Diagne Nafissatou, Faye Atoumane, Ndao Awa Cheikh, Djiba Boundia, Kane Baidy Sy, Ndongo Souhaibou, Pouye Abdoulaye
Médecine Interne, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.
Pan Afr Med J. 2016 Sep 14;25:6. doi: 10.11604/pamj.2016.25.6.7868. eCollection 2016.
Basedow-Graves disease is an autoimmune affection characterized by the association of thyrotoxicosis with variable frequency events such as goiter, ophthalmopathy and pretibial myxedema. Its diagnosis is often easy, while its management remains difficult. A simple medical treatment exposes patient to recurrence risk. In Senegal and Sub-Saharan Africa few studies have focused on Basedow-Graves disease. This study aims to describe the epidemiological, clinical, therapeutic and evolutionary aspects of Basedow-Graves disease at a Hospital in Dakar. This was a retrospective study conducted from 1 January 2010 to 31 December 2013 in the Department of Internal Medicine at the Aristide Le Dantec University Hospital. During this period, 108 patients receiving outpatient treatment for Basedow-Graves disease were included out of a total of 834 patients receiving outpatient treatment. The diagnosis was made on the basis of clinical, biological and immunological signs. One hundred and eight patients suffering from Basedow-Graves disease were included out of a total of 834 consultations. Sex ratio was 7.3 and the average age was 34.6 years. The main reasons for consultation were: palpitations and weight loss in 46.3% and 39.8% of cases respectively. Thyrotoxicosis syndrome was found in 93.5% of patients, goiter was found in 87% of patients and exophthalmos in 78.7% of patients. The main complication was cardiothyreosis found in 11.1% of patients. All patients underwent antithyroid synthetic drugs treatment. The evolution was favorable in 19,4% of cases. Disease recurrence was observed in 57% of cases and in 23.1% of patients were lost to follow-up. Basedow-Graves disease is the most common cause of hyperthyroidism, The patient's clinical picture is dominated by manifestations related to hypermetabolism. This study highlights that thyroidectomy isn't the first-line of treatment if we consider the high number of recurrences after medical treatment.
巴塞多-格雷夫斯病是一种自身免疫性疾病，其特征是甲状腺毒症与甲状腺肿、眼病和胫前黏液性水肿等不同频率的事件相关联。其诊断通常容易，但治疗仍然困难。简单的药物治疗会使患者面临复发风险。在塞内加尔和撒哈拉以南非洲，很少有研究关注巴塞多-格雷夫斯病。本研究旨在描述达喀尔一家医院中巴塞多-格雷夫斯病的流行病学、临床、治疗和演变情况。这是一项回顾性研究，于2010年1月1日至2013年12月31日在阿里斯蒂德·勒丹泰克大学医院内科进行。在此期间，在总共834名接受门诊治疗的患者中，有108名接受巴塞多-格雷夫斯病门诊治疗的患者被纳入研究。诊断基于临床、生物学和免疫学体征。在总共834次会诊中，有108名患有巴塞多-格雷夫斯病的患者被纳入。性别比为7.3，平均年龄为34.6岁。主要会诊原因分别是：心悸和体重减轻，分别占病例的46.3%和39.8%。93.5%的患者发现有甲状腺毒症综合征，87%的患者发现有甲状腺肿，78.7%的患者发现有突眼。主要并发症是甲状腺心脏病，在11.1%的患者中发现。所有患者均接受抗甲状腺合成药物治疗。19.4%的病例病情好转。57%的病例观察到疾病复发，23.1%的患者失访。巴塞多-格雷夫斯病是甲状腺功能亢进最常见的原因，患者的临床表现以与高代谢相关的症状为主。这项研究强调，如果考虑到药物治疗后复发率高，甲状腺切除术不是一线治疗方法。
