Trends in diagnostic and therapeutic criteria in Graves' disease in the last 10 years

A questionnaire describing a typical clinical case of Graves' disease and 1 0 variations on it was mailed to 70 Spanish units of endocrinology with the aim of assessing the new diagnostic and therapeutic trends for hyperthyroi dism caused by Graves' disease in Spain and to compare the results obtained from previous studies carried out in Europe and Spain 10 years previously. Responses indicated that thyrotrophin (98%) and free thyroxine (88%) were t he most used tests in the in vitro diagnosis of Graves' disease with a sign ificant decrease in the use of total thyroxine, total triiodothyronine, and thyroglobulin in comparison with the surveys conducted 10 years previously in Europe and Spain. The presence of antibodies against the thyrotrophin r eceptor was the most frequently used immune marker in the diagnosis (78%) a nd the new use of antithyroperoxidase antibodies (36%) in diagnosis is note worthy. Antithyroid drugs remain the treatment of choice (98%). Surgery was used mainly for large size goitres (33%) and radioiodine for recurrences a fter medical (61%) or surgical (80%) treatment. In conclusion, the responses obtained from this questionnaire provide insig ht into current specialist diagnostic and therapeutic practices with respec t to Graves' disease and which could be of value to non-specialist units of endocrinology.