PREVALENCE AND SIGNIFICANCE OF STEATORRHEA IN PATIENTS WITH ACTIVE GRAVES-DISEASE

Objective: The aim of this study was to determine the prevalence of st eatorrhea in patients with Graves' disease and to assess its significa nce and correlation with changes in body mass index (BMI), coefficient of fat absorption (COFA), and pancreatic exocrine function in these p atients. Methods: Daily dietary fat intake, 24 h fecal fat, COFA, feca l chymotrypsin activity las an index of pancreatic exocrine function), and total T3, T4, and TSH levels were assessed in 28 patients with ac tive Graves' disease. In 24 patients, reassessment was done after atta ining a euthyroid state with carbimazole therapy. Results: In the thyr otoxic state, 13 of 28 patients had steatorrhea, whereas 15 had normal (<6 g/day) fat excretion (11.4 +/- 6.7 g vs 2.9 +/- 0.8 g,p = 0.0007) . Daily fat intake, basal BMI, and serum T3 and T4 levels were similar in the steatorrheic and nonsteatorrheic groups. The mean COFA of the steatorrheic group was significantly lower than that of nonsteatorrhei c group (91.6% +/- 4.8% vs 97.7% +/- 0.9%, respectively; p = 0.0006). In the steatorrheic group, fat excretion and COFA normalized after att ainment of euthyroidism (changes in fat excretion and COFA = 7.3% +/- 6.3 g/day and 7.7% +/- 5.4%, respectively). Fecal chymotrypsin levels were similar in the steatorrheic and nonsteatorrheic thyrotoxics and i n 16 healthy control subjects. The levels did not show any significant changes following attainment of euthyroid status. Conclusion: Steator rhea associated with a decrease in COFA can occur in a reversible mann er in 46% of patients with Graves' disease. However, steatorrhea in th ese patients is not linked with weight loss or with pancreatic exocrin e dysfunction. (C) 1998 by Am. Cell. of Gastroenterology.