CLINICAL AND BIOCHEMICAL EVALUATION OF THYROID DYSFUNCTION IN ELDERLY: A RELATIONSHIP BETWEEN WAYNE’S AND ZULEWSKI CLINICAL SCORES WITH THYROID DISORDERS

Authors

  • Gaurav Sharma Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
  • Garima Sharma Department of Obstetrics and Gynecology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
  • Puneet Sharma Department of General Medicine, BLK Hospital, Rajendra, New Delhi, India.
  • Lalitshrimali Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i10.45458

Keywords:

Wayne’s clinical scores, Zulewski clinical scores, thyroid dysfunction, goiter, biochemical

Abstract

Objectives: The objectives of this study were to know the burden and spectrum of thyroid dysfunction in elderly population and to find out the relationship between Wayne’s and Zulewski clinical scores with thyroid disorders.

Methods: This prospective cross-sectional study was conducted at tertiary care teaching hospital of Rajasthan only after approval from the Institutional Ethics Committee. The study participants consist of elderly patients of age 60 years and above. Wayne’s and Zulewski clinical score were used for the diagnosis of hypothyroidism and hyperthyroidism, respectively, and goiter was evaluated by the WHO classification. All the participants were subjected to biochemical test TSH and if required total T3, T4, thyroid antibody (Anti-TPO test), and USG/FNAC neck.

Results: Total 165 patients were studied during the study period. The prevalence of thyroid disorders was 16.36%. The sensitivity of Zulewski clinical scores was 100% for both hypothyroid and overt hypothyroid patients, while the specificity was 58.39% and 54.72%, respectively, in cases of hypothyroidism and overt hypothyroid patients. The sensitivity of Wayne clinical scores for hyperthyroid was 33.33%, while specificity was 100%.

Conclusions: The present study concluded that thyroid dysfunction is common among elderly and hypothyroidism is more common than hyperthyroidism. Clinically, we can suspect thyroid disorder, but, biochemically, thyroid function test is always being a gold standard to diagnose the disease.

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Author Biographies

Gaurav Sharma, Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Assistant Professor, Department of General Medicine

Garima Sharma, Department of Obstetrics and Gynecology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Assistant Professor, Department of Obstetrics and Gynecology

 

Puneet Sharma, Department of General Medicine, BLK Hospital, Rajendra, New Delhi, India.

Consultant, Department of General Medicine

 

Lalitshrimali, Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.

Professor, Department of General Medicine

 

References

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab 2011;15:S78-81. doi: 10.4103/2230-8210.83329, PMID 21966658

Abraham R, Murugan VS, Pukazhvanthen P, Sen SK. Thyroid disorder in women of Puducherry. Indian J Clin Biochem 2009;24:52-9. doi: 10.1007/s12291-009-0009-y, PMID 23105807

Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid. Thyroid deficiency in the Framingham study. Arch Intern Med 1985;145:1386-8. doi: 10.1001/archinte.145.8.1386

Papaleontiou M, Haymart MR. Approach to and treatment of thyroid disorders in the elderly. Med Clin North Am 2012;96:297-310. doi: 10.1016/j.mcna.2012.01.013, PMID 22443977

Bahn RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, et al. Hyperthyroidism and other causes of thyrotoxicosis: Management guidelines of the American thyroid association and American association of clinical endocrinologists. Endocr Pract 2011;17:456-520. doi: 10.4158/EP.17.3.456

Imam SK, Ahmad SI. Thyroid Disorders. Basic Science and Clinical Practice. Switzerland: Springer International Publishing; 2016. p. 76-7.

Zulewski H, Müller B, Exer P, Miserez AR, Staub JJ. Estimation of tissue hypothyroidism by a new clinical score: Evaluation of patients with various grades of hypothyroidism and controls. J Clin Endocrinol Metab 1997;82:771-6. doi: 10.1210/jcem.82.3.3810, PMID 9062480

Elnour A, Hambraeus L, Eltom M, Dramaix M, Bourdoux P. Endemic goitre with iodine sufficiency: A possible role for the consumption of pearl millet in the etiology of endemic goiter. Am J Clin Nutr 2000;71:59-66. doi: 10.1093/ajcn/71.1.59, PMID 10617947

Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al. Subclinical thyroid disease: Scientific review and guidelines for diagnosis and management. JAMA 2004;291:228-38. doi: 10.1001/ jama.291.2.228, PMID 14722150

Babiarczyk B, Turbiarz A. Body mass index in elderly people-do the reference range matter? Poland: Faculty of health science university of Bielsko-Biała. Prog Health Sci 2012;2:51-7.

Akbar DH, Ahmed MM, Hijazi NA. Subclinical hypothyroidism in elderly women attending an outpatient clinic. Med Sci Monit 2004;10:CR229-32. PMID 15114275

Cappola AR, Fried LP, Arnold AM, Danese MD, Kuller LH, Burke GL, et al. Thyroid status, cardiovascular risk and mortality in older adults. JAMA 2006;295:1033-41. doi: 10.1001/jama.295.9.1033, PMID 16507804

Hintze G, Burghardt U, Baumert J, Windeler J, Köbberling J. Prevalence of thyroid dysfunction in elderly subjects from the general population in an iodine deficiency area. Aging (Milano) 1991;3:325-31. doi: 10.1007/ BF03324028, PMID 1841604

Jain A, Paranjape S. Prevalence of Type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian J Endocrinol Metab 2013;17:S318-22. doi: 10.4103/2230-8210.119647, PMID 24251200

Tănase DM, Ionescu SD, Ouatu A, Ambăruş V, Rezuş C, Arsenescu- Georgescu C. Thyroid dysfunction and ischemic heart disease--clinical correlations, progressive implications and impact on the prognosis. Rev Med Chir Soc Med Nat Iasi 2014;118:63-70. PMID 24741777

Hameed S, Chethana K, Brahmbhatt KR, Patil DC, Prasanna KS, Jayaram S, et al. Prevalence of hypertension and its correlates in elderly population of Coastal Karnataka. Natl J Commun Med 2014;5:25-8.

Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules: Final report of a 15-year study of the incidence of malignancy. Ann Intern Med 1968;69:537-40. doi: 10.7326/0003-4819- 69-3-537, PMID 5673172

Iglesias P, Munoz A, Guerrero MT, Macias MC, Ridruejo E, Tajada P, et al. Alterations in thyroid functions in aged hospitalized patients: Prevalence, aetiology and clinical outcome. Clin Endocrinol (Oxf) 2009;70:961-7.

Doucet J, Trivalle C, Chassagne P, Perol MB, Vuillermet P, Manchon ND, et al. Does age play a role in clinical presentation of hypothyroidism? J Am Geriatr Soc 1994;42:984-6. doi: 10.1111/j.1532- 5415.1994.tb06592.x, PMID 8064109

Madhuvan HS, Ravishankar SN, Reddy S, Chandrasekhara P, Nikhil. A prospective study of thyroid dysfunction in elderly patients and its clinical correlation. Arch Med 2013;5:1-2.

Limpawattana P, Sawanyawisut K, Mahankanukrau A,Wongwipaporn C. Clinical manifestation of primary hyperthyroidism in the elderly patients at the out-patient clinic of Srinagarind hospital. J Med Assoc Thai 2006;89:178-81. PMID 16579003

Canaris GJ, Steiner JF, Ridgway EC. Do traditional symptoms of hypothyroidism correlate with biochemical disease? J Gen Intern Med 1997;12:544-50. doi: 10.1046/j.1525-1497.1997.07109.x, PMID 9294788

Crooks J, Murray IP, Wayne EJ. Statistical methods applied to the clinical diagnosis of thyrotoxicosis. Q J Med 1959;28:211-34. PMID 13658351

Published

07-10-2022

How to Cite

Sharma, G., G. Sharma, P. Sharma, and Lalitshrimali. “CLINICAL AND BIOCHEMICAL EVALUATION OF THYROID DYSFUNCTION IN ELDERLY: A RELATIONSHIP BETWEEN WAYNE’S AND ZULEWSKI CLINICAL SCORES WITH THYROID DISORDERS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 15, no. 10, Oct. 2022, pp. 67-71, doi:10.22159/ajpcr.2022.v15i10.45458.

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