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Hipertiroidismo: diagnóstico y tratamiento

Anne Mounsey1, Ryan Paulus1, Wesley Roten1

  • 1University of North Carolina, Chapel Hill.

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PubMed
Resumen
Este resumen es generado por máquina.

El hipertiroidismo, una sobreproducción de la hormona tiroidea, afecta al 1,3% de los adultos estadounidenses. El diagnóstico se basa en niveles bajos de tirotropina, siendo la enfermedad de Graves la causa más común.

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Área de la Ciencia:

  • Endocrinología
  • Médico interno

Sus antecedentes:

  • El hipertiroidismo implica un exceso de producción de hormonas tiroideas, que afecta al 1,3% de los adultos estadounidenses.
  • La tirotoxicosis, un estado de exceso de hormonas tiroideas, puede provenir de hipertiroidismo, tiroiditis o fuentes exógenas.
  • Los síntomas comunes incluyen debilidad, palpitaciones, pérdida de peso e intolerancia al calor; los signos incluyen bocio, taquicardia, debilidad muscular y temblor.

Objetivo del estudio:

  • Para describir las causas, el diagnóstico y el tratamiento del hipertiroidismo.
  • Para diferenciar entre las diversas causas de la tirotoxicosis.
  • Revisar las opciones de tratamiento para el hipertiroidismo.

Principales métodos:

  • Los criterios de diagnóstico incluyen niveles bajos de hormona estimulante de la tiroides (tirotropina).
  • La enfermedad de Graves, la causa más común, se identifica por la enfermedad ocular de la tiroides o los anticuerpos del receptor de la tirotropina.
  • Las exploraciones de yodo radiactivo diferencian otras causas como el bocio multinodular tóxico y la tiroiditis.

Principales resultados:

  • Las tionamidas (por ejemplo, metimazol) inducen la remisión en la enfermedad de Graves y controlan otras formas.
  • El yodo radiactivo trata eficazmente el hipertiroidismo en más del 90% de los casos de enfermedad de Graves y bocio multinodular.
  • El hipotiroidismo es un resultado común un año después del tratamiento con yodo radiactivo.

Conclusiones:

  • El tratamiento del hipertiroidismo varía según la etiología y la presentación del paciente.
  • Las tionamidas, el yodo radiactivo y la tiroidectomía son las principales modalidades de tratamiento.
  • Se prefiere la tiroidectomía para los bocios que causan síntomas de compresión.