Öz
Objectives: There are no studies regarding awareness about
Graves’ disease in our country. We aimed to determine the level of the
awareness using a questionnaire in this study as well as the demographic,
clinical, and laboratory data of patients with Graves’ disease.
Materials and Methods: A
questionnaire consisting of 22 consecutive questions regarding definition (4
questions), symptoms (7 questions), treatment modalities and their adverse
effects (7 questions), and treatment during pregnancy and lactation (4
questions) was applied to 83 patients who were either diagnosed or already
followed-up with Graves' disease between March-August 2013. Data regarding
gender, age, educational level, occupation, smoking status, salt type,
frequency of the seafood consumption, comorbid disorders, symptoms at
presentation, the source of the knowledge and treatment modalities were
recorded before starting the questionnaire. Laboratory data and treatment
modalities were also evaluated.
Results: Of the 83 patients, 43 were
male, 40 were female and the mean age was 43,86±13,19 years. The rates of consumption
of iodized salt and seafood less than once a day per month were 65,06% and
45,78%, respectively. Thirty-three patients (39,76%) were diagnosed during
routine examinations. The treatment of choice was antithyroid drugs. The source
of information was the treating physician in 75,90% patients. The least known
subject in this questionnaire was related to the management of disease during
pregnancy and lactation. In general the patients had a little idea about
hyperthyroidism related osteoporosis, lack of cancer association, duration of
drug therapy, adverse effects of radioactive iodine therapy.
Conclusion: Increased knowledge and
awareness of Graves’ disease would provide favourable effects in diagnosis and
treatment period.
Anahtar Kelimeler
Graves’disease questionnaire symptom treatment modalities awareness
Kaynakça
- Weetman AP. Graves' Disease. N Engl J Med 2000;343:1236-48.
- Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease. Endocrinol Metab (Seoul) 2016;31:213-22.
- Menconi F, Marcocci C, Marinò M. Diagnosis and classification of Graves' disease. Autoimmun Rev 2014;13:398-402.
- Ergin A. Levotiroksin Sodyum Kullanan Hastalarda Yan Etki Farkındalığının Araştırılması. Uzmanlık Tezi, Atatürk Üniversitesi Tıp Fakültesi, Dahiliye AD, Erzurum; 2015.
- Sibel Ocak Serin, Muzaffer İlhan, Seda Ahcı, et al. Tiroid Hastalıklarında Bilinç Düzeyi. Şişli Etfal Hastanesi Tıp Bülteni 2016;50:181-5.
- Wiersinga WM. Graves' Disease: Can It Be Cured? Endocrinol Metab (Seoul) 2019;34:29-38.
- Sarfo-Kantanka O, Sarfo FS, Ansah EO, Kyei I. Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors. Clin Med Insights Endocrinol Diabetes 2018;11:1179551418759076.
- Jurecka-Lubieniecka B, Bednarczuk T, Ploski R, et al. Differences in gene-gene interactions in Graves’ disease patients stratified by the age of onset PLoS One 2016;11:e0150307.
- Lanas A, Diaz P, Eugenin D, et al. [Clinical features of patients with Basedow Graves disease seen at a university hospital]. Rev Med Chil 2017;145:436-40.
- Fairweather D, Frisancho-Kiss S, Rose NR. Sex Differences in Autoimmune Disease from a Pathological Perspective Am J Pathol 2008;173:600-9.
- Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab 2010;24:1-11.
- Erdoğan G, Erdogan MF, Emral R, et al. Iodine status and goiter prevalance in Turkey before mandatory iodization J Endocrinol Invest 2002;25:224–8.
- Erdoğan MF, Ağbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest 2009;32:617-22.
- Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoğlu II, Akgün HS. İodine intake is still inadequate among pregnant women eight years after mandotary iodination of salt in Turkey. J Endocrinol Invest 2010;33:461-4.
- Hegazi MO, Ahmed S. Atypical clinical manifestations of graves' disease: an analysis in depth. J Thyroid Res 2012;2012:768019.
- Yasuda T, Okamoto Y, Hamada N, et al. Serum vitamin D levels are decreased in patients without remission of Graves' Disease. Endocrine 2013;43:230-2.
- Wang J, Lv S, Chen G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients 2015;7:2485-98.
- Planck T, Shahida B, Malm J, Manjer J. Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics. Eur Thyroid J 2018;7:27-33.
- Xu MY, Cao B, Yin J, Wang DF, Chen KL, Lu QB. Vitamin D and Graves' Disease: A Meta-analysis Update Nutrients 2015;7:3813–27.
- Burch HB, Burman KD, Cooper DS. A 2011 survey of clinical practice patterns in the management of Graves' disease. J Clin Endocrinol Metab 2012;97:4549-58.
- Brito JP, Schilz S, Singh Ospina N, et al. Antithyroid drugs-the most common treatment for Graves’ disease in the United States: a nationwide population-based study. Thyroid 2016;26:1144-5.
Öz
Amaç:
Ülkemizde Graves hastalarında hastalığın farkındalığı ile ilgili yayınlanan bir
çalışma bulunmamaktadır. Biz bu çalışmamızda, Graves tanılı hastaların
demografik, klinik ve laboratuar verilerinin yanı sıra hastalık hakkındaki
bilgi düzeyini anket çalışması ile belirlemeyi amaçladık.
Materyal ve Metot: Mart -Ağustos
2013 tarihleri arasında Graves Hastalığı tanısı konan veya takip edilen 83
hastaya 22 sorudan oluşan anket çalışması yapıldı. Anketin ilk 4 sorusu
hastalığın tanımını, 7 soru semptomlarını, 7 soru tedaviyi ve yan etkilerini ve
4 soru gebelik ve emzirme dönemindeki tedavi ile ilgili hastaların bildiklerini
kapsamaktaydı. Ankete başlamadan önce hastaların cinsiyeti, yaşı, eğitim durumu,
mesleği, sigara kullanım durumu, kullandıkları tuz çeşidi, deniz ürünleri
kullanımının sıklığı, eşlik eden hastalıklarının olup olmadığı, başvuru
anındaki semptomları ve hastalıkları ile ilgili bilgi edinme kaynakları
soruldu. Ayrıca laboratuar verileri ve uygulanan tedaviler kaydedildi.
Bulgular: 83 hastanın 43’ü erkek,
40’ı kadın ve yaşlarının ortalama değeri 43,86±13,19 yıl idi. İyotlu tuz
kullanım oranı %65,06 iken hastaların %45,78'i ayda günde birden az deniz
ürünleri tükettiğini bildirdi. Hastaların %39,76’sına (n: 33) rutin tetkikler
esnasında tanı konulduğu saptandı. Tedavide ilk seçenek olarak antitiroid
ilaçlar tercih edilmişti. Hastaların bilgi edinme kaynaklarının %75,90'ı
doktorlar idi. Bu anket çalışmasında en az fikir sahibi olan konunun gebelik ve
emzirme döneminde hastalığın yönetimi olduğu görüldü. Bunun yanında, hastalığın
osteoporoza neden olabileceği, kansere dönüşmeyeceği, ilaç tedavisinin kullanım
süresi, RAI tedavisinin yan etkileri genel olarak bilinmemekteydi.
Sonuç: Hastaların hastalık hakkında
bilgi sahibi olması tanı ve tedavi aşamasında olumlu gelişmeler yaratacaktır.
Anahtar Kelimeler
Kaynakça
- Weetman AP. Graves' Disease. N Engl J Med 2000;343:1236-48.
- Wiersinga WM. Clinical Relevance of Environmental Factors in the Pathogenesis of Autoimmune Thyroid Disease. Endocrinol Metab (Seoul) 2016;31:213-22.
- Menconi F, Marcocci C, Marinò M. Diagnosis and classification of Graves' disease. Autoimmun Rev 2014;13:398-402.
- Ergin A. Levotiroksin Sodyum Kullanan Hastalarda Yan Etki Farkındalığının Araştırılması. Uzmanlık Tezi, Atatürk Üniversitesi Tıp Fakültesi, Dahiliye AD, Erzurum; 2015.
- Sibel Ocak Serin, Muzaffer İlhan, Seda Ahcı, et al. Tiroid Hastalıklarında Bilinç Düzeyi. Şişli Etfal Hastanesi Tıp Bülteni 2016;50:181-5.
- Wiersinga WM. Graves' Disease: Can It Be Cured? Endocrinol Metab (Seoul) 2019;34:29-38.
- Sarfo-Kantanka O, Sarfo FS, Ansah EO, Kyei I. Graves Disease in Central Ghana: Clinical Characteristics and Associated Factors. Clin Med Insights Endocrinol Diabetes 2018;11:1179551418759076.
- Jurecka-Lubieniecka B, Bednarczuk T, Ploski R, et al. Differences in gene-gene interactions in Graves’ disease patients stratified by the age of onset PLoS One 2016;11:e0150307.
- Lanas A, Diaz P, Eugenin D, et al. [Clinical features of patients with Basedow Graves disease seen at a university hospital]. Rev Med Chil 2017;145:436-40.
- Fairweather D, Frisancho-Kiss S, Rose NR. Sex Differences in Autoimmune Disease from a Pathological Perspective Am J Pathol 2008;173:600-9.
- Andersson M, de Benoist B, Rogers L. Epidemiology of iodine deficiency: Salt iodisation and iodine status. Best Pract Res Clin Endocrinol Metab 2010;24:1-11.
- Erdoğan G, Erdogan MF, Emral R, et al. Iodine status and goiter prevalance in Turkey before mandatory iodization J Endocrinol Invest 2002;25:224–8.
- Erdoğan MF, Ağbaht K, Altunsu T, et al. Current iodine status in Turkey. J Endocrinol Invest 2009;32:617-22.
- Kut A, Gursoy A, Senbayram S, Bayraktar N, Budakoğlu II, Akgün HS. İodine intake is still inadequate among pregnant women eight years after mandotary iodination of salt in Turkey. J Endocrinol Invest 2010;33:461-4.
- Hegazi MO, Ahmed S. Atypical clinical manifestations of graves' disease: an analysis in depth. J Thyroid Res 2012;2012:768019.
- Yasuda T, Okamoto Y, Hamada N, et al. Serum vitamin D levels are decreased in patients without remission of Graves' Disease. Endocrine 2013;43:230-2.
- Wang J, Lv S, Chen G, et al. Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients 2015;7:2485-98.
- Planck T, Shahida B, Malm J, Manjer J. Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics. Eur Thyroid J 2018;7:27-33.
- Xu MY, Cao B, Yin J, Wang DF, Chen KL, Lu QB. Vitamin D and Graves' Disease: A Meta-analysis Update Nutrients 2015;7:3813–27.
- Burch HB, Burman KD, Cooper DS. A 2011 survey of clinical practice patterns in the management of Graves' disease. J Clin Endocrinol Metab 2012;97:4549-58.
- Brito JP, Schilz S, Singh Ospina N, et al. Antithyroid drugs-the most common treatment for Graves’ disease in the United States: a nationwide population-based study. Thyroid 2016;26:1144-5.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırmalar |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 19 Sayı: 3 |
