Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- goiter
Otros factores de diagnóstico
- heat intolerance, hyperphagia, or weight loss
- depression
- nervousness or palpitations
- oligomenorrhea
- hyperdefecation
- stare or lid lag
- warm, moist skin
- tachycardia
- irregular pulse
- tremor
- muscle weakness
- shortness of breath or choking sensation
- Pemberton sign
Factores de riesgo
- iodine deficiency
- age >40 years
- head and neck irradiation
- family history of thyroid nodules
- female sex
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- thyroid-stimulating hormone (TSH)
Pruebas diagnósticas que deben considerarse
- free T4 (or total T4 with a measure of binding)
- total T3 with a measure of binding (or free T3)
- I-123 thyroid scan and uptake
- Tc-99 pertechnetate scan
- thyroid ultrasound
- metabolic panel
- CBC
- thyroid peroxidase antibodies
- TSH receptor antibodies
- ECG
- CT neck (noncontrast)
Algoritmo de tratamiento
nonpregnant nonlactating adults: without mass effect or suspicion of cancer
mass effect or suspicion of cancer
pregnant or lactating: without mass effect or suspicion of cancer
Colaboradores
Autores
Elizabeth N. Pearce, MD
Professor of Medicine
Boston University Medical Center
Boston
MA
Divulgaciones
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.
Agradecimientos
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, a previous contributor to this topic. SF was previously employed by BMJ.
Revisores por pares
Petros Perros, BSc, MBBS, MD, FRCP
Consultant Endocrinologist
Freeman Hospital
Newcastle-Upon-Tyne
UK
Divulgaciones
PP declares that he has no competing interests.
Ronald Merrell, MD, FACS
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
Divulgaciones
RM declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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 Resumen
Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015 Apr;3(4):286-95. Resumen
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;26:1343-1421.Texto completo Resumen
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;26:1-133.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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