小结
定义
病史和体格检查
关键诊断因素
- dor cervical
- tireoide sensível à palpação, firme e aumentada
- febre
- palpitações
其他诊断因素
- infecção viral recente
- mialgia
- mal-estar
- tremor
- intolerância ao calor
危险因素
- infecção viral
- Determinados alelos de HLA e B35
诊断性检查
首要检查
- hormônio estimulante da tireoide (TSH) sérico
- nível sérico de T4 total, T3 total, T3 livre, índice de T4 livre e T4 livre
- proporção T3:T4
- captação de iodo radioativo
- Velocidade de hemossedimentação (VHS) sérica
- Proteína C-reativa sérica
- Anticorpos antitireoide séricos (anticorpos antitireoperoxidase [TPO Ab])
需考虑的检查
- biópsia por aspiração com agulha fina
- hemograma completo
新兴检查
- ultrassonografia da tireoide
治疗流程
fase de hipertireoidismo (tireotóxica)
fase hipotireoidiana
撰稿人
作者
Angela M. Leung, MD, MSc
Associate Professor of Medicine
UCLA David Geffen School of Medicine
VA Greater Los Angeles Healthcare System
Los Angeles
CA
利益声明
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.
鸣谢
Dr Angela M. Leung would like to gratefully acknowledge Dr Stephanie L. Lee, the previous contributor to this topic.
利益声明
SLL declares that she has no competing interests.
同行评议者
Georg Hennemann, MD
Professor of Medicine and Endocrinology
Medical Center Spijkenisse
The Hague
The Netherlands
利益声明
Not disclosed.
Ronald Merrell, MD
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
利益声明
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.
参考文献
关键文献
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. 摘要
Stasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021 Dec;22(4):1027-39.全文 摘要
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
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.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.
鉴别诊断
- Doença de Graves
- Tireoidite infecciosa, supurativa ou aguda
- Bócio multinodular tóxico
更多 鉴别诊断指南
- 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
更多 指南患者教育信息
Hipotireoidismo
更多 患者教育信息
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