Graves disease: Clinical features and treatment results

In the last years the diagnosis of Grave's disease has become easier and ac celerated due to new laboratory and instrumental tests. The therapeutic pos sibilities improved also by using antithyroidal drugs, surgery and radioiod ine application subsequently. In a retrospective study 278 outpatients with Graves disease, treated and controlled by our centre for thyroid diseases in 1992-1999, were investigated to evaluate the initial and leading subject ive symptoms which led the patients to seek medical help ("guide symptoms") . These obtained guide symptoms were compared with the objective "clinical signs" observed at the beginning of the disease. Weight loss turned out to be the most frequent (26 %) guide symptom, whereas tachycardia (> 90 beats/ min) and moist skin were the most frequently observed clinical signs (71 an d 61 % respectively). The beginning of therapy, dosage of drugs, length of application and result s of treatment are critically evaluated, with special emphasis on the rate and time of remission, on the frequency of recurrences and on the success o f additional treatments such as surgery and/or radioiodine application. Pha rmacological treatment alone induced a persistent remission (at least 6 mon ths of euthyroidism) in 156 patients (in 113 after the first and in 43 afte r the 2(nd) drug trial). Surgery was successful in 46, radioiodine applicat ion in 40 patients. The sequential use of drug therapy, surgery and radioio dine as it is performed in our institution leads to a permanent remission i n 242 of 278 (= 87 %) patients.