Document Detail

Natural history of subclinical hyperthyroidism in elderly patients with TSH between 0.1 and 0.4 mIU/L: a prospective study.
MedLine Citation:
PMID:  19744104     Owner:  NLM     Status:  Publisher    
SUMMARY Context: One important aspect in the decision to treat or not elderly patients with subclinical hyperthyroidism (SCH) is the risk of progression to overt hyperthyroidism (OH). Objective: To define the natural history of endogenous SCH in elderly patients with TSH between 0.1 and 0.4 mIU/L. Design: Prospective study. One hundred two women aged >/= 60 years with persistently low TSH ranging from 0.1 to 0.4 mIU/L and normal free T4 and T3 were studied. Patients using L-T4 or antithyroid drugs, previously treated for hyperthyroidism, with pituitary disease, using corticosteroids, amiodarone, dopaminergic agonists, with atrial fibrillation or heart disease were excluded. Seven patients had Graves' disease, 91 had nodular disease and 4 presented no defined cause. The time of follow-up ranged from 12 to 70 months (median 41 months). Results: Three patients progressed to overt hyperthyroidism (elevated T4 and/or T3) and 4 other patients to persistently low TSH (< 0.1 mIU/L) in the presence of increase in serum T3 compared to baseline. These patients were treated. Twenty-four women presented sustained normalization of TSH and none progressed to hypothyroidism. SCH with TSH in the 0.1 to 0.4 mIU/L range persisted in 71 patients, 4 of them (5.6%) being treated due to the development of atrial fibrillation or heart disease during follow-up. The only independent predictor of progression of SCH was an initial TSH value < 0.2 mIU/L. Conclusions: In elderly patients with endogenous SCH and TSH between 0.1 and 0.4 mIU/L progression to clinical hyperthyroidism is uncommon (approximately 1% per year), spontaneous TSH normalization may occur, and persistence of SCH for many years is the most likely.
Pedro Weslley Rosario
Related Documents :
18410374 - Hypokalemic thyrotoxic periodic paralysis: clinical characteristics and predictors of r...
104514 - Failure of the trh test to predict the clinical course of patients in remission after a...
3794094 - Thyroid dysfunction during chronic amiodarone therapy.
2878674 - Detection of tsh-binding inhibiting immunoglobulins in patients with graves' disease an...
17229224 - Assessment of dietary nutrients that influence perception of intra-oesophageal acid ref...
12790924 - Treatment of constipation in adults associated with idiopathic megarectum by behavioura...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-9-10
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-9-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Postgraduation Program, Santa Casa de Belo Horizonte, Minas Gerais, Brazil * Thyroid Department, Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Metabolic cardiovascular disease risk factors and their clustering in subclinical hypothyroidism.
Next Document:  How should we treat patients with low serum thyrotropin concentrations?