Tireoidite linfocítica indolor
Резюме
Definition
History and exam
Key diagnostic factors
- intolerância ao calor
- nervosismo
- pequeno bócio insensível à palpação
- tremor
Other diagnostic factors
- palpitações
- perda de peso
- fadiga excessiva
- distensão abdominal
- cãibras musculares
- ganho de peso
- baixa concentração
- intolerância ao frio
- taquicardia
Risk factors
- período pós-parto
- sexo feminino
- anticorpos antitireoperoxidase (anti-TPO)
- terapia imunomoduladora
- terapia com lítio
- terapia com amiodarona
- diabetes do tipo 1 e outras doenças autoimunes
- história familiar autoimune
Diagnostic tests
1st tests to order
- hormônio estimulante da tireoide (TSH)
- T4 e T3 livres séricos
- anticorpos antitireoperoxidase (anti-TPO)
- anticorpos receptores de TSH (TRAb)
- captação de 4, 6 ou 24 horas de radioiodo
- razão T3/T4 total
Tests to consider
- teste de pertecnetato de tecnécio-99m
- tireoglobulina sérica
- biópsia da tireoide
- ultrassonografia com dopplerfluxometria colorida
Treatment algorithm
fase tireotóxica (hipertireoidiana): leve
fase tireotóxica (hipertireoidiana): moderada
fase tireotóxica (hipertireoidiana): grave
fase hipotireoidiana: leve
fase hipotireoidiana: moderada a grave
tireoidite recorrente
Contributors
Authors
Petros Perros, MD
Honorary Consultant
Department of Endocrinology
Newcastle upon Tyne Hospitals NHS Foundation Trust
Newcastle upon Tyne
UK
Disclosures
PP has received consultancy fees, served as a member of an advisory board, and been reimbursed for attending conferences held by IBSA Institut Biochimique SA (the manufacturer of Tirosint).
Acknowledgements
Dr Petros Perros would like to gratefully acknowledge Dr Douglas S. Ross, the previous contributor to this topic. DSR declares that he has no competing interests.
Peer reviewers
John Lazarus, MA, MD, FRCP, FACE, FRCOG
Centre for Endocrine and Diabetes Sciences
Cardiff University School of Medicine
University Hospital of Wales
Heath Park
Cardiff
UK
Disclosures
JL declares that he has no competing interests.
Ronald Merrell, MD
Professor of Surgery
Virginia Commonwealth University
Richmond
VA
Disclosures
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.
References
Key articles
Muller I, Moran C, Lecumberri B, et al. 2019 European Thyroid Association guidelines on the management of thyroid dysfunction following immune reconstitution therapy. Eur Thyroid J. 2019 Jul;8(4):173-85.Full text Abstract
National Institute for Health and Care Excellence. Thyroid disease: assessment and management. Oct 2023 [internet publication].Full text
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Tireoidite (linfocítica crônica) de Hashimoto
- Doença de Graves
- Bócio multinodular tóxico
More DifferentialsGuidelines
- ACR practice parameter for the performance of therapy with unsealed radiopharmaceutical sources
- Thyroid disease in pregnancy
More GuidelinesPatient information
Hipotireoidismo
More Patient information
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