LONG-TERM EFFECTS OF TREATMENT OF GRAVES-DISEASE BY 4 DIFFERENT THERAPEUTICS

  • 1 January 1977
    • journal article
    • research article
    • Vol. 38  (4) , 273-282
Abstract
Patients [166] with Graves'' disease were treated between 1967 and 1971 with 4 different methods (carbimazole alone, carbimazole plus surgery, 131I, 131I plus carbimazole between the 10th and 50th days). Isotope was calculated to deliver 7000 rads in 76 cases and 10,000 rads in 17 more severe cases. Patients, [129] were submitted to a long term followup. Medical treatment resulted in euthyroidism in 34/47 after a mean duration of 8 mo. One-third to 1/2 of the patients relapsed between 1-9 yr. Surgical treatment was successful in 25/26 after a total period of 5.5 mo. Eight relapsed and 3 became hypothyroid. Relapses were more frequent after bilateral subtotal thyroidectomy than after total lobectomy plus subtotal contralateral lobectomy. Isotope therapy resulted in a complete cure in 14 patients (delay 4.1 mo.) and in 34, a complementary treatment was necessary (delay 13.5 mo.). Relapses (12/94) were detected in general after 2 yr. The results were the same after 7000 and 10,000 rads doses and whether the patient did or did not receive carbimazole. The treatment of Graves'' disease is long and difficult. An excellent result is obtained only in half of the cases. One third of these good results needs less than 6 mo. and 2/3 needs 12 mo. A thyroid gland weighing less than 40 g incurs an increasing risk of hypothyroidism after surgical treatment or after isotopic irradiation.

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