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The Management of Hyperthyroidism due to Graves' Disease in Europe in 1986: Results of an International Survey
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1987
Year
Dietary Iodine IntakeClinical ThyroidologyIodine Deficiency DisordersThyroid DiseaseParathyroid HormoneClinical TrialsThyroid DisordersParathyroid GlandThyroid HormoneInternational SurveyEndocrinologyMedicinePublic HealthThyroid PhysiologyHormone ProductionEndocrine Disease
In 1986, a survey on the management of hyperthyroidism due to Graves’ disease was undertaken in Europe. The survey was based on the results of a questionnaire mailed to all clinicians who were members of the ETA. Why was it decided to organize an international survey on Graves’ hyperthyroidism? There were four main reasons for ‘revisiting’ this well-known disease. First, clinical thyroidology is changing rapidly owing to the introduction of new techniques for the diagnosis and follow-up of patients with Graves’ disease (such as assays for the quantification of free hormones, TSH-receptor antibody measurements, 123I scintigraphy). It was therefore decided to assess the impact of these innovations. Second, Graves’ disease is a common endocrine disorder, for which three therapeutic options are available: antithyroid drug therapy, radioiodide administration, and surgery. Each of these treatments has advantages and drawbacks and recently, new recommendations for therapy have been proposed by Hennemann et al. (1986) It was therefore considered important to observe how this disease is treated in Europe. Third, hyperthyroidism due to Graves’ disease is a chronic disorder which results from a rather unusual biological association of pathogenic factors: a partly genetic, auto-immune perturbation which leads to abnormal glandular stimulation and to excessive hormone production, coupled with environmental factors chiefly related to dietary iodine intake. Hence, prediction of disease outcome is a crucial issue for the selection of adequate therapy. One of the goals of the study was to assess if and which predictive indices were used. Finally, it was felt that the responses obtained from such a survey could serve to trigger and orient future research, especially as no equivalent inquiry had ever been performed, with the consequence that no general pattern of the management of hyperthyroidism due to Graves’ disease was available.