Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- neck pain
- tender, firm, enlarged thyroid
- fever
- palpitations
Outros fatores diagnósticos
- recent viral infection
- myalgia
- malaise
- tremor
- heat intolerance
Fatores de risco
- viral infection
- Certain HLA and B35 alleles
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- serum thyroid-stimulating hormone (TSH)
- serum total T4, total T3, free T3, free T4 index, and free T4
- T3:T4 ratio
- radioactive iodine uptake
- Serum ESR
- Serum CRP
- Serum thyroid antibodies (thyroid peroxidase antibodies [TPO Ab])
Investigações a serem consideradas
- fine needle aspiration biopsy
- complete blood count
Novos exames
- ultrasonography of thyroid
Algoritmo de tratamento
hyperthyroid (thyrotoxic) phase
hypothyroid phase
Colaboradores
Autores
Angela M. Leung, MD, MSc
Associate Professor of Medicine
UCLA David Geffen School of Medicine
VA Greater Los Angeles Healthcare System
Los Angeles
CA
Declarações
AL has served on the board of directors of the American Thyroid Association. She is editor-in-chief of Clinical Thyroidology, a journal of the American Thyroid Association. AL is a speaker for Medical Education Resources and MCE Conferences. She has consulted for Vertice Pharma and received article process charges paid by IBSA Institut Biochimique for an invited review article. AL has lectured at a conference sponsored by Merck and presented educational content for the Endocrine Society and the American Association of Clinical Endocrinology. AL is an advisor to Medscape and has received research funding from the U.S. Dept of Veterans Affairs.
Agradecimentos
Dr Angela M. Leung would like to gratefully acknowledge Dr Stephanie L. Lee, the previous contributor to this topic.
Declarações
SLL declares that she has no competing interests.
Revisores
Georg Hennemann, MD
Professor of Medicine and Endocrinology
Medical Center Spijkenisse
The Hague
The Netherlands
Declarações
Not disclosed.
Ronald Merrell, MD
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
Declarações
RM 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
Nishihara E, Ohye H, Amino N, et al. Clinical characteristics of 852 patients with subacute thyroiditis before treatment. Intern Med. 2008;47(8):725-9. Resumo
Stasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021 Dec;22(4):1027-39.Texto completo Resumo
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
Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017 Mar;27(3):315-89.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.
Diagnósticos diferenciais
- Graves disease
- Infectious, suppurative, or acute thyroiditis
- Toxic multinodular goiter
Mais Diagnósticos diferenciaisDiretrizes
- Thyroid disease: assessment and management
- 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum
Mais DiretrizesFolhetos informativos para os pacientes
Underactive thyroid
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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