Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 16 P807

ECE2008 Poster Presentations Thyroid (146 abstracts)

Clinical variables associated with recurrence of hyperthyroidism in Graves’ disease

Familiar Cristina 1 , Moraga Inmaculada 1 , Cruces Eva 2 , Vicente Almudena 2 , Sastre Julia 2 & Lopez Jose 2


1Mostoles Hospital, Mostoles, Madrid, Spain; 2Virgen de la Salud Hospital, Toledo, Spain.


Introduction: In Graves’ hyperthyroidism with long-term antithyroid drugs (ATD) treatment, remission is often umpredictable. However variables at diagnosis or at the end of the ATD regimen are associated with a highest likelihood of recurrence and could be used to decide an ablative treatment.

Objective: To identify variables before and at the end of a long-term treatment with ATD (>6 months) associated with higher rates of relapse during a follow-up of at less 1 year after discontinuing ATD.

Subjects: About 250 subjects with a first episode of Graves’ disease between January 1999 and December 2004 seen in the same institution.

Results: At baseline mean age was 41±14 years, 21% were male and 33% smokers, 49% used iodinated salt and 40% were classified as having a goiter > grade 2. Mean TSI decreased from 11±18 to 2.5±4 (P<0.05) at the end of ATD regimen. About 29% were excluded of a further analysis because of an ablative treatment as soon as ATD were stopped. Relapse ocurred in 60% of the resting 177 subjects submitted to a long-term treatment (mean 18±8 months) during the follow-up period (mean: 3.1±1.7 years). Of analyzed variables at diagnosis,only male gender, smoking history and iodinated salt use were significantly associated with failure of medical treatment. In a logistic regression analysis only male gender and smoking cigarettes were independent predictive factors for recurrence. TSI 3 times above the normal value at the end of the treatment yield a 98% positive predictive value for relapse.

Conclusion: Recognition of variables at diagnosis of Graves’ disease or at the end of long-term ATD course could be used to select pacients for surgery or radioiodine because of lower remission rate with medical treatment.

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