Trends in diagnostic and therapeutic criteria in Graves' disease in the last 10 years

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 result...

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Bibliographic Details
Published in:Postgraduate medical journal 2000-06, Vol.76 (896), p.340-344
Main Authors: Escobar-Jiménez, F, Férnandez-Soto, M L, Luna-López, V, Quesada-Charneco, M, Glinoer, D
Format: Article
Language:English
Subjects:
Antibodies
Antithyroid Agents - therapeutic use
antithyroid drugs
Autoantibodies - blood
Biomarkers - blood
Endocrinology - trends
Graves disease
Graves Disease - diagnosis
Graves Disease - drug therapy
Humans
Hyperthyroidism
Iodide Peroxidase - immunology
Iodine
Iodine Radioisotopes - therapeutic use
Original
Polls & surveys
Questionnaires
radioiodine
Receptors, Thyrotropin - immunology
Recurrence
Scintigraphy
Spain
surgery
Surveys and Questionnaires
Thyroid Function Tests - trends
Thyroid gland
Thyrotropin - blood
Thyroxine - blood
Trends
Ultrasonic imaging
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Summary: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.
ISSN:0032-5473
1469-0756
DOI:10.1136/pmj.76.896.340