Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- palpable thyroid nodule
- younger age
Outros fatores diagnósticos
- hyperphagia
- weight loss
- sweating/heat intolerance
- nervousness
- palpitations
- oligomenorrhea
- hyperdefecation
- dyspnea
- stare or lid lag
- tachycardia
- tremor
- warm moist skin
- muscle weakness
- hoarseness
- dysphagia
- choking
- mood change
Fatores de risco
- young adult age
- iodine deficiency
- head and neck irradiation
- family history of thyroid nodules
- female sex
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- thyroid stimulating hormone (TSH)
Investigações a serem consideradas
- free thyroxine (T4; or total T4 with a measure of binding)
- total T3 with a measure of binding (or free T3)
- thyroid scan and uptake
- thyroid ultrasound
- metabolic panel
- CBC
- TSH receptor antibodies
- thyroid peroxidase antibodies
- ECG
- CT neck (noncontrast)
Algoritmo de tratamento
nonpregnant nonlactating adults without mass effect
nonpregnant nonlactating adults with mass effect
pregnant or lactating
Colaboradores
Autores
Elizabeth N. Pearce, MD
Professor of Medicine
Boston University Medical Center
Boston
MA
Declarações
ENP is a member of the Management Council of the Iodine Global Network. She was the 2018-2019 President of the American Thyroid Association (ATA) and served on its board and executive committee until 2020. She is a current member of the ATA's thyroid in pregnancy guidelines writing task force. She is currently a Deputy Editor at the Journal of Clinical Endocrinology and Metabolism and has previously served as an Associated Editor for the journals Thyroid, Endocrine Practice, and Clinical Thyroidology. She is an author of a number of references cited in this topic.
Agradecimentos
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, the previous contributor to this topic.
Revisores
John C. Morris, MD
Professor of Medicine
Mayo Clinic
Rochester
MN
Declarações
JCM declares that he has no competing interests.
Petros Perros, BSc, MBBS, MD, FRCP
Consultant Endocrinologist
Freeman Hospital
Newcastle-Upon-Tyne
UK
Declarações
PP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-421.Texto completo Resumo
Gharib H, Papini E, Garber JR, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules - 2016 update. Endocr Pract. 2016 May;22(5):622-39.Texto completo Resumo
Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1-133.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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