Presentation and surgical management of hyperthyroidism in Kenyatta National Hospital

Abstract

Hyperthyroidism is the second. commonest endocrine disease seen in Kenyatta National Hospital (KNH), second only to diabetes mellitus. Every year about forty new patients with hyperthyroidism are recruited in the thyroid clinic while another fifty-seven undergo thyroidectomy for various forms of goitres, majority whom are hyperthyroid. Though anecdotal evidence point to diffuse goitre as the main cause of hyperthyroidism, no survey has been done to classify the clinical presentation, surgical management and outcome of various hyperthyroid states as seen in KNH. A ten-year retrospective study was designed to look into the presentation of hyperthyroidism as seen in KNH and subsequent surgical management. Outcome was assessed for the immediate post operative period and up to oneyear post operatively. The Main Findings Were: The disease is more common in females with a male: female ratio of 1:4.2 and peak incidence at 37 years. Gravels disease affects a younger population with

average age of 31 years while Toxic Multinodular Goitre occurs in people 10 years older. The commonest presenting symptoms were a neck swelling, heat intolerance and palpitations while the main clinical signs were goitre, tachycardia and exophthalmos.