Profile of Spontaneous Primary Hypothyroidism in Adults at the Abass Ndao Hospital: Based on 302 Cases Collected

Abstract

Introduction: Primary hypothyroidism is a deficiency in thyroid hormone secretion due to primary damage to the thyroid gland, resulting in a state of hypometabolism. It may be spontaneous or acquired, permanent or transient. Hypothyroidism is less studied in our context. Hence, we deemed it necessary to study the profile of adult patients followed over a 13-year period in a reference center specialized in monitoring metabolic and endocrine diseases, the Abass Ndao Hospital in Senegal. Patients and Methods : This was a retrospective descriptive study. Adult patient records followed for spontaneous primary hypothyroidism were collected over a 13-year period from January 2011 to April 2023. Results: In total, 302 patients were enrolled. There was a peak in patient frequency in 2021 (14.9%), followed by 2020 (11.9%) and 2012 (10.6%). The mean age of our patients was 40.2 ± 16. Clinical and paraclinical signs included asthenia (39.70%), facial edema (7.62%), headache (13.20%), myalgia (4.64%), constipation (29.80%), and menstrual disorders (2.32%). Clinical examination of the thyroid revealed the presence of a goiter in 228 patients (75.5%). All patients had a thyroid function test. Free T4 was low in 244 patients (80.8%). TSH was elevated in 296 patients (98.0%). Anti-thyroperoxidase antibodies (ac anti-TPO) were positive in 288 patients (95.4%). Heterogeneous diffuse goiter was noted in 205 patients (67.9%), followed by thyroid atrophy in 24.5%. The most frequent etiology in our patients was Hashimoto’s thyroiditis (74.83%), followed by chronic atrophic thyroiditis (23.84%). Twenty-three patients had hypertension (41.10%), 19 had diabetes mellitus (33.90%), and 4 had adrenal insufficiency (7.14%). Levothyroxine was used in 297 patients (98.3%). The mean dose of levothyroxine was 67.17 µg. Conclusion: Primary hypothyroidism is a frequent endocrine disease. Early diagnosis remains crucial to prevent long-term complications. Treatment with levothyroxine has greatly improved patients’ quality of life. However, challenges remain, particularly in terms of dosage adjustment, long-term follow-up, and management of subclinical forms.