Lanas Alejandra, Díaz Patricia, Eugenin Daniela, González Franco, Cid Pía, Cordero Francisco, Araya Verónica, Liberman Claudio, Barberan Marcela, Gac Patricio, Saldías Neil, Pineda Pedro
Sección Endocrinología y Diabetes, Hospital Clínico, Universidad de Chile, Santiago, Chile.
Hospital de Medicina Veterinaria, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2017 Apr;145(4):436-440. doi: 10.4067/S0034-98872017000400003.
Basedow Graves disease (BGD) is the leading cause of hyperthyroidism. The characteristics of patients seen at a university hospital may differ from those described in the general population.
To describe the clinical features of patients with BGD seen at a university hospital.
Review of medical records of all patients seen at our hospital between 2009 and 2014 with the diagnosis of thyrotoxicosis, hyperthyroidism or BGD. Clinical features, laboratory results and treatments were recorded.
We reviewed clinical records of 272 patients; 15 had to be excluded due to incomplete data. BGD was present in 77.9% (n = 212). The mean age of the latter was 42 years (range 10-81) and 76% were women. Ninety six percent were hyperthyroid at diagnosis and thyroid stimulating hormone was below 0.1 mIU/L in all patients. Median free thyroxin and triiodothyronine levels were 3.26 ng/dl and 3.16 ng/ml, respectively. Thyrotropin-receptor antibodies were positive in 98.5% and 85.7% had positive thyroid peroxidase antibodies. Graves orbitopathy (GO) was clinically present in 55% of patients. Of this group, 47% had an active GO, 26% had a moderate to severe disease and 7.8% had sight-threatening GO. As treatment, 26% received radioiodine, 44% anti-thyroid drugs exclusively, 28% underwent thyroidectomy and 2% did not require therapy.
In this group of patients, we observed a greater frequency of severe eye disease and a high rate of surgical management. This finding could be explained by referral to highly qualified surgical and ophthalmological teams.
巴塞多氏病（Basedow Graves disease，BGD）是甲状腺功能亢进症的主要病因。大学医院所见患者的特征可能与普通人群中描述的不同。
描述在大学医院就诊的BGD患者的临床特征。
回顾2009年至2014年间在我院就诊且诊断为甲状腺毒症、甲状腺功能亢进症或BGD的所有患者的病历。记录临床特征、实验室检查结果及治疗情况。
我们回顾了272例患者的临床记录；15例因数据不完整而被排除。BGD患者占77.9%（n = 212）。后者的平均年龄为42岁（范围10 - 81岁），76%为女性。96%的患者在诊断时甲状腺功能亢进，所有患者的促甲状腺激素均低于0.1 mIU/L。游离甲状腺素和三碘甲状腺原氨酸水平的中位数分别为3.26 ng/dl和3.16 ng/ml。促甲状腺激素受体抗体阳性率为98.5%，甲状腺过氧化物酶抗体阳性率为85.7%。55%的患者临床上存在Graves眼病（GO）。在这组患者中，47%有活动性GO，26%患有中度至重度疾病，7.8%有视力威胁性GO。作为治疗方法，26%的患者接受放射性碘治疗，44%仅接受抗甲状腺药物治疗，28%接受甲状腺切除术，2%不需要治疗。
在这组患者中，我们观察到严重眼病的发生率较高，手术治疗率也较高。这一发现可以通过转诊至高素质的外科和眼科团队来解释。
