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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
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Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence...
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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
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Universal screening versus selective case-based screening for thyroid disorders in pregnancy.

Zahra Jouyandeh1, Shirin Hasani-Ranjbar, Mostafa Qorbani

  • 1Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Endocrine
|September 1, 2014
PubMed
Summary

Universal screening for thyroid dysfunction in pregnant women is more effective than case-finding. Early detection and treatment of thyroid disorders during pregnancy reduce complications and are cost-effective.

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Area of Science:

  • Endocrinology
  • Obstetrics
  • Public Health

Background:

  • Thyroid dysfunction during pregnancy poses significant risks to maternal and fetal health.
  • Early intervention for thyroid disorders in pregnancy is crucial for mitigating adverse outcomes.
  • Current screening strategies lack consensus regarding universal versus case-finding approaches.

Purpose of the Study:

  • To compare the effectiveness of universal versus case-finding screening for thyroid disorders in pregnancy.
  • To evaluate the impact of screening methods on adverse pregnancy outcomes and cost-effectiveness.
  • To synthesize evidence supporting optimal screening strategies for thyroid dysfunction in pregnant populations.

Main Methods:

  • Systematic review of PubMed, Scopus, and Web of Science databases.
  • Inclusion of English-language studies comparing universal and case-finding screening for thyroid dysfunction in pregnancy.
  • Meta-analysis using a random-effects model to account for study heterogeneity.

Main Results:

  • Case-finding screening missed 30-55% of pregnant women with thyroid dysfunction.
  • Universal screening was associated with reduced rates of miscarriage and pregnancy complications.
  • Universal screening for hypothyroidism in pregnancy was found to be cost-effective.

Conclusions:

  • Universal screening for thyroid disorders in pregnancy is superior to case-finding, which can miss a significant proportion of affected individuals.
  • Early detection and management of thyroid dysfunction through universal screening minimize adverse maternal and fetal outcomes.
  • Further large-scale randomized controlled trials are needed to solidify the advantages of universal screening in pregnancy.