HYPERTHYROIDISM IN PEOPLE OLDER THAN 50 Y EARS OF AGE IN SENEGAL - STUDY OF 31 CASES OVER A 14-YEAR PERIOD

Purpose. - Though common in elderly, with poor and masked symptomatolo gy, hyperthyroidism has never been studied in people older than 50 yea rs of age in African countries. Methods. - Of the 300 cases of hyperth yroidism that were observed during this study, 31 belonged to this cat egory. We analyzed the frequency of various parameters, demographic ch aracteristics, motivation for consultating, thyrotoxic syndrom, non th yrotoxic signs, cardiac manifestations, hormonal and scintigraphic cha racteristics, etiology and etiologic factors, and treatment. Results. - The frequency of hyperthyroidism in this population was 10%. Housewi ves were more numerous, with 20 cases observed in the 31 patients. The main group (13/31) war of rural origin. Signs that predominantly led to consultation were weight loss (23/31), cervical tumor (17/31), and palpitations (12/31). Three majors signs were associated with the thyr otoxic syndrome: weight loss (29 cases), tachycardia (27/31), and the existence of tremors in the extremities (22/31). Hormone assays showed that thyroxine (T-4) was about 265 +/- 74 nmol/L and triiodothyronine (T-3) about 6 +/- 2 nmol/L, at immunoradiometric assay; thyroid-stimu lating hormone (TSH) was about 0.17 +/- 0.23 mu IU/mL. Eye protusion p redominated in the nonthyrotoxic syndrom, with 25 cases in the 31 pati ents. Etiologic forms of the disease were composed of 25 Grave's disea se, with 22 typical cases. Etiologic factors were various, however wit hout any case of neoplasia Cardiac complications included two cases of atrial fibrillation No iatrogenic form of the disease was observed Me an initial carbimazole dosage was about 34 +/- 8 mg/d Of the 23 patien ts, 15 had a favourable outcome. Conclusions. - In this series, the hi gh number of housewives and the patients' rural origin were less chara cteristic of hyperthyroidism than the Grave's disease etiology. This m ight be due to the young age of this African population. (C) 1998 Else vier, Paris.