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Treatment outcome 6-10 years after diagnosis of hyperthyroidism in 2916 patients: a longitudinal evaluation of a swedish incidence cohort
University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Stockholm, Sweden; Karolinska University Hospital, ANOVA, Stockholm, Sweden.
Örebro University Hospital, Faculty of Medicine and Health, Örebro, Sweden.
Department of Medicine, Örebro University Hospital, Örebro, Sweden.
Deparment of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Medicine, Uppsala University Hospital, Uppsala, Sweden.
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2018 (English)In: Thyroid, ISSN 1050-7256, E-ISSN 1557-9077, no S1, article id 219Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Treatment of Graves’ disease (GD) and toxic nodular goiter (TNG) has the objectives to cure hyperthyroidism, prevent recurrent disease and preserve thyroid function. Treatment efficacies and long-termout comes of antithyroid drugs (ATD), radioactive iodine (RAI) or surgery varies in the literature. We report outcome of treatment, cure rate and risk factors for relapse for GD and TNG in an unselected cohort. A prospective incidence-cohort of de novo diagnosed GD and TNG patients (n = 2916) from 2003-05, were invited to a follow-up 6 - 10 years after diagnosis. Questionnaires were sent to 2430 patients regarding treatments, cure rate, recurrence, quality of life, demographic data, comorbidities and life-style factors. Patients were treated according to clinical routine with ATD, RAI or surgery. Of those included, 1186 (83.3%) had GD and 237 (16.7%) had TNG. In GD patients, 351 (45.3%), 264 (81.5%), and 52 (96.3%) were cured by ATD, RAI or surgery respectively as first line treatment. Of those, 77.0%, 15.4% and 3.8% respectively were without levothyr-oxine supplementation at follow-up at 8 – 0.9 years. Including all treatment modalities, 851 (71.8%) of GD patients were cured within one treatment period. At follow-up, 278 (23%) of GD patients had been operated. In TNG patients, RAI cured 88.6% and surgery 92.9%, whereof 52/154 (33.8%) and 3/15 (20%) had no levothyroxine supplementation post RAI and surgery, respectively.The proportion that did not feel fully recovered at follow-up was 25.3% of GD and 18.1% of the TNG patients. Overall, treatment of hyperthyroidism results in preserved thyroid function only in 35.3% and 44.7% of GD and TNG cases, respectively. As many as 23.4% of the GD patients end up with surgery although only 4.6% choose it from the beginning. Our treatment tradition cures 71.8% of GD patients and 78.1% of TNG patients within one treatment period. The high number of patients who do not feel recovered 6 -10 years after hyperthyroidism in GD and TNG is are minder of the chronic nature of hyperthyroidism.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2018. no S1, article id 219
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-98966OAI: oai:DiVA.org:oru-98966DiVA, id: diva2:1657579
Conference
88th Annual Meeting of the American Thyroid Association, Washington, DC, United States, October 3-7, 2018
Available from: 2022-05-11 Created: 2022-05-11 Last updated: 2022-05-13Bibliographically approved

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https://doi.org/10.1089/thy.2018.29065.abstracts

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Sjölin, GabrielByström, KristinaWallin, Göran

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