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Atypical features of hyperthyroidism in blacks

W J Kalk

    South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
    |April 26, 1980
    PubMed
    Summary
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    Hyperthyroidism diagnosis in Black patients may be delayed due to atypical symptom presentation, such as goiter, compared to White patients. This study highlights differences in how Black and White individuals experience and report thyrotoxicosis symptoms.

    Area of Science:

    • Endocrinology
    • Internal Medicine
    • Population Health

    Background:

    • Hyperthyroidism is considered rare in indigenous African populations.
    • Variations in clinical presentation may impact diagnosis rates.

    Purpose of the Study:

    • To compare the presenting symptoms and clinical findings of hyperthyroidism in Black and White patients.
    • To investigate reasons for the perceived infrequency of hyperthyroidism diagnosis in Black populations.

    Main Methods:

    • Prospective comparison of volunteered and elicited symptoms, and physical examination findings.
    • Study included 60 Black and 56 White patients with thyrotoxicosis at a single thyroid clinic.

    Main Results:

    • Black patients volunteered fewer weight loss symptoms and more frequently presented with goiter as their sole complaint.

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  • Black patients showed higher rates of complicated hyperthyroidism (cardiac failure, myopathy) and infiltrative ophthalmopathy.
  • Atypical presentations were more common in Black patients, leading to more frequent 'change' diagnoses.

    • Conclusions:

    • Differences in symptom reporting and presentation frequency may contribute to underdiagnosis of hyperthyroidism in Black patients.
    • Socio-economic, educational, and cultural factors likely influence the atypical presentation of hyperthyroidism in Black populations.
    • Recognizing these presentation differences is crucial for timely and accurate diagnosis of thyrotoxicosis in diverse patient groups.