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Hipotireoidismo primário

Última revisão: 16 Aug 2025
Última atualização: 25 Apr 2025

Resumo

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presença de fatores de risco
  • sintomas inespecíficos
Полная информация

Другие диагностические факторы

  • letargia
  • constipação
  • ganho de peso
  • depressão
  • irregularidade menstrual
  • pele seca ou áspera
  • mudança na voz
  • bradicardia
  • hipertensão
  • retardo do relaxamento dos reflexos tendinosos
  • sensibilidade ao frio
  • cabelo grosso
  • edema palpebral
  • bócio
Полная информация

Факторы риска

  • deficiência de iodo
  • sexo feminino
  • meia-idade
  • história familiar de tireoidite autoimune
  • doenças autoimunes
  • tratamento para doença tireoidiana
  • tireoidite pós-parto
  • Síndromes de Turner e de Down
  • diabetes do tipo 1
  • radioterapia de cabeça e pescoço
  • doença infiltrante
  • excesso de iodo
  • exposição a pesticidas
  • uso da amiodarona
  • uso de lítio
  • laringectomia
  • tratamento para tuberculose (TB) resistente a múltiplos medicamentos
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • hormônio estimulante da tireoide (TSH) sérico
Полная информация

Исследования, проведение которых нужно рассмотреть

  • tiroxina livre sérica (T4)
  • anticorpos antitireoperoxidase (anti-TPOAbs)
  • Hemograma completo
  • glicemia de jejum
  • colesterol sérico
Полная информация

Алгоритм лечения

ПРОДОЛЖЕНИЕ

hipotireoidismo primário evidente confirmado

hipotireoidismo subclínico

Составители

Авторы

Wail Malaty, MD

Adjunct Clinical Professor

Department of Family Medicine

University of North Carolina

Chapel Hill

NC

Раскрытие информации

WM declares that he has no competing interests.

Рецензенты

Sun Y. Lee, MD, MSc

Assistant Professor of Medicine

Boston University School of Medicine

Boston

MA

Раскрытие информации

SYL declares that she has no competing interests.

Salman Razvi, MD, FRCP

Consultant Endocrinologist

Queen Elizabeth Hospital

Gateshead

UK

Раскрытие информации

SR declares that he has no competing interests.

Lakdasa Premawardhana, MBBS, FRCP, FRCPE

Consultant Physician

Caerphilly Miners' Hospital

Caerphilly

UK

Раскрытие информации

LP declares that he has no competing interests.

Birte Nygaard, MD, PhD

Associated Professor

Consultant Endocrinologist

Herlev Hospital

University of Copenhagen

Denmark

Раскрытие информации

BN declares that she 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.

Список литературы

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Основные статьи

Taylor PN, Medici MM, Hubalewska-Dydejczyk A, et al. Hypothyroidism. Lancet. 2024 Oct 5;404(10460):1347-64. Аннотация

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.Полный текст  Аннотация

American Association of Clinical Endocrinologists; American Thyroid Association. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028.Полный текст  Аннотация

Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014 Dec;24(12):1670-751.Полный текст  Аннотация

Статьи, указанные как источники

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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