Presentation and management of Graves disease-Experience from a tertiary care center in Eastern India
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 10
Abstract
Graves’ disease has varied presentation and preference for therapeutic modality varies from country to country. We report the presentation and mode of therapy we perform in a tertiary care center in Eastern India. This is a retrospective data of 60 patients with Graves’ disease evaluated and treated at Institute of Post-graduate Medical Education and Research (IPGMER), Kolkata. Patients were recruited consecutively between March 2017 and May 2017. Baseline characteristics revealed median (±IQR) age of presentation 33.1±10.1 years, F:M ratio 2.3:1, median duration 7.7±6.8 months, 28% were overweight and 20 % were smoker. Most common mode of presentation was tremor (93%), followed by palpitation (86.6%), weight loss (85%) and hyperdefecation (25%). Overall 31 (51.6%) patients had eye signs and active eye disease was present in 5 (8.3%) patients. Only 30 patients were screened for glycemic status at disease onset and 12 (40%) were found to have dysglycemia. Diagnosis of Graves’ was mostly done by clinical examination (57%), followed by Isotope studies (38%) and only 3 (5%) patients by Anti TSH receptor antibodies (TRAb). Majority of the patients (70%) underwent medical therapy alone, followed by radioiodine ablation (21.6%) and surgery done in 5 (8.3%) patients only. Average radioiodine dose was 11.9 ± 2.1 mCi and only 2 (13.3%) patient needed repeat dose. 2 patients out of 5 who underwent total thyroidectomy developed permanent hypoparathyroidism. A comprehensive overview of management of Graves’ disease in Eastern India is described. There is high prevalence of dysglycemia but often not screened. Requirement of usage of TRAb is still minimal and restricted to special cases only.
Authors and Affiliations
Subhodip Pramanik, Rana Bhattacharjee, Subhankar Chowdhury
Keywords
Related Articles
- EP ID EP615967
- DOI -
- Views 148
- Downloads 0
Insulin therapy : lessons from shrimad bhagavad gita
Diabetes mellitus is a common disease. One of the most important challenges faced by medical fraternity is a large proportion of diabetic patients remain uncontrolled due to unde-ruse of insulin. This is because of lack...
Insulin therapy in ramadan
Ramadan is one of the five main pillers of islam . A significant proportion of muslim patients with diabetes fast in Ramadan are either already on insulin or may be started (naïve), presenting a challenge for the managem...
Critical care of acute stroke
In the last decade, there has been tremendous interest and growth in setting up ICUs and stroke centers across India. Because of changes in modern stroke therapy and advanced imaging techniques with software for remote r...
Co-morbid conditions of infertile couples a community based study
Infertility is a public health problem affecting people worldwide from all the communities with various causes. In any society being a parent is as a normal assumption of adult life. The crisis of infertility makes the c...
Burden of cardiovascular problem and their risk factors among adolescent school children in Kolkata : an introspection
This cross-sectional study was conducted among the adolescent school children of 9th grade (14- 16 years) studying in 21 schools of Kolkata which were selected by using stratified random sampling based on school types an...