Thyrotoxicosis in Nigeria. Analysis of a five year experience

Fourty cases of thyrotoxicosis seen over a 5-year period in the endocrinology service of a teaching hospital in Ibadan, Nigeria have been reviewed. The clinical manifestations are not different in any way from the pattern described in other parts of the world and there was a female preponderance in a ratio of 4:1. The ratio of diffuse toxic goiter to toxic multinodular goiter was only 3:2, underscoring the relative uncommonness of Grave's disease, an autoimmune disorder, in Nigerian Africans. The study also demonstrated an increase in the hospital prevalence of thyrotoxicosis in Ibadan in the last 10-15 years; however, the incidence rate of 8 cases per year is still low when compared to experiences in other parts of the world. The presence of a goiter, ocular changes, high sleeping pulse rate, fine silky-smooth skin and thin, short and scanty hair have been identified as important clinical clues to look for to aid in the diagnosis of a difficult case in an environment where there are no facilities for thyroid function tests. Surgery was the most dependable form of treatment because of the cost and scarcity of drugs and complete absence of radiotherapy.