[Toxic nodular goiter].

Abstract

INTRODUCTION To date no study in our country was specifically dedicated on toxic nodular goiter. They were just mentioned in generally studies about hyperthyroidism. METHOD The authors report a retrospective series of 62 cases of toxic nodular goitre collected between 1979 and 1999 at the internal medical clinic of Dakar teaching hospital. The diagnostic of toxic nodule was retained on following criteria: to existence of one or several thyroid nodule with signs or thyrotoxicosis, the existence of a hyperfixating nodule at 131 iodine scintigraphy. Increasing of T3 and/or T4 thyroide hormone. The aims of the study was to analyse the epidemiological, clinical, and therapeutics aspects. RESULTS We are collected 49 cases of solitary nodule (79.03%) and 13 cases of multi nodular goitre (20.97%). In the cases of solitary nodule, mean age was 40 years, sex ratio of 0.04 (47 female, 2 men). The nodule was clinically diagnosed in 47 cases (95.9%) and extinctive in 73.5%. 34.3% of patients have cardiothyreosis. In the cases of multi nodular goitre mean age was 45 years, all cases were female, goitre was clinically identified in 95.3% (12 patients) and 46.5% had cardiothyreosis. 62% of patients were lost to follow up during medical treatment. Only 2 patients on the 37 who were addressed for surgery come back after thyroidectomy. CONCLUSION This study confirm the predominance of toxic nodular goitre in young female, its severity related to cardiothyreosis and underlines the difficulties limited to the therapeutical care.