| Allahabadia et al., Birmingham, UK, studied the influence of gender on the presentation and outcome of 508 (82.7% females) patients with Graves’ disease. No differences in sex frequency were present among the four racial groups (Caucasian, Negroid, Oriental, South Asian) in this study. Significant differences between females and males were found for pulse rate (females higher), weight gain to restoration of euthyroidism (females less), and outcome in that males required significantly more doses of radioactive iodine. No significant variation was seen regarding age of onset, family history, number of symptoms, eye disease, free T3 and T4 and autoantibody status and titer. McIver et al., Edinburgh, Scotland, UK and Rochester, MI, USA, randomized a group of 111 untreated patients with hyperthyroid Graves’ disease, 52 of whom received carbimazole only in a titrated dose for 18 months, while 59 received 40 mg carbimazole and in addition a titrated dose of T4 to suppress TSH. The purpose of this study was to see if there was any difference in outcome between the two treatment groups. The decrease in thyrotropin receptor binding antibodies was similar in both groups during treatment, while recurrent hyperthyroidism occurred in 43 and 41% respectively. Also the mean time to relapse was similar in both groups, 12 vs. 11 months respectively. The conclusion from this prospective study is that, with regard to outcome, both treatment modalities give similar results. Allahabadia et al., Birmingham, UK, assessed the influence of smoking and the presence of a goiter on the clinical course of Graves’ disease in a retrospective study of 508 patients. A highly significant association was present between the size of goiter and the age of onset, younger patients having larger goiters more frequently. Smoking and presence of autoantibodies were also related to presence and size of goiter. The larger the goiter, the higher pulse rate, free T4, and free T3 at presentation. Smoking was strongly associated with the presence of TAO and with lower body weight. Andrade et al., Porto Alegre, Brazil, studied the effect of pretreatment with anti-thyroid drugs on changes in serum T4 and T3 after treatment with radioactive iodine. In a randomized prospective study 21 patients were pretreated with methimazole until euthyroidism before receiving 200 mCi/gr. 131I and results were compared with 27 untreated patients with similar characteristics of Graves’ disease with regard to clinical presentation and laboratory data. After treatment TT4 and TT3 levels did not change significantly in either group as tested frequently in the first 30 days. (Comment: The results suggest that the dose 131I administered had no acute effect on stored thyroid hormones, irrespective of pretreatment with anti-thyroid drugs) |
