PATTERNS, CLINICAL PRESENTATIONS AND TREATMENT OUTCOME OF THYROID DISORDERS AMONG ADULT PATIENTS ATTENDING DEPARTMENT OF INTERNAL MEDICINE AND SURGICAL REFERRAL CLINIC OF HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background: Thyroid diseases are common endocrine abnormalities affecting the cellular metabolism of the body with a number of potentially serious complications. There are few studies addressing the clinical picture of thyroid diseases in Ethiopia. Objective: This study aims to assess the patterns, clinical presentations, and treatment outcome of thyroid disorders among adult patients. Methods: An institution based cross-sectional study with medical chart review conducted among 395 randomly selected adult patients following at medical department & surgical referral units of Hiwot Fana Comprehensive Specialized Hospital from June 1, 2018 to June 30, 2023. Descriptive analysis was used for statistical analysis. The data was processed using SPSS20, summarized and presented in the form of narratives & tables. Result: A total of 395 patients with thyroid disease, 86.3% were female and 13.7% were male, with an age range of 18 to 82 years and 64.4% ranges from 30-49 years. Among all, 65.3% had overt hyperthyroidism and 24.3% had hypothyroidism while subclinical hyperthyroidism and subclinical hypothyroidism were documented in 8.5% & 1.5% of the patients. TMNG and TA were responsible for 73.6% of hyperthyroidism cases as primary hypothyroidism due to hashimoto’s thyroiditis accounted for 53.3% of the hypothyroidism cases. Heat intolerance (90.1%), Palpitation (79.1) & hyperhidrosis (76.4%) were the commonest presentations of thyrotoxicosis, whereas hypothyroidism patients presented mostly with fatigue (92.2%), menstrual disturbance (25%), cold intolerance (20.5%) & coarse puffy face (27.2%).Thyrotoxicosis was treated with Propylthiouracil (56.8%) with or without beta blockers, thyroidectomy was done in 126 (43.2%), none received radioiodine therapy. Hypothyroidism patients were treated with thyroxin. About half of hyperthyroid patients achieved euthyroid state with treatment. Conclusion: Thyroid diseases were more common in females and more prevalent in middle agers. More than two thirds of the thyroid disorders were caused by TMNG and primary hypothyroidism. Euthyroid state was achieved in only half of treated patients. Therefore, it is better to create endocrine unit to improve follow up, avail proper investigation & medications, xii and introduce advanced modalities including radioactive iodine uptake study and radioactive iodine therapy.