小结
定义
病史和体格检查
关键诊断因素
- 颈疼痛
- 触痛,坚实,肿大的甲状腺
- 发热
- 心悸
其他诊断因素
- 近期病毒性感染
- 肌痛
- 不适感
- 震颤
- 怕热
危险因素
- 病毒感染
- HLA-Bw35基因和B35基因
诊断性检查
首要检查
- 促甲状腺素 (TSH)
- 总T4,总T3,T3树脂吸收水平,游离甲状腺素
- T3:T4比值
- 放射性碘摄取
- 红细胞沉降率 (ESR)
- C 反应蛋白 (CRP)
- 抗甲状腺抗体(甲状腺过氧化物酶抗体)
需考虑的检查
- 细针抽吸活检
新兴检查
- 甲状腺超声扫描
- 唾液C反应蛋白
治疗流程
甲亢阶段
甲减阶段
撰稿人
作者
Stephanie L. Lee, MD, PhD
Associate Chief
Director of the Thyroid Health Center
Section of Endocrinology, Diabetes and Nutrition
Boston Medical Center
Associate Professor of Medicine
Boston University School of Medicine
Boston
MA
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.
Jim Stockigt, MD, FRACP, FRCPA
Consultant Endocrinologist
Epworth and Alfred Hospitals
Professor of Medicine
Monash University
Melbourne
Australia
利益声明
At the time of review, JS declared that he had no competing interests. Unfortunately, we have since been made aware that JS is deceased.
鉴别诊断
- Graves 病
- 感染,化脓性,或急性甲状腺炎
- 毒性多结节性甲状腺肿
更多 鉴别诊断指南
- 2017 年美国甲状腺协会妊娠期和产后甲状腺疾病诊断和管理指南
- 2016 年美国甲状腺协会甲状腺功能亢进和其他原因导致的甲状腺毒症的诊断和管理指南
更多 指南患者教育信息
Underactive thyroid
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