[Thyroid pathology in a health center]

Abstract

Objective: To describe the thyroid pathology seen at our health centre (HC) and its evolution.

Design: A longitudinal, retrospective study.

Setting: La Mina HC, Sant Adrià de Besòs, Barcelona.

Patients: Patients older than 14 who, between January 1985 and June 1993, had presented functional or morphological thyroid function disorders. They belonged to four general medical practices which attended 5,834 people.

Measurements and main results: 160 people (2.74%) presented thyroid disorders at some point. Average age was 56.5 +/- 15.6 years. Women presented thyroid pathology more often: 142 (88.7%) against 18 (11.3%). The commonest disorder was Hypothyroidism with 68 cases (42.5%). 38 (58.8%) were sub-clinical (HS). Toxic diffuse goitre (TDG) was the most common diagnosis among the 15 cases of hyperfunction. Among morphological disorders, 19 cases of thyroid nodule (3 carcinomas: 2 papillary and 1 follicular) and 16 cases of non-toxic diffuse goitre were recorded. There were 5 cases of hypothyroidism associated with amiodarone treatment. Five women were diagnosed as having exogenous Hyperthyroidism. Of the 38 HS patients, 5 (13.2%) evolved towards Hypothyroidism and 3 died. Average period of observation was 43.6 +/- 27.4 months. At present 122 people (2.09%) present thyroid pathology, with women predominating (4.16% vs 0.35%). The most common diagnoses are: normally functioning goitre (25 cases), HS (20), and primary hypothyroidism in adults (HPA) (16). There are 13 cases of post-surgical hypothyroidism and 11 of autoimmune thyroiditis or probable Hashimoto's disease. The incidence of TDG in the last 5 years is 3 per 10,000 inhabitants per year.

Conclusions: Our work contributes data on thyroid pathology among the population covered by a health centre. A proper procedure for tackling thyroid pathology in primary care could improve care for these patients.