Aspects épidémiologique, clinique, thérapeutique et évolutif de la maladie de Basedow en Médecine Interne au CHU Ledantec Dakar (Sénégal)

Diagne, Nafissatou; Faye, Atoumane; Ndao, Awa Cheikh; Djiba, Boundia; Kane, Baïdy Sy; Ndongo, S.; Pouye, Abdoulaye

doi:10.11604/pamj.2016.25.6.7868

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…27 However, the 2 peak age ranges at diagnosis in the 30s and 50s shown in our patients with GD are similar to that seen in other studies. 7,27 Overall, the presentation of GD in our setting was largely due to goitre and cardiovascular symptoms as well as hypermetabolic manifestations as those found in other areas of the world, with a few atypical presentations. 30 Also, clinical signs were dominated by cardiovascular and ophthalmologic complications.…”

Section: Discussionsupporting

confidence: 90%

“…11,26 There appears a lower female:male ratio among blacks, as a similar study involving patients with GD in Senegal yielded only slightly higher ratio compared with this study. 27 In general, the increased association of GD with the female sex and, in particular, its rarity before puberty and after menopause strongly implicates the role of sex steroids in its causation. 19 Again, the protective role of androgens in the development of autoimmune thyroid disease provides an additional layer of evidence to the role played by female sex hormones in the determination of GD.…”

Section: Discussionmentioning

confidence: 99%

“…36 Additional factors associated with an inability to achieve remission at 24 months in our study cohort included patients with a relatively high FT3/FT4 ratio. 27,37 The FT3/FT4 has also been an indicator of thyroid activity. 38 Patients with GD who routinely missed clinic appointments were 5× associated with the inability to achieve remission.…”

Section: Discussionmentioning

confidence: 99%

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Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Sarfo‐Kantanka

Ansah

Kyei

2018

Clin Med Insights Endocrinol Diabetes

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BackgroundGraves disease (GD) has increased in prevalence over the past decade in Africa. Despite this, the condition is not well described, especially in sub-Saharan Africa.ObjectiveWe have described the clinical characteristics and associated factors of GD in a cohort of patients attending a resource-limited setting tertiary hospital.MethodsPatients were examined thoroughly and systematically tested for the degree of clinical and biochemical thyroid status. Thyroid volume, characteristics, and blood flow were assessed at presentation using ultrasonography. Factors associated with an inability to achieve clinical and biochemical thyroid remission were evaluated using multiple logistic regression analysis.ResultsOverall, 182 patients were studied, 152 (83.5%) were women with a female:male ratio of 5.1:1.0. The mean age at presentation was 39.9 ± 14.7 years with women significantly older than men. Thyroid-associated orbitopathy (TAO) was observed in 56% of the participants and pretibial myxoedema in 6%. About 84% of the participants were hyperthyroid at presentation, 9% were euthyroid, 4% were hypothyroid, and 3% had subclinical hyperthyroidism. Inability to achieve biochemical and clinical remission at 24 months was associated with increased thyroid volume (odds ratio [OR]: 2.35, 95% confidence interval [CI]: 1.85-2.52, P < .001), presence of TAO (OR: 2.15, 95% CI: 2.12-2.33, P < .001), increased FT3/FT4 ratio (OR: 1.33, 95% CI: 1.24-2.56, P = .004), and missed clinic appointment (OR: 5.2, 95% CI: 4.55-7.89, P < .001).ConclusionsGraves disease among Ghanaians is associated with significant signs at presentation. Inability to achieve remission within the first 24 months is associated with increased thyroid volume, TAO, an increased FT3/FT4 ratio, as well as missed clinic appointment.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Sarfo‐Kantanka

Ansah

Kyei

2018

Clin Med Insights Endocrinol Diabetes

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“…Graves' disease is the most common cause of hyperthyroidism [3]. A recent study in our country shows that hyperthyroidism accounts for about 18% of outpatient visits and 72% of these cases were related to Graves' disease [4].…”

Section: Discussionmentioning

confidence: 98%

Association of Hashimoto’s Thyroiditis and Graves’ Disease: A Case Report and Review of the Literature

Diagne¹,

Sow²,

Faye³

et al. 2021

CRCM

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Graves' disease and Hashimoto's thyroiditis are two common autoimmune diseases. Their association with other autoimmune diseases is not exceptional. However, the co-occurrence of these two diseases is not often described. In this case, report, we describe the observation of a patient who had long been followed for exophthalmos and pretibial myxedema as a sign of thyrotoxicosis. Examination of this patient revealed a clinical picture of clinical and biological hypothyroidism related to Hashimoto's thyroiditis. This case had made it possible to retain an association between Hashimoto's thyroiditis and basedowdisease, which is rarely described. This observation underscores the importance of monitoring these patients with autoimmune disease systematically even if there is no clinical manifestation.

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“…It is the most common cause of hyperthyroidism [1]. The prevalence of Graves' disease in Senegal is estimated to be approximately 4% [2].…”

Section: Introductionmentioning

confidence: 99%

Resistance to Anti-Thyroid Drugs in Graves’ Disease: Clinical-Biological Characteristics and Alternative Therapy in Tropical Area

Diack¹,

Ndiaye²,

Sène³

et al. 2020

OJEMD

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Background: Resistance to anti-thyroid drugs (ATDs) is a rare entity recently described. We report two African observations in the treatment of Graves' disease. Case 1: A 19-year-old Senegalese woman presented on admission with thyrotoxicosis syndrome associated with diffuse goitre and Grave's orbitopathy. TSH levels were low (0.005 mIU/ml; N = 0.27-4.20) and fT4 elevated (60 pmol/L; N = 12-22]. Combination therapy with propranolol (40 mg/day) and carbimazole (starting dose of 45 mg/day and increased to 60 mg/day) was initiated. In view of the persistence of symptoms despite good therapeutic compliance, carbimazole was replaced by methimazole with an initial starting dose of 40 mg/day, followed by 60 mg/day. Despite the change in therapy, clinical symptoms of thyrotoxicosis persisted, and fT4 levels remained elevated. The patient was diagnosed with resistance to ATDs in Graves' disease. Total thyroidectomy following 10 days of preoperative preparation with 1% Lugol's solution was performed successfully. Case 2: A 22-year-old woman was referred for continued management of Graves' disease with elevated thyroid-stimulating hormone receptor antibody (TRAb) levels (34 UI/mL; N < 1.75). Treatment included propranolol (80 mg/day) and carbimazole at an unusual dose of 80 mg/day. Combined therapy was clinically and biologically ineffective, with an fT4 level of 100 pmol/L [N: 12-22]. Upon admission, methimazole (40 mg/day) followed by propylthiouracil (800 mg/day) replaced carbimazole. Despite good patient compliance, the patient's symptoms remained unaltered and fT4 levels elevated. A total robot thyroidectomy using the right axillary approach was performed successfully after 10 days of preoperative preparation, including prednisone (40 mg/day

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Aspects épidémiologique, clinique, thérapeutique et évolutif de la maladie de Basedow en Médecine Interne au CHU Ledantec Dakar (Sénégal)

Cited by 10 publications

References 9 publications

Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors

Association of Hashimoto’s Thyroiditis and Graves’ Disease: A Case Report and Review of the Literature

Resistance to Anti-Thyroid Drugs in Graves’ Disease: Clinical-Biological Characteristics and Alternative Therapy in Tropical Area

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