title: Clinical presentation of hyperthyroidism in a large representative sample of outpatients in France: relationships with age, aetiology and hormonal parameters.
abstract: OBJECTIVE
  Signs and symptoms of thyrotoxicosis are not specific, and thyroid function tests are frequently prescribed to recognize such thyroid dysfunction. Ultrasensitive assays of thyroid-stimulating hormone (TSH) allow early diagnosis and identification of mild hyperthyroidism (generally designed as 'subclinical'). The aim of this study was to re-evaluate the clinical picture of thyrotoxicosis in the context of the current large utilization of ultrasensitive TSH assays.
  
  
  METHODS
  Prospective descriptive cohort.
  
  
  METHODS
  Clinical presentation of 1572 patients with a recent (<3 months) diagnosis of thyrotoxicosis recruited by a large representative sample of 263 French endocrinologists was studied using two questionnaires (one at inclusion and the second after 3 months) concerning symptoms, hormonal evaluation and treatment.
  
  
  RESULTS
  A total of 1240 (78·9%) patients were women, mean age 48 ± 17 years. Subclinical hyperthyroidism (SCHT) was present in 86 patients (10·4%). Symptoms of thyrotoxicosis were in decreasing frequency order: palpitations, weakness, heat-related signs and disturbed sleep. A total of 64·9% of patients had lost weight. Signs and symptoms were more frequent in Graves' disease, in young patients, and were partially related to biochemical severity. Symptoms were less frequent in elderly patients except for cardiac manifestations (atrial fibrillation). Most patients with SCHT had one or several signs or symptoms of thyrotoxicosis.
  
  
  CONCLUSIONS
  This study confirms that elderly patients have less symptoms of thyrotoxicosis than younger subjects but are at increased risk of cardiac complications. Our results show that most patients with 'subclinical' HT have in fact signs or symptoms of thyrotoxicosis.
authors.affiliation: Department of Internal Medicine, Endocrinology and Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.|Faculté de Médecine, Université de Strasbourg, Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Goichot
authors.affiliation: Department of Endocrinology, Metabolic diseases and Nutrition, Pôle Cardio-vasculaire et Métabolique, CHU Larrey, Toulouse, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Caron
authors.affiliation: Medical Affairs Department, Merck Serono, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Landron
authors.affiliation: CEMKA, Bourg La Reine, France.
authors.forename: S
authors.initials: S
authors.lastname: Bouée
mesh_terms: D000236:Adenoma / Q000150:complications / Q000175:diagnosis; D000328:Adult; D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis; D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006044:Goiter, Nodular / Q000150:complications / Q000175:diagnosis; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013972:Thyrotropin / Q000378:metabolism; D013974:Thyroxine / Q000378:metabolism; D014284:Triiodothyronine / Q000378:metabolism
chemical_list: D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine