Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Oct 2003)

Initial clinical feature of hypothyroidism in Iodine deficient area, Babol and Ghaemshahr

  • B Heidari,
  • SH Savad Kouhi

Journal volume & issue
Vol. 5, no. 4
pp. 27 – 32

Abstract

Read online

Background and Objective: Manifestations of hypothyroidism range is severity from subtle alteration of thyroid functions with no apparent symptoms or nonspecific complications to myxedema coma. So many symptoms of hypothyroidism may be unnoticed or attributed to other disease. The purpose of this study was to determine the clinical presenting features of hypothyroid patients in an iodine deficient area of the north of Iran. Methods: This study was performed on all hypothyroid patients attended in Babol Shahid Beheshti hospital during 1995-2000. Diagnosis of hypothyroidism was based on clinical findings and assessment of serum TSH and T4. Patients with prior diagnosis of thyroid or non-thyroidal diseases were excluded. Data was provided by taking history, clinical examinations and interview. In statistical analysis, the relative frequency of each variables based on sex was determined and compared with X2 test. Findings: 213 patients (177 females, 36 males) with mean ±SD age of 40±14 (About 14-16 years) were studied. Duration of presenting symptoms prior to diagnosis of hypothyroidism was less than one month in 23%, 1-3 months in 22%, 3-12 months in 16% and more than one year in 30%. Hypothyroidism presented with facial and periorbital puffiness and edema in 48%, which was accompanied by feet and hand edema in 7% and 2.3% respectively. Facial edema was more common in men than women (75% vs. 43%, P<0.001), goiter and neck discomfort in 18%, musculoskeletal symptoms such as joint and muscle pain and stiffness in 10%, hand and fingers paresthesia, characteristics of carpal tunnel syndrome in 9%, tiredness and fatigue in 6.5%, menstrual and problems related to pregnancy in 2.3%, hoarse voice in 1%, abdominal distension and pain in 1% and unknown cause in 2.4%. Conclusion: Many cases of hypothyroidism begin with nonspecific symptoms that it is essential for primary care physicians to be aware of them.

Keywords