open access

Vol 70, No 2 (2019)
Original papers
Published online: 2018-11-27
Submitted: 2018-08-17
Accepted: 2018-10-24
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Subclinical hyperthyroidism in the course of autonomous nodules — clinical evaluation

Grzegorz Mieczysław Rudzki, Monika Lenart-Lipińska, Agata Smoleń, Beata E. Chrapko, Beata Matyjaszek-Matuszek
DOI: 10.5603/EP.a2018.0088
·
Pubmed: 30480751
·
Endokrynologia Polska 2019;70(2):157-164.

open access

Vol 70, No 2 (2019)
Original papers
Published online: 2018-11-27
Submitted: 2018-08-17
Accepted: 2018-10-24

Abstract

Introduction: Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature.

Material and methods: From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures.

Results: Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism.

Conclusions: Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in the
right lobe. 

Abstract

Introduction: Subclinical hyperthyroidism (SCH), also known as mildly symptomatic hyperthyroidism, has recently been diagnosed more frequently. One of the main endogenous causes of this disorder is autonomously functioning thyroid nodule (AFTN). Despite the fact that it is usually asymptomatic, SCH entails repercussions on the cardiovascular system and bone, and it carries a risk of progression to overt hyperthyroidism with a typical clinical picture. Treatment is still controversial, and its benefits are widely debated in literature.

Material and methods: From 459 patients authors selected a group of 49 patients (10.6% of all subjects with hyperthyroidism), 41 women (83.7%) with AFTN at the stage SCH treated in the Outpatient Endocrinological Clinic and the Department of Endocrinology of the Medical University of Lublin over a three-year period. The method applied in the study was a retrospective analysis of medical records with a particular account of medical history, physical examination, and additional tests obtained during the process of diagnostic and therapeutic procedures.

Results: Forty-one patients (83.7%) suffered from typical symptoms of hyperthyroidism; only eight patients (16.3%) were asymptomatic. The most frequently reported symptoms were tachycardia in women (51.2%) and anxiety in men (50%). The type of thyrostatic drugs and the length of therapy did not affect the outcome of iodine-131 therapy. In the vast majority of the patients (87.8%) radioidodine therapy was effective; 30 patients (61.2%) reached euthyreosis and 13 patients (22.5%) developed hypothyroidism.

Conclusions: Most patients with SCH in the course of AFTN suffered from typical symptoms of overt hyperthyroidism; only every sixth patient was asymptomatic. The volume of autonomous adenomas did not affect the result of 131I therapy; however, the impact of AFTN volume as well as the thyroid volume on RIT efficacy requires futher investigation. In the vast majority of patients 131I therapy was an effective method of treatment, and an earlier therapeutic effect was observed more often in the patients with focal lesions located in the
right lobe. 

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Keywords

subclinical hyperthyroidism; SCH; autonomous nodule; AFTN; 131I; radioiodine therapy

About this article
Title

Subclinical hyperthyroidism in the course of autonomous nodules — clinical evaluation

Journal

Endokrynologia Polska

Issue

Vol 70, No 2 (2019)

Pages

157-164

Published online

2018-11-27

DOI

10.5603/EP.a2018.0088

Pubmed

30480751

Bibliographic record

Endokrynologia Polska 2019;70(2):157-164.

Keywords

subclinical hyperthyroidism
SCH
autonomous nodule
AFTN
131I
radioiodine therapy

Authors

Grzegorz Mieczysław Rudzki
Monika Lenart-Lipińska
Agata Smoleń
Beata E. Chrapko
Beata Matyjaszek-Matuszek

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