Hirsutism in Saudi females of reproductive age: a hospital-based study

Hirsutism among women of fertile age is commonly seen in clinical practice, but the pattern of the disease in Saudi Arabs has not been studied. The aim of the study was to determine the clinical, biochemical and etiologic features of hirsutism in Saudi females. 101 Saudi Arab women presenting with hirsutism at King Khalid University Hospital, Riyadh, Saudi Arabia, from 1 January 2000 to 31 December 2005 were prospectively assessed using the recently approved diagnostic guidelines for hyperandrogenic women with hirsutism. Polycystic ovary syndrome [PCOS] was the cause of hirsutism in 83 patients [82%] followed by idiopathic hirsutism [IH] in 11 patients [11%]. Others causes of hirsutism included late onset congenital adrenal hyperplasia in 4 patients [4%], microprolactinoma in 2 [2%] and Cushing's syndrome in 1 [1%] patient. Age at presentation of PCOS was 24.5_6.6 years [mean +/- SD] and 51% of the subjects were obese. Furthermore, 74 [89%] of patients with PCOS had an oligo/anovulatory cycle while the remaining 9 patients [11%] maintained normal regular menstrual cycle. Luteinizing hormone and total testosterone were significantly higher in patients with PCOS than in those with IH [P<.05]. The present data show PCOS to be the commonest cause of hirsutism in our clinical practice and PCOS is prominent amongst young obese females. However, further studies on a larger scale are needed to verify our findings

Treatment of Graves' hyperthyroidism - prognostic factors for outcome

To determine whether clinical and biochemical features of Graves' disease at presentation predict response to medical and radioiodine treatment. We carried out a retrospective 10-year study of 194 consecutive Saudi subjects with Graves' disease who were treated with antithyroid drugs, radioiodine therapy, or both, between January 1995 and December 2004 at King Khalid University Hospital, Riyadh, Saudi Arabia. At diagnosis, the mean age was 32 +/- 0.9 years. Only 26% of patients had successful outcome after a course of antithyroid medication. None of the clinical or biochemical factors were associated with a favorable outcome of antithyroid treatment. One dose of radioiodine [13-15 mCi [481-555 MBq]] cured hyperthyroidism in 83% of patients. Presence of ophthalmopathy at presentation was shown to be a significant contributing factor to failure to respond to a single dose of radioiodine [odds ratio, 6.4; 95% CI, 1.51-24.4; p<0.01]. Failure of radioiodine treatment was also associated with higher serum free T3 concentration at presentation [p=0.003]. In patients with Graves' hyperthyroidism, radioiodine treatment is associated with higher success rate than antithyroid drugs. A dose of 13-15 mCi [481-555 MBq] seems to be practical and effective, and should be considered as first line therapy. Patients with high free T3 concentration and, those with ophthalmopathy at presentation were more likely to fail radioiodine treatment. A higher dose of radioiodine may be advisable in such patients