Propylthiouracil: 4-6 Year Follow-Up of Selected Patients With Graves' Disease

IN A previous study of propylthiouracil (1), we concluded that the patients with hyperthyroidism who were most likely to obtain a permanent remission were those who met two specifications: 1) a diagnosis of Graves' disease and 2) a small to moderate sized goiter. This is a rather highly selected group of patients. Such a selection excludes those who have nodular goiters with hyperthyroidism, those who have Graves' disease with goiters estimated to be over 100 grams in weight, and those who have already demonstrated their propensity to recrudescence by having a postoperative recurrence. At the time of the previous study, there were 60 patients who met the above specifications. Fourteen (23.3 per cent) had experienced relapses, and 46 (76.6 per cent) were in a state of remission. This paper constitutes a follow-up of the latter group, with the addition of a few similar cases treated one year later. It is of some value to compare our results with those obtained by other workers. Iversen (2) reported 144 cases of thyrotoxicosis which had been followed for an average of three years. One hundred and twenty-five (86.8 per cent) of these cases were toxic diffuse goiters (8.6 per cent with “large” glands). He found a remission rate of 79.5 per cent. Although these patients were treated with methylthiouracil, the efficacy of propylthiouracil and methylthiouracil are comparable.