Int J Thyroidol.  2017 Nov;10(2):77-81. 10.11106/ijt.2017.10.2.77.

The Recurrence Rate of Graves' Disease among Patients with Subclinical Thyrotoxicosis after Initial Remission with Antithyroid Agents

• Shim MS
• Nam SM
• Yoo JS
• Kim HK
• Lee SJ
• Lee MY

• KMID: 2396810
• DOI: http://doi.org/10.11106/ijt.2017.10.2.77

Abstract

BACKGROUND AND OBJECTIVES
The recurrence rate of patients with Graves' disease (GD) is estimated to be 50-55% after withdrawal of antithyroid drug therapy, and relapse is frequent in the first year after discontinuing the medication. Follow-up examination of these patients frequently reveals laboratory findings consistent with subclinical thyrotoxicosis in the first year after stopping the antithyroid agents. We investigated the risk of recurrence of GD among patients with resurfacing subclinical thyrotoxicosis state after remission of initial GD with antithyroid treatments.
MATERIALS AND METHODS
We reviewed the patients diagnosed with GD who visited the Department of Endocrinology at two tertiary medical centers: Wonju Severance Christian Hospital and Gangneung Asan Hospital. We enrolled patients whose GD was completely treated after initial treatment with antithyroid agents who then developed subclinical thyrotoxicosis after discontinuation of antithyroid agents.
RESULTS
We reviewed a total of 44 patients (29 females, 15 males; age, 48.93±18.04; range, 17-85 years). The recurrence rate was 27.3% (12/44 patients), and recurrence occurred 3 months to 12 months later resurfacing of subclinical thyrotoxicosis. Patients with recurred GD was significantly older than non-recurred patients (44.63±17.75 years vs. 58.58±15.48 years, p=0.02). Other clinical parameters measured at the time of initial diagnosis were not different between the two groups.
CONCLUSION
The recurrence rate of GD in patients with resurfacing subclinical thyrotoxicosis after initial remission of the disease was less than 30%. A close monitoring is recommended in these subgroup patients, especially in older patients.

Keyword

Graves' disease; Antithyroid agents; Recurrence

MeSH Terms

Antithyroid Agents*
Chungcheongnam-do
Diagnosis
Drug Therapy
Endocrinology
Female
Follow-Up Studies
Gangwon-do
Graves Disease*
Humans
Male
Recurrence*
Thyrotoxicosis*
Antithyroid Agents

Figure

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  Fig. 1 The level of TSI at initial diagnosis of Graves' disease and subclinical thyrotoxicosis state after withdrawl of antithyroid agents. TSI: thyroid stimulating immunoglobulin

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