P. Jouanny et al., CLINICAL AND LABORATORY TEST ABNORMALITIE S IN ELDERLY PATIENTS WITH THYROID-DYSFUNCTION, La Semaine des hopitaux de Paris, 71(17-18), 1995, pp. 512-517
Nonthyroidal clinical manifestations and laboratory test abnormalities
in subjects older than 70 years with thyroid dysfunction were studied
. There were 46 patients with hyperthyroidism, 68 with hypothyroidism,
and 61 with high TSH syndrome. The control group was composed of 72 e
lderly subjects without thyroid dysfunction taken at random among pati
ents hospitalized in an internal medicine department. Patients with hy
perthyroidism were significantly more likely than controls to have ast
henia (78.1 % vs 45.4 %), ACFA (39.1 % vs 16.9 %), heart failure (39.1
% vs 6.9 %), and diarrhea (37.5 % vs 11.3 %). As compared with contro
ls, patients with hypothyroidism had lower diastolic blood pressure (7
1 mmHg vs 76 mmHg) and hemoglobin (11.7 g/dl vs 12.8 g/dl) values and
were more likely to have high serum cholesterol levels (12.9 % vs 2.7
%). There were no significant differences between patients-with high T
SH syndrome and controls or patients with hypothyroidism. Amiodarone t
herapy was associated with lan increased risk of hyperthyroidism (odds
ratio 4.0) and hypothyroidism (odds ratio 2.8). Thyroid dysfunction i
s common in elderly inpatients. Clinical manifestations are often subt
le and overshadowed by symptoms due to comorbid conditions. As a conse
quence, looking for symptoms indicative of thyroid dysfunction may not
be sufficient in elderly individuals. Broad criteria should be used t
o indicate thyroid hormone assays in elderly inpatients.