Toxic thyroid adenoma
小结
定义
病史和体格检查
关键诊断因素
- palpable thyroid nodule
- younger age
其他诊断因素
- 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
危险因素
- young adult age
- iodine deficiency
- head and neck irradiation
- family history of thyroid nodules
- female sex
诊断性检查
首要检查
- thyroid stimulating hormone (TSH)
需考虑的检查
- 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)
治疗流程
nonpregnant nonlactating adults without mass effect
nonpregnant nonlactating adults with mass effect
pregnant or lactating
撰稿人
作者
Elizabeth N. Pearce, MD
Professor of Medicine
Boston University Medical Center
Boston
MA
利益声明
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.
鸣谢
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, the previous contributor to this topic.
同行评议者
John C. Morris, MD
Professor of Medicine
Mayo Clinic
Rochester
MN
利益声明
JCM declares that he has no competing interests.
Petros Perros, BSc, MBBS, MD, FRCP
Consultant Endocrinologist
Freeman Hospital
Newcastle-Upon-Tyne
UK
利益声明
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.
参考文献
关键文献
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.全文 摘要
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.全文 摘要
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.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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