RECURRENT HYPERTHYROIDISM AFTER ANTITHYROID THERAPY AND THYROIDECTOMY*

Abstract

From 1943-1949, 1800 patients with hyperthyroidism received antithyroid therapy followed by subtotal thyroidectomy. In this group, 1670 cases (93%) were followed for approx. 3-8 yrs. Recurrent hyperthyroidism developed in 33 patients. No patient operated on for nodular goiter with hyperthyroidism developed recurrent symptoms and, if these cases are excluded, the incidence was 2.4%. The incidence of recurrence in patients who had recurrent hyperthyroidism when initially seen was 4.7% approx. twice the incidence following primary operation. Hyperthyroidism was found to recur most commonly in the 1st 3 yrs. after operation. Of the 33 patients with recurrent hyperthyroidism, the disease was satisfactorily controlled by I medication in half of the group in spite of moderate-sized remnants in some cases. In addition to this, the hyperthyroidism was controlled by antithyroid drugs in 2 cases, by X-ray therapy in one and by radioactive I in one. 13 patients were submitted to secondary operation because of failure of medical treatment. These patients were operated on without mortality and with a low rate of complications.