[Diagnosis and therapy of Basedow hyperthyroidism. Results of an Austrian study]

After organisation and presentation of an European survey about "The management of Hyperthyroidism due to Graves disease" by the European Thyroid Association (ETA) national studies have been proposed. The Austrian survey was realized by the Austrian Society of Nuclear Medicine (ONG). Based on the original questionnaire of the ETA with a simple case report of uncomplicated Graves' disease and with 8 variations of the basic case including sex, age, thyroid volume and recurrence participants were asked to comment diagnostic and therapeutic procedures. Out of 42 participants 19 were heads of departments, 19 assistants and 4 internal specialists in practice with main clinical work in the field of thyroid diseases. Thyroid scintigraphy is performed in 98% (Tc 99 m 78%, J 123 15%) and ultrasound in 64%. "In vitro"-procedures include 5-6 tests (means = 5,7). 21% prefer determination of total hormones, 31% of free hormones. Various combinations of both hormone determinations are used most frequently. TRH-Test ist performed in 52.4%. Auto-antibodies are measured in 81%. TSH-receptor auto-antibodies and microsomal and thyreoglobulin auto-antibodies as well are determined in 40%. Therapeutic options of the basal case report and the 8 variations showed antithyroid drugs (ATD) in 62%, radioiodine (RI) in 26% and surgery in 12%. RI is proposed in elder patients (79%) and in patients with recurrence of the disease (45%). Surgery is recommended in patients with large thyroid volume (57%). For ATD administration only carbimazole and methimazol in a mean dosage of 60 mg/die (range 20-120 mg/die) is chosen. After euthyroidism is reached ATD is reduced to 50-90% of the original dosage.(ABSTRACT TRUNCATED AT 250 WORDS)