Diagnosis, treatment and long-term consequences of hyperthyroidism: use of existing data to generate new knowledge

Torlinska, Barbara (2017). Diagnosis, treatment and long-term consequences of hyperthyroidism: use of existing data to generate new knowledge. University of Birmingham. Ph.D.

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Abstract

Hyperthyroidism is a common endocrine disorder with multiple aetiologies, manifestations and potential therapies. This thesis explores the challenges relating to the diagnosis, treatment and long-term consequences of thyrotoxicosis in real-world outpatient and inpatient settings. We performed a number of epidemiological studies analysing data from large, detailed, routinely collected data sources. We confirmed that classical manifestations of hyperthyroidism are significantly less prevalent in older patients and established that newly diagnosed thyroid dysfunction is rare in hospitalised subjects despite high volume thyroid function testing in this setting where we found a high proportion of abnormal thyroid tests in those with pre-existing thyroid dysfunction. We determined that thionamides are effective in a half of subjects treated with a prolonged course and that appropriate patient selection improves success rates. We established that treatment of hyperthyroidism with radioactive iodine results in more weight gain than antithyroid drugs and that hyperthyroidism in hospitalised patients is associated with longer hospital stays, higher frequency of admissions and increased mortality. In conclusion, this thesis provides important new insights into the diagnosis and treatment of hyperthyroidism and highlights that correct evaluation and management of patients may minimise the long-term consequences associated with this common disorder.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):