Thyrotoxicosis and dilated cardiomyopathy in developing countries
| Autor: | Merhawit Atsbha Abera, Hirut Teame Gebru, Bisrat Tesfay Abera, Gebretsadik Berhe, Hiluf Ebuy Abraha, Girmatsion Fisseha Abreha, Mohamedawel Mohamedniguss Ebrahim |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Cardiomyopathy Dilated Male Pediatrics medicine.medical_specialty Goiter Adolescent Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism β-Blocker Diseases of the endocrine glands. Clinical endocrinology Young Adult 03 medical and health sciences 0302 clinical medicine Antithyroid Agents Diabetes mellitus medicine Humans Thyroid storm 030212 general & internal medicine Sodium Chloride Dietary Developing Countries Dilated Cardiomyopathy Methimazole business.industry Research Thyroid Atrial fibrillation Dilated cardiomyopathy General Medicine Middle Aged RC648-665 medicine.disease Cross-Sectional Studies Thyrotoxicosis medicine.anatomical_structure Propylthiouracil Etiology Female Ethiopia business Goiter Nodular Iodine medicine.drug |
| Zdroj: | BMC Endocrine Disorders, Vol 21, Iss 1, Pp 1-7 (2021) BMC Endocrine Disorders |
| ISSN: | 1472-6823 |
| DOI: | 10.1186/s12902-021-00796-5 |
| Popis: | BackgroundThyrotoxicosis is the state of thyroid hormone excess. But, in sub-Saharan Africa (SSA), specifically Northern Ethiopia, scientific evidence about thyrotoxicosis and its cardiac complications like dilated cardiomyopathy is limited. Therefore, this study aimed to explore the thyrotoxicosis presentation and management and identify factors associated with dilated cardiomyopathy in a tertiary hospital in Northern Ethiopia.MethodsAn institution-based cross-sectional study was conducted in Ayder Comprehensive Specialized Hospital from 2017 to 2018. Data from 200 thyrotoxicosis cases were collected using a structured questionnaire. After describing variables, logistic regression was conducted to identify independent predictors of dilated cardiomyopathy. Statistical significance was declared atp ResultsMean age at presentation of thyrotoxicosis was 45 years and females accounted for 89 % of the cases. The most frequent etiology was multinodular toxic goiter (51.5 %). As well, the most common symptoms and signs were palpitation and goiter respectively. Thyroid storm occurred in 6 % of the cases. Out of 89 patients subjected to echocardiography, 35 (39.3 %) of them had dilated cardiomyopathy. And, the odds of dilated cardiomyopathy were higher in patients who had atrial fibrillation (AOR = 15.95, 95 % CI:5.89–38.16,p = 0.001) and tachycardia (AOR = 2.73, 95 % CI:1.04–7.15,p = 0.040). All patients took propylthiouracil and 13.0 % of them experienced its side effects. Concerning β-blockers, propranolol was the most commonly (78.5 % of the cases) used drug followed by atenolol (15.0 %). Six patients underwent surgery.ConclusionsIn developing countries like Ethiopia, patients with thyrotoxicosis have no access to methimazole which is the first-line anti-thyroid drug. Besides, they greatly suffer from dilated cardiomyopathy (due to late presentation) and side effects of propylthiouracil. Therefore, we recommend that patients should get adequate health information about thyrotoxicosis and anti-thyroid drugs including their side effects. Additionally, hospitals and other concerned bodies should also avail of TSH tests and methimazole at an affordable cost. Furthermore, community awareness about iodized salt and iodine-rich foods should be enhanced. |
| Databáze: | OpenAIRE |
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