Characteristics and outcomes of patients with hyperthyroidism attending a hospital endocrine clinic-A retrospective study

Aims: A study looking at the distribution, management and outcomes of patients referred to a secondary care endocrine clinic with a diagnosis of hyperthyroidism. Methods: Retrospective longitudinal study of 442 patients referred over a 15-year period (2002-2017) with a diagnosis of hyperthyroidism to a secondary care endocrine clinic. Information on demographics, diagnosis, treatments and outcomes was recorded as patients attended for clinic visits. Patients were initially treated with 1-2 courses of thionamides and subsequently referred for radioiodine or surgery in cases of relapse. Results: Patients (75% female, age range 17-91 years) were treated with thionamides for an average of 295 days. As expected, the majority of patients had Graves Disease (GD) (80%), followed by those with multinodular goitre (MNG) (8.6%), amiodarone-induced hyperthyroidism (6.7%) and toxic nodule (3.7%). Drug-induced remission rates were best seen in patients with GD (43%), and side effects necessitating change in treatment were relatively low (2.5%). In 121 patients who received radioiodine, hypothyroidism occurred in 50% of patients and was commoner in patients with GD (65%) than in those with MNG (22%) and toxic nodule (6.3%). Conclusions: This study is only one of a few reporting on the characteristics of patients with hyperthyroidism attending a typical secondary care endocrine clinic. Whilst we appreciate its limitations, we encourage similar methods of collecting valuable real world data to facilitate conduction of specialist peer review visits in other similar clinic settings.