Dysthyroidism in Elderly Subjects

Abstract

Introduction: Aging is associated with an anatomical and functional heterogeneity of the thyroid which varies according to the iodized status. The aim was to describe the clinical, etiology and therapeutic profile of dysthyroidism in elderly subjects in the internal medicine at the Abass Ndao University Hospital. Patients and methods: This was a retrospective, descriptive and analytical study, including all subjects aged 60 and over followed from January 1, 2010 to December 31, 2019 (10 years) for thyroid disease. Results: 371 Patients were collected with a prevalence of 3.8%. The sex ratio was 0.15 and the mean age was 65.3 years. The circumstances of discovery of the disease were a grade 2 - 3 goiter (62.5%), exophthalmos (24.5%), thyrotoxicosis (56.6%), a symptom of low metabolism (5.4%), a cervical compression (10.8% including 8% of dysphasia), and a cardiothyreosis (9.4%). It was hyperthyroidism (65.2%), and hypothyroidism (7.2%). The main etiologies were toxic multinodular goiter (33.2%), Graves’s disease (29.6%), euthyroidism nodular goiter (26.8%), toxic adenoma (2.4%), and Hashimoto’s thyroiditis (6.7%). The compressive manifestations were exclusive of nodular goiter. Among the 35 cases of cardiothyreosis, there was a rhythm and conduction disorder in 25 cases (6.7%) and the underlying thyreopathy was a toxic nodular goiter in 57.1%. Thyroidectomy involved 44.7% of patients, including 32.6% of Graves’ disease, 48.3% of toxic nodular goiter, and 61.8% of nodular goiter in euthyroidism. We found 02 cases of papillary carcinomas on multinodular goiter. Conclusion: In our hospital series, there is variability in the clinical manifestations of dysthyroidism in the elderly. Complications, mainly cardiac and compressive, remain a major reason for consultation. Toxic nodular goiter is preponderant and its management, especially radical, must be multidisciplinary and according to the profile.