Supklinička hipotireoza

master's thesis

• Title (english): Subclinical hypothyroidism
• Author: Danijela Mosković
• Mentor: Dražen Huić (mentor)
• Committee member: Sanja Kusačić-Kuna (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Dražen Huić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Nuclear Medicine); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Nuclear Medicine

Abstract

Supklinička hipotireoza definira se kao povišena razina serumskog tireoidnog stimulirajućeg hormona (TSH) uz normalne serumske vrijednosti hormona štitnjače, tiroksina (T4) i trijodtironina (T3).
Češće je zapažena kod žena i osoba starije dobi, a rizični čimbenici još su pretilost, sklonost autoimunim bolestima i neadekvatan unos joda. Najčešći uzrok supkliničke hipotireoze je kronični limfocitni tireoiditis, poznatiji kao Hashimoto tireoiditis. Ostali uzroci su parcijalna tireoidektomija, infiltrativni poremećaji štitnjače, subakutni tireoiditis, radioterapija, neadekvatno liječenje hipertireoze, nedostatak joda, disgeneza štitnjače i utjecaj nekih lijekova. Uglavnom je asimptomatsko stanje. Iznimno, javlja se uz simptome karakteristične za hipotireozu, kao što su slabost, konstipacija, suha koža, poremećaji kognitivne funkcije, povišenje tjelesne mase. Dijagnoza se postavlja laboratorijskom analizom serumskog TSH, uz kontrolno testiranje za 2 - 3 mjeseca kako bi se isključili reverzibilni uzroci i prolazno povišenje TSH. Poželjno je utvrditi jesu li pozitivna antitireoidna protutijela i otkriti etiologiju poremećaja. Smjernice za liječenje nisu detaljno definirane i potreba za terapijom određuje se individualno.
Preporučena je terapija levotiroksinom pri serumskim razinama TSH višim od 10 mIU/L, trudnicama, simptomatskim bolesnicima i ako postoji kardiovaskularni rizik. Pacijente je nužno redovito kontrolirati kako bi se odredila optimalna terapija ovisno o kliničkoj prezentaciji i razinama TSH.

Abstract (english)

Subclinical hypothyroidism is defined as an elevated level of serum thyroid stimulating hormone (TSH) with normal serum values of thyroid hormones, thyroxine (T4) and triiodothyronine (T3).
It is more frequent in women and elderly people. Other risk factors are obesity, autoimmune diseases and inadequate iodine intake. The most common cause of subclinical hypothyroidism is chronic autoimmune thyroiditis, better known as Hashimoto thyroiditis. Other causes are partial thyroidectomy, infiltrative thyroid disorders, subacute thyroiditis, radiotherapy, inadequate treatment of hyperthyroidism, iodine deficiency, thyroid dysgenesis and some medications. It is mostly an asymptomatic condition. Exceptionally, it occurs with symptoms common in hypothyroidism, weakness, constipation, dry skin, cognitive disorders, weight gain. The diagnosis is established by laboratory analysis of serum TSH, with control testing in 2 - 3 months to rule out reversible causes and transient TSH elevation. It is necessary to check the levels of antithyroid antibodies, and to define the etiology of the disorder. The need for therapy is determined individually.
Levothyroxine therapy is recommended for patients with serum TSH levels higher than 10 mIU/L, pregnant women, symptomatic patients and if there is a cardiovascular risk. Patients should be monitored regularly to determine optimal therapy depending on clinical presentation and TSH levels.

• Keywords: levotiroksin; supklinička hipotireoza; TSH
• Keywords (english): levothyroxine; subclinical hypothyroidism; TSH
• Language: croatian
• URN:NBN: urn:nbn:hr:105:220623
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-02 18:14:48