DOI: http://dx.doi.org/10.18203/2349-3933.ijam20195254

Is the clinic pathological profile of hypothyroidism gradually changing: a comparative study from North India

Rahul Sud, Sagar Bhagat

Abstract


Background: Thyroid dysfunction has been subject of academical and therapeutically interest not only to the endocrinologist but also to the disciplines of medicine. Statistical data and studies on hypothyroidism are scanty, clinical picture is varied, investigations are usually not available at all levels and therefore to enlarge clinical profile of hypothyroidism minimal base line investigation, clinical approach and effects of replacement therapy and complications are to be studied.

Methods: Observational cross-sectional study conducted among patients with hypothyroidism registered at the Air Force Central Medical Establishment (AFCME) New Delhi.

Results: Among 50 patients with hypothyroidism were enrolled in this study during the study period. Idiopathic hypothyroidism was present in 98% patients while only one patient (2%) had Hashimotto’s thyroiditis. Generalized weakness was the commonest presenting symptom followed by lethargy and anorexia. Thyroid swelling was diffuse in nature with no predilection to right or left lobe enlargement. Hypertension (40%) and ischemic heart diseases (36%) were the most common comorbid condition. Mean serum TSH was elevated while serum T3 and T4 values were reduced. Antithyroid antibody titre was positive in more than seventy percentage of patients. X-ray among patients revealed cardiomegaly in ten patients (20%), pulmonary Koch’s in (4%) of patient and in rest of patients x-ray chest PA view was normal. ECG changes showed low voltage on electrocardiogram in (20%) of patients and sinus bradycardia in (24%) of patients. Most of the patients were put on replacement therapy (L. thyroxine) in dose of 1.6 - 1.7 mcg/kg/day.

Conclusions: Hypothyroidism as a clinical entity is common between 4th and 6th decade of life and seen more among females. Though etiology remained unknown in majority of the patients, weakness, and lethargy were the common clinical presentation.


Keywords


Antithyroid antibody, Hypothyroidism, India, Triiodothyronine, Thyroxine, Serum thyroid-stimulating hormone

Full Text:

PDF

References


Mullur R, Liu YY, Gregory A. Brent. Thyroid Hormone Regulation of Metabolism. Physiol Rev. 2014; 94(2): 355-82.

Dunlap DB. Thyroid Function Tests. Clinical Methods: The history, physical, and laboratory examinations. 3rd edition. Boston: Butterworths; 1990:666-669.

Sathyamurthy P, Rajkumar M. Clinico-laboratory Profile of Hypothyroidism with Emphasis on Cardiovascular Manifestations. Pana J Med Sci. 2016;6(2):59-65.

Sinha RK, Bhattacharya A, Roy BK, Saha SK, Nandy P, Doloi M, et al. Body iodine status in school children and availability of iodised salt in Calcutta. Ind J Pub Health. 1999;43(1):42-8.

Roy VC, Unnithan RR, Bahuleyan CG. Echocardiographic evaluation of pericardial effusion in hypothyroidism: incidence, biochemical and therapeutic correlations. J Assoc Phys Ind. 1986 Feb;34(2):111.

Dhadhal R, Mulchandani V, Parakh R, Ashish Joshee A, Ketan Mangukiya K, Nihari Bathwar N. A cross sectional study of prevalence of hypothyroidism in adult population of Udaipur district. GJBB. 2015;4(1):103-6.

Bose A, Sharma N, Hemvani N, Chitnis DS. A hospital-based prevalence study on thyroid disorders in Malwa region of Central India. Int J Curr Microbiol App Sci. 2015;4(6):604-11.

Kikuchi. Aging and thyroid decrease requirement of thyroid hormone in old patients. Am Med J. 1983;75:206-9.

Larsen PR, Ingbar SH. The thyroid gland. In: Wilson JD, Fosteer DW eds. William’s textbook of endocrinology, 13th ed. Philadelphia: W. B. Saunders Company; 2016: 457-491.

Somalwal AM, Jalagaonker PB. Cerebellar sign in myexdema. JAPI. 1995;241.

Caraccio N, Ferrannini E, Monzani F. Lipoprotein profile in subclinical hypothyroidism: response to levothyroxine replacement, a randomized placebo-controlled study. J Clin Endocrinol Meta. 2002 Apr 1;87(4):1533-8.