[Profile of graves disease in the region of kairouan: about 186 cases]

ABSTRACT

In this retrospective study we tried to determine the epidemiologic, clinical, therapeutic and evolutive features in 186 patients with Graves disease [GD] followed at the ibn el Jazzar hospital in Kairouan during 15 years. GD represents the most frequent cause of hyperthyroidism [67%], mainly in young adults [mean age 35.8 +/- 12.3 years] with a clear female prevalence [83.9%]. The diagnosis is suggested clinically in presence of a homogeneous [80.6%] and vascular [61.2%] goitre associated or not with an exophtalmy [52.2%]. The most frequent clinical signs of hyperthyroidism are weight loss [81.2%], tachycardia [86%], asthenia [74.4%] and tremor [55.9%]. R-TSH antibodies testing was performed in 35 patients with a rate of positivity of 91,4%. Thyroid scintiscanning was practised in 77,5% of the cases and echography in 23,4%. Antithyroid drug therapy was the only management in 51,5% of the cases with a rate of euthyroidism of 67% [mean follow up of 58,2 months]. Radioactive iodine was given in the event of failure of the Antithyroid drug therapy in 35,8% of the cases with 38.7% of hypothyroidism [mean follow up of 54,6 months]. The surgical treatment was a subtotal thyroidectomy in 89,5% of the cases with euthyroidism in 22.2% of the cases and hypothyroidism in 77.8% [mean follow up of 53.4 months]; hypoparathyroidism represented the major complication of the surgery [transient 15.9% and definitive 5.3%]