Thyrotoxicosis in Nigeria--a study of forty-six patients.

In a review of 874 Nigerian patients with various types of thyroid gland disorders, forty-six patients were found to be thyrotoxic (5·3%), supporting the common observation of many authors that thyrotoxicosis is rarer in the African than in Europe and North America where thyrotoxicosis accounts for 20-50% of all thyroidectomies. The incidence of thyrotoxicosis is higher in the female than male though there is a higher proportion of males in this series than in the United Kingdom. There is a higher incidence of secondary thyrotoxicosis than has been reported elsewhere. The clinical features of hyperthyroidism in the Nigerian are no different from those reported in other countries, though our patients tend to report rather late. Primary thyrotoxicosis occured a decade earlier in this series than in Britain. Two of the forty-six patients had adenocarcinoma of the thyroid although only in twenty-seven patients was thyroid tissue available for histological examination. Laboratory investigations were essential in borderline cases, especially estimation of the PBI in those with multinodular goitres. The standard methods of treatment by antithyroid drugs, 131I and surgery were employed with immediately satisfactory results, though the follow-up was so poor that it is impossible to evaluate the late effects of treatment.