. About 60% of men and 35% of women relapsed. Twenty-one patients had eye signs. The difference in the recurrence rate between patients with eye signs (47.6%) and those without eye signs (35%) was highly significant (0.01<P<0.005). Twenty-nine patients had T4 levels >40. The relapse rate in those with high T4 levels (45%) and those with low T4 levels (20%) was not statistically significantly different (0.1<P<0.05). There was no significant difference between the recurrence rate in smokers and non-smokers; positive and negative antibody levels; family and no family history. From this we would like to conclude that it may be beneficial for men, and those with eye signs to have initial definitive treatment, instead of the current practise of anti-thyroid treatment for 18 months first.