Trends in diagnostic and therapeutic criteria in Graves' disease in the last 10 years
F Escobar-Jiméneza, M L Férnandez-Sotoa, V Luna-Lópeza, M Quesada-Charnecoa, D Glinoerb
a Endocrinology and
Clinical Nutrition Service, Department of Medicine, University Hospital
San Cecilio, Granada, Spain, b Department of Internal Medicine, Hospital
Saint-Pierre, Universite Libre de Bruxelles, Belgium
Correspondence to: Dr Fernando Escobar-Jiménez, Department of Endocrinology, Hospital Universitario de Granada, C/ Doctor Oloriz, 16, 18012 Granada, Spain (e-mail: amalia{at}goliat.ugr.es)
Submitted 20 July 1999;
Accepted 27 October 1999
A questionnaire describing a typical clinical case of Graves'
disease and 10 variations on it was mailed to 70 Spanish units of
endocrinology with the aim of assessing the new diagnostic and
therapeutic trends for hyperthyroidism caused by Graves' disease in
Spain and to compare the results obtained from previous studies carried
out in Europe and Spain 10 years previously.
Responses indicated that thyrotrophin (98%) and free
thyroxine (88%) were the most used tests in the in vitro diagnosis of Graves' disease with a significant decrease in the use of total thyroxine, total triiodothyronine, and thyroglobulin in comparison with the surveys conducted 10 years previously in Europe and Spain. The
presence of antibodies against the thyrotrophin receptor was the most
frequently used immune marker in the diagnosis (78%) and the new use
of antithyroperoxidase antibodies (36%) in diagnosis is noteworthy.
Antithyroid drugs remain the treatment of choice (98%). Surgery was
used mainly for large size goitres (33%) and radioiodine for
recurrences after medical (61%) or surgical (80%) treatment.
In conclusion, the responses obtained from this questionnaire
provide insight into current specialist diagnostic and therapeutic practices with respect to Graves' disease and which could be of value
to non-specialist units of endocrinology.
Keywords: Graves' disease; antithyroid drugs; radioiodine; surgery
© 2000 by The Fellowship of Postgraduate Medicine
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