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Cited by 91Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryOphthalmology and Eye Disorders

Thyrotoxicosis in the very old

Tibaldi, Joseph M., Barzel, Uriel S., Albin, Joan, Surks, Martin·1986·The American Journal of Medicine
DOI 10.1016/0002-9343(86)90547-4
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Abstract

The records of 25 patients older than 75 years of age with the diagnosis of hyperthyroidism were reviewed. The mean age of the group (22 women and three men) was 81.5 years, the eldest being 95 years old. Twenty-one patients had Graves' disease, three had multinodular goiter, and one had toxic adenoma. Major presenting symptoms included weight loss (44 percent), palpitations (36 percent), and weakness (32 percent). The average number of thyrotoxic symptoms was only two per patient. Two patients were asymptomatic. Clinical signs included fine skin (40 percent), tremor (36 percent), atrial fibrillation (32 percent), and tachycardia (28 percent). The thyroid was palpable in only three patients with Graves' disease. Mean blood thyroxine level was 15.6 micrograms/dl (range, 11.5 to 24); blood triiodothyronine level was elevated in only half of the patients. One patient had triiodothyronine toxicosis. Mean 24-hour radioiodine uptake was 52 percent. Five patients had normal uptake. No correlation could be established between age, clinical symptoms, signs, and hormone blood levels. Because signs and symptoms of hyperthyroidism in the very old may be too subtle for clinical diagnosis, all elderly subjects should have periodic screening of blood thyroxine levels.

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Crossref · 10.1016/0002-9343(86)90547-4

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Authors
Tibaldi, J. M., Barzel, U. S., Albin, J., & Surks, M.
Affiliations
Albert Einstein College of Medicine (US)
Corresponding author
Barzel, Uriel S.
ORCID
Tibaldi, Joseph M.
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
1986-10
Volume
81
Issue
4
Pages
619-622
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/0002-9343(86)90547-4
OpenAlex
W2005616311
Cited by
91
References
14
Citations by year
2025: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2016: 2 · 2015: 2 · 2014: 2 · 2012: 3
FWCI
1.93
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
Keywords
thyrotoxicosis, hyperthyroidism, elderly patients, oldest old, Graves' disease, multinodular goiter, toxic adenoma, radioiodine uptake, clinical features
MeSH terms
Aged, Aged, 80 and over, Female, Humans, Male, Medical Records, Thyroid Diseases, Thyroid Function Tests, Thyrotoxicosis

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