Progression Profile of Graves’ Disease after Treatment with Antithyroid Medications in the Initial Phase with a Loading Dose at the University Teaching Hospital of Brazzaville
Introduction: Graves’ disease is an autoimmune thyroid disorder and the leading cause of hyperthyroidism. Initial management involves treatment with antithyroid drugs (ATD) for an initial period of 3 to 6 weeks, with the aim of normalizing thyroid function and stabilizing the patient’s clinical condition. However, individual patient characteristics and the response of thyroid function to treatment can influence the progression of the disease. The objective of this study was to investigate the progression profile of Graves’ disease after treatment with ATD in the initial phase at the University Teaching Hospital of Brazzaville. Patients and Methods: This was an observational, retrospective, and descriptive study conducted from January 1, 2022, to September 30, 2025, in the Metabolic and Endocrine Diseases Department of the University Teaching Hospital of Brazzaville. The study included patients aged 18 years or older with Graves’ disease who received ATD treatment organized into an initial and a maintenance phase. The duration of the initial ATD loading dose phase in our study was 4 weeks. Results: We collected data from 76 patients with a median age of 35 years (20; 58), with a clear predominance of females (72.4%). Patients consulted on average 11.6 ± 4.55 months after the onset of symptoms, for goiter (86.8%), exophthalmos (78.9%), or weight loss with palpitations (39.5%). Thyrotoxicosis syndrome was found in 92.1% of cases. Specific signs of Graves’ disease found were vascular goiter (86.8%), bilateral exophthalmos (78.9%), and pretibial myxedema (2.6%). Thyroid hormone levels showed overt hyperthyroidism (decreased TSH and elevated fT4) in 92.1% of cases. In 7.9% of cases, hormone tests revealed subclinical hyperthyroidism (decreased TSH and normal fT4). Immunological testing revealed the presence of thyrotropin receptor antibodies (TSH-R-Abs) in 42.1% of cases. All patients received ATD medication. A non-cardioselective beta-blocker was prescribed in 81.6% of cases and an anxiolytic in 52.6% of cases. After the initial phase with a loading dose of ATD, the progression was marked by clinical improvement with biological euthyroidism (67.1%), biological hypothyroidism (13.2%), and persistence of thyrotoxicosis syndrome with biological hyperthyroidism (19.7%). Conclusion: Our study shows that antithyroid medications are effective in achieving biological euthyroidism. However, the persistence of hyperthyroidism and the onset of hypothyroidism in some patients demonstrate the need for
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