Factor predicting the outcome of treatment for Graves’ disease
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Abstract
Background : Graves’ disease is an autoimmune disorder that leads to an overactive thyroid gland. The treatments available are antithyroid drugs, radioiodine, and surgery. Opinions vary as to the optimal form of therapy, as no single treatment regularly results in permanent euthyroidism. Antithyroid drugs are effective in controlling hyperthyroidism, but long term remission rates are low, varying between 30–50%.
Methods : A retrospective study of 201 patients with Graves’ hyperthyroidism to examined the hypothesis that simple clinical features, such as gender, age, thyroid hormone level free T3,free T4 and freeT3 freeT4 ratio at diagnosis to predict response to treatment.
Results: The study showed that among 201 patients, patients younger than 40 years success to treatment with antithyroid drug than older patients p 0.028 The dose of iodine 131 for the treatment of patients younger than 40 years will use the iodine 131 dose at 17.24 +/- 1.06 mci, patients older than 40 years used the iodine 131 dose at 14.90 +/- 0.85 mci, p = 0.036 when considering patients with a Free T3/Free T4 ratio < 4.4, indicating that they will be more successful in the treatment with iodine 131 compared to patients with a Free T3/Free T4 ratio > 4.4. more than one dose of I131 was required for treatment p 0.062 and patients who achieved treatment received fewer doses of radioiodine than patients treated with higher doses (p < 0.006). However, factors such as gender, age, Free T4 level at first diagnosis, and Free T3/Free T4 ratio < 4.4 were not found to be significant factors affecting the success of treatment for Graves' hyperthyroidism.
Conclusion: The study’s findings indicated that patients younger than 40 years were more successful in treatment with antithyroid drug compared to older patients. However, it cannot be used to predict the outcome of treatment for Graves' disease. Additional tests, such as TSH receptor antibody levels or radioactive iodine uptake, might be necessary.
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