Kebede Dawit, Abay Zinahbezu, Feleke Yeweyenhareg
Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University.
Ethiop Med J. 2012 Oct;50(4):287-95.
Thyroid diseases are common endocrine abnormalities affecting the cellular metabolism of the body. There are limited recent studies addressing the different aspects of thyroid diseases in Ethiopia.
To assess the pattern, clinical presentations, management and associated illnesses of thyroid diseases in endocrine referral clinics of Tikur Anbessa Specialized Tertiary Hospital (TASH).
A cross-sectional study was conducted on consecutive thyroid patient attending endocrine referral clinics of TASH from Nov 2009 to March 2010. Patients with thyroid diseases, 14 years of age and above, thyroid patients with other endocrine diseases were included in the study. Data were collected by trained nurses and physicians using pre-constructed questionnaires. Review of charts for patients, presenting manifestations, date of diagnosis, laboratory investigation results, treatment and other pertinent information was conducted.
Among 376 patients with thyroid diseases, females were 337 (90%) and males were 39 (10.4%). The mean (SD) age of female participants was 43.1 +/- 15.2 males was 37.3 +/- 17.3. Age 40 and above accounted for 59%. The prevalence of Hyperthyroidism and hypothyroidism in 376 patients were 233 (61.7%) and 129 (34.3%) respectively. Toxic Multinodular Goiter occurred in 135 (35.9%), Toxic nodules in 32 (8.5%) and of Graves' disease in 65 (17.3%), Seven patients progressed from Graves' disease to Hashimoto's thyroiditis. Subclinical hypothyroidism occurred in 5(1.32%), and secondary hypothyroidism in 4 patients. Palpitation (96%), goiter (99%) and hot intolerance (81.9%) were the commonest presentations of thyrotoxicosis, whereas hypothyroidism patients presented mostly with cold intolerance (50.4%) and goiter (38%). Autoimmune polyglandular syndrome occurred in 16 (4.3%) patients. 26 (7.0%) had history of pregnancy, 82 (22.2%) had family history of thyroid diseases and seven patients had history of alcohol intake. Thyrotoxicosis was treated with Propylthiouracil (96.8%) with or with out beta blockers, thyroidectomy was done in 16 (6.8%), few received radioiodine therapy. Hypothyroidism patients were treated with thyroxin.
Thyroid diseases were more common in females and more prevalent in age group of 40-49. Toxic Multinodular Goiter, Graves' disease and Toxic Nodular Goiter were causes of thyrotoxicosis. The most common presenting feature of thyrotoxicosis was palpitation, and hypothyroidism was cold intolerance. A few Graves' disease cases were progressed to hypothyroidism. Autoimmune Polyglandular Syndrome was an important associated disease. There was limited access for radioiodine treatment.
To conduct further studies in different aspects of thyroid disease, strengthening access for radioiodine therapy and introduce anti thyroid antibody tests.
甲状腺疾病是常见的内分泌异常，影响身体的细胞代谢。近期针对埃塞俄比亚甲状腺疾病不同方面的研究有限。
评估提库尔·安贝萨专科医院（TASH）内分泌转诊诊所中甲状腺疾病的模式、临床表现、治疗及相关疾病。
对2009年11月至2010年3月在TASH内分泌转诊诊所连续就诊的甲状腺患者进行横断面研究。纳入年龄14岁及以上的甲状腺疾病患者以及合并其他内分泌疾病的甲状腺患者。由经过培训的护士和医生使用预先构建的问卷收集数据。对患者的病历、临床表现、诊断日期、实验室检查结果、治疗及其他相关信息进行回顾。
在376例甲状腺疾病患者中，女性337例（90%），男性39例（10.4%）。女性参与者的平均（标准差）年龄为43.1±15.2岁，男性为37.3±17.3岁。40岁及以上者占59%。376例患者中，甲状腺功能亢进症和甲状腺功能减退症的患病率分别为233例（61.7%）和129例（34.3%）。毒性多结节性甲状腺肿135例（35.9%），毒性结节32例（8.5%），格雷夫斯病65例（17.3%），7例患者从格雷夫斯病进展为桥本甲状腺炎。亚临床甲状腺功能减退症5例（1.32%），继发性甲状腺功能减退症4例。心悸（96%）、甲状腺肿（99%）和不耐热（81.9%）是甲状腺毒症最常见的表现，而甲状腺功能减退症患者主要表现为不耐寒（50.4%）和甲状腺肿（38%）。自身免疫性多腺体综合征发生在16例（4.3%）患者中。26例（7.0%）有妊娠史，82例（22.2%）有甲状腺疾病家族史，7例患者有饮酒史。甲状腺毒症采用丙硫氧嘧啶治疗（96.8%），联合或不联合β受体阻滞剂，16例（约6.8%）接受甲状腺切除术，少数接受放射性碘治疗。甲状腺功能减退症患者采用甲状腺素治疗。
甲状腺疾病在女性中更常见，在40 - 49岁年龄组中更为普遍。毒性多结节性甲状腺肿、格雷夫斯病和毒性结节性甲状腺肿是甲状腺毒症的病因。甲状腺毒症最常见的表现是心悸，甲状腺功能减退症是不耐寒。少数格雷夫斯病病例进展为甲状腺功能减退症。自身免疫性多腺体综合征是一种重要的相关疾病。放射性碘治疗的可及性有限。
对甲状腺疾病的不同方面进行进一步研究；加强放射性碘治疗的可及性；引入抗甲状腺抗体检测。
