EVALUATION OF UNDERLYING THYROID DISORDERS IN PATIENTS PRESENTING WITH THYROID DYSFUNCTION

Abstract

INTRODUCTION
 Thyroid disorders are common problems following diabetes mellitus in endocrine clinic in Myanmar and the prevalence of thyroid disorders was unknown in the previous decades. This study was to evaluate the spectrum of thyroid disorders in endocrine clinic.

METHODOLOGY
 A six-month, hospital-based, cross-sectional descriptive study was carried out and 251 subjects who had attended endocrine clinic with thyroid problems in a tertiary private hospital in Myanmar were selected. Thyroid function test and thyroid autoimmunity were analyzed. Different types of thyroid disorders were classified according to hyperthyroidism and hypothyroidism.

RESULTS
Average age was 51 years with 87.6% female. Those who have hyperthyroidism and hypothyroidism were nearly of similar percentages (43.0% and 44.2% respectively). Among hyperthyroid patients, majority (69 cases or 27.5%) were Graves’ disease, followed by subacute De Quervain's thyroiditis (10.4%), toxic MNG (2%), 3 cases toxic adenoma. Among hypothyroid cases, 25% were associated with raised anti-TPO which could be Hashimotos’ thyroiditis or iodine-induced thyroid dysfunction. Others were thyroidectomy for goiter (7.2%) and carcinoma (1.2%) and Graves’ disease (0.8%), previous radioactive iodine ablation (2.4%) and secondary hypothyroidism due to pituitary dysfunction (0.8%). Subclinical hyperthyroidism (2%) and subclinical hypothyroidism (4.4%) were detected. Thyroid enlargement with normal TFT was 12.7%. Among them, two cases of papillary thyroid carcinoma and 1 case of follicular thyroid cancer were detected.

CONCLUSION
This study suggests that Graves’ disease and hypothyroidism with increased anti-TPO are common causes of thyroid dysfunction but thyroid nodules such as thyroid cancer are rarely referred to endocrine clinic. Hence, this will be a baseline data for Myanmar population in future.