Caracterización de pacientescontrolados por enfermedad deBasedow Graves en un hospitaluniversitario

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ARTÍCULO DE INVESTIGACIÓN 436 Rev Med Chile 2017; 145: 436-440 Caracterización de pacientes controlados por enfermedad de Basedow Graves en un hospital universitario Alejandra Lanas1, Patricia Díaz1, Daniela Eugenin1, Franco González2,a, Pía Cid1, Francisco Cordero1, Verónica Araya1, Claudio Liberman1, Marcela Barberan1, Patricio Gac3, Neil Saldías4, Pedro Pineda1 Clinical features of patients with Basedow Graves disease seen at a university hospital Background: 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. Aim: To describe the clinical features of patients with BGD seen at a university hospital. Material and Methods: 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. Results: 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. Conclusions: 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. (Rev Med Chile 2017; 145: 436-440) Key words: Graves Disease; Hyperthyroidism; Thyroidectomy. 1Sección Endocrinología y Diabetes. Hospital Clínico de la Universidad de Chile. Santiago, Chile. 2Hospital de Medicina Veterinaria de la Universidad de Chile. Santiago, Chile. 3Departamento de Cirugía. Hospital Clínico de la Universidad de Chile. Santiago, Chile. 4Departamento de Oftalmología. Hospital Clínico de la Universidad de Chile. Santiago, Chile. aMédico veterinario. Recibido el 13 de septiembre de 2016, aceptado el 4 de abril de 2017. Correspondencia a: Dra. Alejandra Lanas Santos Dumont 999, Sección de Endocrinología. Independencia. Santiago, Chile. Teléfono: 29788430 alelanasm@gmail.com La tirotoxicosis es una condición caracterizada por un excesivo efecto de las hormonas tiroideas a nivel tisular. El hipertiroidismo es el cuadro resultante del exceso de síntesis de hormonas a nivel tiroideo. En un estudio poblacional, la prevalencia reportada es de 1,3%, correspondiendo 0,7% a hipertiroidismo subclínico, el cual se define por TSH baja con niveles plasmáticos normales de T3 y T42. La principal causa de hipertiroidismo en regiones con suficiencia de yodo es la enfermedad de Basedow Graves (EBG)3. Es una patología tiroidea autoinmune causada por el estímulo de anticuerpos antireceptor de TSH (TRAb) sobre células


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