Thyrotoxicosis in Ethiopian patients--a prospective study

Forty-six cases of thyrotoxicosis, 8 males and 38 females, were seen over a period of two years from March 1979. There were 19 cases of toxic multinodular goitre, 22 of Graves' disease, four of toxic adenoma and one of subacute thyroiditis. The median age of those with toxic multinodular goitre was 49 and of those with Graves' disease was 30 years. The five most common symptoms were sweating/heat intolerance (82.6%), weight loss (82.6%), palpitations (82.6%), nervousness and irritability (73.9%) and insomnia (69.6%). Six of 24 non-pregnant females of child-bearing age had menstrual disturbances. The five most common signs were goitre (97.8%), tachycardia (100.0%), sweating (84.7%), and fine finger and tongue tremors (89.1%). Among the 22 cases of Graves' disease, 13 (59.1%) had exophthalmos and 4 (18.2%) had pretibial myxoedema. Treatment with propylthiouracil or carbimazole was effective in controlling the thyrotoxicosis. Granulocytopenia developed in two cases and skin allergy in one other, necessitating use of alternative treatment. Seven cases had subtotal thyroidectomy after preparation with antithyroid drugs or propranolol and Lugol's iodine.