Assessment of the Diagnosis, Follow-up and Treatment Outcomes in Patients with Hyperthyroidism at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia
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Date
2021-05
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Addis Abeba University
Abstract
Background
Hyperthyroidism is a disease condition characterized by increased synthesis and secretion of
thyroid hormone by the thyroid gland. A diagnosis of hyperthyroidism is made based on clinical
presentation and abnormality in TFT characterized by low level of TSH and elevated thyroid
hormones. Diagnosing the different forms of hyperthyroidism based on clinical manifestations and
TFT alone is challenging.
Objective
To assess the diagnosis, follow-up and treatment outcomes in patients with hyperthyroidism at
Endocrine Clinic, TASH.
Methods
A retrospective follow-up study was employed to evaluate the diagnosis, follow-up and treatment
outcomes of patients with hyperthyroidism at Endocrine Clinic, TASH. A census was performed
to those patients who were aged 18 years and above, diagnosed to have hyperthyroidism on
Antithyroid drug for more than 18 months on follow up from September 2009 to August 2012 E.C,
excluding pregnant women. Patients’ response to different treatment options were evaluated. Also,
factors associated with treatment outcomes were identified. While descriptive statistics (mean,
proportion, percentage and standard Deviations) were used to summarize the results, multivariate
logistic regression and chi square test were used as appropriate to check the association between
dependent and independent variables. Statistical significance was determined at a p value of < 0.05
and CI of 95%.
Results
In this study, a total of 230 patients with hyperthyroidism were involved, of which 208[ 90.4%] of
them were female and 22[ 9.6%] were male. The female to male ratio was 9.4 to 1. The mean age
of the participants was 44 years +/-13 SD. In about 60 % of patients the duration of diagnosis of
hyperthyroidism was less than 04 years. The most common symptom and sign were palpitation
and goiter accounting [89.6%] and [78.2%] respectively.
Significant association was found with therapy and duration of treatments. Those patients who had
been following treatment for four years and above, were more likely to have improved outcome compared to those who were following their treatment for less than four year (AOR=2.869,
CI=1.173-7.0211, p=0.021). In addition, those patients who were on initial combination therapy
(Beta adrenergic blocker + ATD) were 2.189 times highly likely to have improved outcomes
compared to those who took single therapy (ATD or Beta-adrenergic blocker) (AOR=2.189,
CI=1.144-4.187, p=0.018).
Conclusions
In this study, the most common cause of hyperthyroidism was TMNG and Treatment outcome
was strongly associated with duration of hyperthyroidism and initial usage of combination
therapy.
Description
Keywords
Hyperthyroidism, Toxic Multinodular Goiter, Graves’ Disease, Toxic Adenoma