Akcije

Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma 'Zlatibor'
kako citirati ovaj članak
podeli ovaj članak

Metrika

  • citati u SCIndeksu: 0
  • citati u CrossRef-u:0
  • citati u Google Scholaru:[]
  • posete u poslednjih 30 dana:9
  • preuzimanja u poslednjih 30 dana:0

Sadržaj

članak: 4 od 5  
Back povratak na rezultate
Dijagnoza hipotiroidizma
Klinički centar Srbije, Klinika za endokrinologiju dijabetes i bolesti metabolizma, Beograd

e-adresabtrbojev@eunet.yu
Ključne reči: hipotiroidizam; dijagnoza hipotiroidizma; klasifikacija hipotiroidizma
Sažetak
Hipotiroidizam je sindrom hipometabolizma sa nedovoljnom proizvodnjom ili neadekvatnim dejstvom tiroidnih hormona. Klasifikuje se na osnovu vremena pojavljivanja (kongenitalni ili stečeni), prema mestu na kome se poremećaj dešava (primarni, sekundarni tercijarni i kvaternerni) i prema težini kliničke slike odnosno ispoljavanja (manifestni (klinički) ili blag (subklinički). Hipotiroidizam može biti prolazan, kada se ispoljava samo kao faza u toku nekih zapaljenskih stanja štitaste žlezde ili tajan. Najčešći uzrok kongenitalnog hipotiroidizma je endemski nedostatak joda. Prolazni hipotiroidizam novorođenčeta može da nastane zbog transplacentnog prenošenja inhibitornih antitirotropin receptorskih antitela od majke. U odraslih, hipotiroidizam je najčešće posledica hroničnog tiroiditisa ili ablativnih intervencija. Centralni hipotiroidizam (hipofizni i hipotalamusni) posledica je hirurške traume ili neoplazmi ovog područja. Rezistencija na tiroidne hormone je redak nasledni sindrom sa učestalošću od 1: 50 000 živorođenih. Klinička dijagnoza hipotiroidizma nije jednostavna zbog nespecifičnosti kliničkih manifestacija i suptilnog stepena ispoljavanja hipotiroidizma. Prvenstveno se postavlja dijagnoza hipometaboličkog sindroma. Posle toga se pristupa dijagnozi uzroka hipotiroidizma. U slučaju dovoljne kliničke sumnje pristupa se laboratorijskoj potvrdi kojom se utvrđuje stepen i priroda hipotiroidizma. Merenje tirotropina u serumu je dijagnostički test prve linije za dijagnozu hipotiroidizma. U osoba sa centralnim hipotiroidizmom nema porasta tirotropina (TSH je nizak, neadekvatno normalan ili samo blago povišen) zbog nemogućnosti da se luči iz hipofiznih tirotrofa ili se luče izoforme molekula TSH. Centralni hipotiroidizam je moguć kada postoje kliničke pojave a nema laboratorijskog dokaza porasta TSH. U kliničkoj praksi najveći izazov u dijagnozi hipotiroidizma su promene tiroidnih hormona i rezultata tiroidnih funkcijskih testova koji se vide u nekim teškim netiroidnim bolestima.
Reference
Asvold, B.O., Vatten, L.J., Nilsen, T.I., Bjoro, T. (2007) The association between TSH within the reference range and serum lipid concentrations in a population-based study: The HUNT study. Eur J Endocrinol, Feb;156(2), str. 181-6
Baloch, Z., Carayon, P., Conte-Devolx, B., Demers, L.M., Feldt-Rasmussen, U., Henry, J., LiVosli, V.A., Niccoli-Sire, P., John, R., Ruf, J., Smyth, P.P.A., Spencer, C.A., Stockigt, J.R. (2003) Laboratory medicine practice guidelines: Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid, 13(1): 3-126
Basaria, S., Cooper, D.S. (2005) Amiodarone and the thyroid. Am J Med, 118(7): 706-14
Benvenga, S., Vigo, T., Ruggeri, R.M., Lapa, D., Almoto, B., LoGiudice, F., Longo, M., Blandino, A., Campenni, A., Cannavo, S., Trimarchi, F. (2004) Severe head trauma in patients with unexplained central hypothyroidism. Am J Med, 116(11): 767-71
Bocchetta, A., Loviselli, A. (2006) Lithium treatment and thyroid abnormalities. Clinical Practice and Epidemiology in Mental Health, 2(1): 23
Brabant, G., Beck-Peccoz, P., Jarzab, B., Laurberg, P., Orgiazzi, J., Szabolcs, I., Weetman, A.P., Wiersinga, W.M. (2006) Is there a need to redefine the upper normal limit of TSH?. Eur J Endocrinol, May; 154(5), str. 633-7
Brucker-Davis, F., Oldfield, E.H., Skarulis, M.C., Doppman, J.L., Weintraub, B.D. (1999) Thyrotropin-secreting pituitary tumors: Diagnostic criteria, thyroid hormone sensitivity, and treatment outcome in 25 patients followed at the National Institutes of Health. J Clin Endocrinol Metab, 84(2): 476-86
Burman, K.D., Mckinley-Grant, L. (2006) Dermatologic aspects of thyroid disease. Clin Dermatol, Jul-Aug, 24(4), str. 247-55
Caraccio, N., Natali, A., Sironi, A., Baldi, S., Frascerra, S., Dardano, A., Monzani, F., Ferrannini, E. (2005) Muscle metabolism and exercise tolerance in subclinical hypothyroidism: A controlled trial of levothyroxine. J Clin Endocrinol Metab, 90(7): 4057-62
Chadarevian, R., Bruckert, E., Leenhardt, L., Giral, P., Ankri, A., Turpin, G. (2001) Components of the fibrinolytic system are differently altered in moderate and severe hypothyroidism. J Clin Endocrinol Metab, 86(2): 732-7
Dagre, A.G., Lekakis, J.P., Papaioannou, T.G., Papamichael, C.M., Koutras, D.A., Stamatelopoulos, S.F., Alevizaki, M. (2005) Arterial stiffness is increased in subjects with hypothyroidism. International Journal of Cardiology, 103(1): 1
Davis, P.J., Davis, F.B. (1996) Nongenomic actions of thyroid hormone. Thyroid, 6(5): 497-504
Dayan, C.M., Daniels, G.H. (1996) Chronic autoimmune thyroiditis. N Engl J Med, 335(2): 99-107
Dekkers, O.M., Pereira, A.M., Roelfsema, F., Voormolen, J.H., Neelis, K.J., Schroijen, M.A., Smit, J.W., Romijn, J.A. (2006) Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab, May;91(5), str. 1796-801
Dernellis, J., Panaretou, M. (2002) Effects of thyroid replacement therapy on arterial blood pressure in patients with hypertension and hypothyroidism. Am Heart J, 143(4): 718-24
Gillam, M.P., Kopp, P. (2001) Genetic defects in thyroid hormone synthesis. Curr Opin Pediatr, 13(4): 364-72
Gottehrer, A., Roa, J., Stanford, G.G., Chernow, B., Sahn, S.A. (1990) Hypothyroidism and pleural effusions. Chest, 98(5): 1130-2
Gruters, A., Biebermann, H., Krude, H. (2003) Neonatal thyroid disorders. Horm Res, 59 Suppl 1: 24-9
Gumieniak, O., Perlstein, T.S., Hopkins, P.N., Brown, N.J., Murphey, L.J., Jeunemaitre, X., Hollenberg, N.K., Williams, G.H. (2004) Thyroid function and blood pressure homeostasis in euthyroid subjects. J Clin Endocrinol Metab, 89(7): 3455-61
Huang, S.A., Tu, H.M., Harney, J.W., Venihaki, M., Butte, A.J., Kozakewich, H.P., Fishman, S.J., Larsen, P.R. (2000) Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. N Engl J Med, 343(3): 185-9
Iqbal, A., Jorde, R., Figenschau, Y. (2006) Serum lipid levels in relation to serum thyroid-stimulating hormone and the effect of thyroxine treatment on serum lipid levels in subjects with subclinical hypothyroidism: The Tromso Study. Journal of Internal Medicine, 260(1), 53-61
Jabbour, S.A. (2003) Cutaneous manifestations of endocrine disorders: A guide for dermatologists. Am J Clin Dermatol, 4(5): 315-31
Jensen, E., Blaabjerg, O., Petersen, P.H., Hegedus, L. (2007) Sampling time is important but may be overlooked in establishment and use of thyroid-stimulating hormone reference intervals. Clin Chem, Feb;53(2), str. 355-6
Jensen, E., Hyltoft, P.P., Blaabjerg, O., Hansen, P.S., Brix, T.H., Kyvik, K.O., Hegedüs, L. (2004) Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults: The importance of environmental factors, including thyroid antibodies. Clin Chem Lab Med, 42(7): 824-32
Kassan, S.S., Moutsopoulos, H.M. (2004) Clinical manifestations and early diagnosis of Sjögren syndrome. Arch Intern Med, 164(12): 1275-84
Kaye, C.I., Committee on Genetics, Accurso, F., la Franchi, S., Lane, P.A., Northrup, H., Pang, S., Schaefer, G.B. (2006) Introduction to the newborn screening fact sheets. Pediatrics, Sep;118(3), str. 1304-12
Koenig, R.J. (1998) Thyroid hormone receptor coactivators and corepressors. Thyroid, 8(8): 703-13
Kopp, P. (2002) Perspective: Genetic defects in the etiology of congenital hypothyroidism. Endocrinology, 143(6): 2019-24
Kratzsch, J., Fiedler, G.M., Leichtle, A., Brugel, M., Buchbinder, S., Otto, L., Sabri, O., Matthes, G., Thiery, J. (2005) New reference intervals for thyrotropin and thyroid hormones based on National Academy of Clinical Biochemistry criteria and regular ultrasonography of the thyroid. Clin Chem, 51(8): 1480-6
Ladenson, P.W., Sherman, S.I., Baughman, K.L., Ray, P.E., Feldman, A.M. (1992) Reversible alterations in myocardial gene expression in a young man with dilated cardiomyopathy and hypothyroidism. Proc Natl Acad Sci USA, 89(12): 5251-5
Ladenson, P.W. (2000) Diagnosis of hypothyroidism. u: Braverman L.E., Utiger R.D. [ur.] The thyroid: a fundamental and clinical text, Philadelphia: Lippincott Williams and Wilkins, str. 848-852, 8th edn
Lawrence, J.E., Lamm, S.H., Pino, S., Richman, K., Braverman, L.E. (2000) The effect of short-term low-dose perchlorate on various aspects of thyroid function. Thyroid, 10(8): 659-63
Lazarus, J.H. (2005) Thyroid disorders associated with pregnancy: Etiology, diagnosis, and management. Treatments in Endocrinology, 4(1): 31
Manach, C., Williamson, G., Morand, C., Scalbert, A., Remesy, C. (2005) Bioavailability and bioefficacy of polyphenols in humans, I: Review of 97 bioavailability studies. Am J Clin Nutr, 81(1 Suppl): 230S-242S
Mandel, S.J., Spencer, C.A., Hollowell, J.G. (2005) Are detection and treatment of thyroid insufficiency in pregnancy feasible?. Thyroid, 15(1): 44-53
Oerter, K.E., Kamp, G.A., Munson, P.J., Nienhuis, A.W., Cassorla, F.G., Manasco, P.K. (1993) Multiple hormone deficiencies in children with hemochromatosis. J Clin Endocrinol Metab, 76(2): 357-61
Persani, L., Ferretti, E., Borgato, S., Faglia, G., Beck-Peccoz, P. (2000) Circulating thyrotropin bioactivity in sporadic central hypothyroidism. J Clin Endocrinol Metab, 85(10): 3631-5
Prummel, M.F., Wiersinga, W.M. (2005) Thyroid peroxidase autoantibodies in euthyroid subjects. Best Pract Res Clin Endocrinol Metab, 19(1): 1-15
Roberts, C.G.P., Ladenson, P.W. (2004) Hypothyroidism. Lancet, 363(9411), 793-803
Roos, A., Bakker, S.J., Links, T.P., Gans, R.O., Wolffenbuttel, B.H. (2007) Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab, Feb; 92(2), str. 491-6
Ross, D.S. (2001) Serum thyroid-stimulating hormone measurement for assessment of thyroid function and disease. Endocrinol Metab Clin North Am, 30(2): 245-64, vii
Schlienger, J.L., Vinzio, S., Grunenberger, F., Luca, F., Goichot, B. (2006) Is subclinical hypothyroidism a cardiovascular risk factor?. Rev Med Interne, Dec;27(12):927-31
Sinclair, D. (2006) Clinical and laboratory aspects of thyroid autoantibodies. Ann Clin Biochem, May;43(Pt 3):173-83
Slatosky, J., Shipton, B., Wahba, H. (2000) Thyroiditis: Differential diagnosis and management. Am Fam Physician, 61(4): 1047-52, 1054
Trbojević, B.J. (2003) Supklinička tireoidna bolest -da li je lečiti, da li tragati za njom?. Srpski arhiv za celokupno lekarstvo, vol. 131, br. 11-12, str. 467-473
Umbreit, J. (2005) Iron deficiency: A concise review. Am J Hematol, 78(3): 225-31
Utiger, R.D. (2006) Iodine nutrition: More is better. New England Journal of Medicine, 354(26): 2819
Vassart, G., Dumont, J.E. (2005) Thyroid dysgenesis: Multigenic or epigenetic.. or both?. Endocrinology, Dec, 146(12), str. 5035-7
Waise, A., Belchetz, P.E. (2000) Lesson of the week: Unsuspected central hypothyroidism. BMJ, 321(7271): 1275-7
Walsh, J.P., Bremner, A.P., Bulsara, M.K., O'leary, P., Leedman, P.J., Feddema, P., Michelangeli, V. (2005) Thyroid dysfunction and serum lipids: A community-based study. Clin Endocrinol (Oxf), Dec;63(6):670-5
Weeks, A.D. (2000) Menorrhagia and hypothyroidism: Evidence supports association between hypothyroidism and menorrhagia. BMJ, 320(7235): 649
Wiersinga, W.M. (2005) Hypothyroidism and myxoedema coma. u: De Groot L.J. [ur.] Endocrinology, Elsevier, ch 105
Yen, P.M. (2001) Physiological and molecular basis of thyroid hormone action. Physiol Rev, 81(3): 1097-142
 

O članku

jezik rada: srpski, engleski
vrsta rada: neklasifikovan
objavljen u SCIndeksu: 08.08.2008.

Povezani članci

Materia medica (2010)
Subklinički hipotiroidizam
Gluvić Zoran M., i dr.

J Med Biochemistry (2017)
Direktna procena referentnih intervala za parametre štitne žlezde u Republici Srpskoj
Mirjanić-Azarić Bosa, i dr.

Materia medica (2016)
Elementi metaboličkog sindroma kod bolesnica sa subkliničkim hipotireoiduzmom
Popović-Radinović Vesna

prikaži sve [27]