[Primary hypothyroidism in the adult older than 60 years. Characteristics and follow-up after initiation of replacement treatment in hospital].
OBJECTIVE
Primary hypothyroidism is common in the elderly. Yet its care remains unclear.


METHODS
Clinical, biological characteristics and outcome of 45 patients aged over 60 years admitted for in-hospital initiation of treatment for primary hypothyroidism were recorded. Causes and tolerance of treatment (clinical and ECG monitoring in hospital) were seek for.


RESULTS
Initial symptoms, predominantly fatigue (84.4%), were moderate, contrasting with severe biological hormonal deficiency. The most common routine biological change was hypercholesterolemia (57.6%). Female predominance was obvious (77.8%) and the most usual aetiology autoimmune chronic thyroiditis. Despite variability of symptoms, long term follow-up demonstrates a positive response to treatment, including an improvement in fatigue, eye-lid swelling, bradycardia and overweight. This clinical improvement was achieved on an average dose of 1.22 +/- 0.47 mg/kg/day L-T4 in order to maintain normal TSH (3.76 +/- 2.93 mUI/l). Cardiovascular incidents while starting treatment require experienced care and low dose initial treatment.


CONCLUSIONS
Primary hypothyroidism is still lately discovered in the elderly. Yet, since treatment is efficacious and simple, the disease should be searched for and cared after whenever a related symptom occurs.
Yazbeck
R
R
Service d'Endocrinologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand.
Benoit
P
P
Roche
B
B
Boeglin
M B
MB
Tauveron
I
I
Thieblot
P
P
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D006760:Hospitalization; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*
D013972:Thyrotropin; D013974:Thyroxine