Eh. Sidibe et al., HYPERTHYROIDISM IN PEOPLE OLDER THAN 50 Y EARS OF AGE IN SENEGAL - STUDY OF 31 CASES OVER A 14-YEAR PERIOD, La Revue de medecine interne, 19(4), 1998, pp. 237-241
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.