Retrospective evaluation of patients those admitted to endocrinology andmetabolism clinic with thyrotoxicosis

Retrospective Evaluation of Patients Those Admitted to Endocrinology and Metabolism Clinic with Thyrotoxicosis Thyrotoxicosis is a common chronic disease that affects all age groups. It is important to making an accurate diagnosis and start treatment. In this study, in which thyrotoxicosis etiology and treatment approaches were evaluated retrospectively, 1651 patients with TSH level <0.55 μIU/mL were evaluated. The mean age was 51.29 years. 1350 patients (81,8%) age were below 65 years and 301 patients (18,2%) were 65 years or older. 18% of the patients were male and 82% were female. In this study we conducted with 1651 patients with low TSH values, it was observed that the most common cause of low TSH was drug-related thyrotoxicosis (71,4%). Levothyroxine use rate was 97,9% among drug-related thyroytoxicosis causes. 8,1% of the levothyroxine users were consisted of patients who received high dose levothyroxine therapeutically after thyroid malignancy. It was observed that the frequency of thyrotoxicosis associated with contrast agent and amiodarone were 1,2%, and 0,2% respectively. Our study showed us as the most common causes of hyperthyroidism were Graves (15,1%) and TMNG-TN (8,9%) and these findings are consisant with the literature. When patients over 65 years of age were evaluated separately, TMNG and TN were found to be the most common cause of hyperthyroidism, which is also similar to the literature. When the patient groups, those below 65 years of age and over 65 years of age were compared in terms of etiological causes of low TSH, we found that the frequency of TMNG and TN was higher in the group of over 65 years of age, and this elevation was statistically significant (p<0.001). We noticed that the frequency of drug-related thyrotoxicosis in women (76,9%) was higher than in men, and this height was statistically significant (p<0,001). Graves (30,5%), TMNG (13,1%) and TN (5,4%) rates were higher in men than women, and this height was statistically significant (p<0.001). 49 Graves patients were followed up for 2-3 years after an average of 12 months of antithyroid drug treatment. At the end of this period, it was observed that 22,2% of Graves patients were in remission, 50% of were received RAI treatment after relapse, and 15,9% were surgically treated after relapse. We grouped Graves patients as relapse and remission groups. In the comparison of these two groups according to age, gender and laboratory parameters, we found that the TRAb values were higher in patients with relapses compared to patients in remission, and this elevation was statistically significant (p=0,001). In the analysis performed with age, gender and laboratory parameters of graves patients who developed relapses and were followed in remission, it was determined that TRAb values were higher in graves patients who developed relapse than in patients with remission and it was seen that height was statistically significant (p=0.001). Being a single center study and it's retrospective feature are limitations of this study. More prospective, multi-centered studies, which with large patient groups and with longer follow up time, are needed in this regard. Key Words: Graves, Thyotoxicosis, Causes of Thyrotoxicosis, Treatment Methods, Drug Related Thyrotoxicosis