Keywords
Graves’
Ophthalmopathy
pregnancy
survey
Colombia
How to Cite
Abstract
Introduction: The main cause of hyperthyroidism in the world is Graves' disease and its incidence is rising. In Colombia, the epidemiology of Graves’ disease has been assumed to be like that of other countries with iodine sufficiency. In other regions, differences have been reported between specialists in the diagnosis and treatment of Graves' disease.
Purpose: A national survey was conducted based on hypothetical clinical cases to know the decisions of Colombian endocrinologists in the treatment of Graves' disease.
Methodology: Survey based on a web management service applied to specialists in endocrinology members of the Colombian Association of Endocrinology. The percentage of responses was obtained individually for each question, using the number of respondents in the denominator.
Results: Of the contacted endocrinologist 36% answered the survey. At the time of diagnosis most would repeat the measurement of TSH and free T4 (83% and 81%, respectively). 61% would request a thyroid scan with technetium. Most of the respondents would use beta blockers associated with an antithyroid as the first line of treatment and in all cases the selected antithyroid was methimazole. A significant proportion of respondents would follow up with a blood count or liver function tests besides than thyroid function tests. A non-negligible number of patients would be treated by their physician with antithyroid for a period of less than one year.
Conclusions: This study suggests the current treatment state of Graves' Disease in Colombia by specialists in endocrinology, which in most aspects follow the recommendations of the guidelines published in other countries. Some behaviors are far from evidence-based recommendations and this could expose patients with Graves' disease to unnecessary risks or impose additional costs to the healthcare system. Some of the reported practices are influenced by conditions of the Colombian health system or availability, which suggests that local guides adapted to these peculiarities should be developed.
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