THE MANAGEMENT OF HYPERTHYROIDISM DUE TO GRAVES-DISEASE IN THE FORMER USSR IN 1991 - RESULTS OF A SURVEY

A survery of the current management of Graves' disease was performed in the USSR among members of All Union Endocrine Society. The questionnaire was based on the format used previously for a survey of members of European Thyroid Association. The aim of a similar survery in the USSR was to obtain a comprehensive pattern of management of Graves' disease in Soviet endocrinology clinics and to compare medical attitudes in the former USSR to those in other European countries. One hundred and twenty questionnaires were mailed with 55 returned (46%). The responses originated from 33 cities, representing major endocrinology centers of the former Soviet Republics. Initial diagnosis was conducted both in hospitals (55%) and ambulatory care settings (45%). Thyroid scintigraphy was requested by 42.3% of the respondents; a majority of them (90%) used I-131. Thyroid ultrasonography was performed in more than 50% of cases. Measurements of cholesterol, total T4 and T3 were the most frequent laboratory tests requested to confirm the diagnosis. For the treatment with ATD, methimazole was the exclusive choice (PTU is not currently in use in the USSR). Beta-blocking agents were prescribed by a majority of respondents. For the long term treatment, a combination procedure of MMI and thyroid hormones was clearly preferred by almost 3/4 of the respondents. A fixed period of treatment was preferred by 62% of the respondents, with a duration of therapy of 18-24 months. Surgery for treatment of the index patient was chosen by only 6%, and radioiodine by 3%. The number of responses was too limited to attempt any characterization of the two latter modalities.