[Therapeutic results in hyperthyroid patients from the Bern endemic goiter region]

Among 239 hyperthyroid patients from the Bernese endemic goiter area referred to specialist, 66% were found to have Graves' disease (MB), 12% hyperthyroid autonomous adenoma ( AAH ) and 22% multinodular toxic goiter (HK). 189 (79%) of these 239 patients have been followed up 5.4 +/- 3.8 years after the last treatment. At the time of follow-up, 146 patients (77%) were euthyroid without additional treatment. 97 of these (51%) became euthyroid after a single, initial treatment (41% of the MB, 83% of the AAH and 67% of the HK). 68 patients (36%) developed recurrences, in some cases several (48% of the MB, 4% of the AAH and 15% of the HK). These recurrences occurred in 56% of cases treated with carbimazole, in 19% of the thyroidectomies and in 11% of the radioiodine treated cases. 30% of the recurrences occurred two or more years after the last treatment. At the time of follow-up, 40 patients (21%) were found to be hypothyroid (23% of the MB, 13% of the AAH and 21% of the HK). However, only 20 of these patients had been treated properly with 1-thyroxin; the other 20 were either insufficiently treated or not at all. Hypothyroidism has been observed in 27 (25%) patients after thyroidectomy and in 13% (23%) patients after radioiodine. No complications were recorded after radioiodine or under carbimazole treatment. After surgery, 2.8% of the patients had recurrent nerve palsy and 2.8% permanent hypoparathyroidism. The present data are in accordance with those published from outside the goiter areas.(ABSTRACT TRUNCATED AT 250 WORDS)