Title Hipertireoza u trudnoći Title (english) Hyperthyroidism in pregnancy Author Marina Udovičić Mentor Velimir Altabas (mentor)Committee member Maja Baretić (predsjednik povjerenstva)Committee member Željko Duić (član povjerenstva)Committee member Velimir Altabas (član povjerenstva)Granter University of Zagreb Defense date and country 2020-07-17, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Hipertireoza u trudnoći očituje se kao hipermetaboličko stanje uzrokovano povećanom proizvodnjom i lučenjem hormona štitnjače. Najčešći uzroci nastanka hipertireoze u trudnoći su autoimune bolesti štitnjače, poput Gravesove bolesti, ili prolazno povećanje razine hCG na početku trudnoće poznato kao gestacijska tranzitorna tireotoksikoza. Rjeđi uzroci uključuju multinodoznu toksičnu gušu, toksični adenom, funkcionalne metastaze karcinoma štitnjače, strumu ovarija, te tireotropinome. Povišene razine hormona štitnjače mogu biti uzrokovane i subakutnim tireoiditisom, te egzogenim unosom hormona. Dijagnoza se postavlja na temelju kliničkog pregleda i laboratorijskih testova. Procjena tireoidne funkcije uključuje mjerenje serumskih koncentracija TSH i perifernih hormona štitnjače, tiroksina i trijodtironina. Hormoni štitnjače predstavljaju važan faktor za normalan rast i razvoj fetusa. Pravovremeno prepoznavanje i liječenje hipertireoze smanjuje vjerojatnost nastanka komplikacija i neželjenih ishoda trudnoće. Niske doze antitireoidnih lijekova, ukoliko su potrebne, obično u trudnoći dovode do eutireoze. Pri odabiru adekvatnog lijeka potrebno je uzeti u obzir gestacijsku dob, moguće teratogeno djelovanje i nuspojave. Kirurško liječenje razmatra se kada postoje kontraindikacije za upotrebu antitireoidnih lijekova i provodi se obično u drugom trimestru. Trudnoća je, kao i dojenje, apsolutna kontraindikacija za liječenje radioaktivnim jodom. Liječenje i praćenje pacijentica potrebno je nastaviti i u poslijeporođajnom razdoblju zbog povećanog rizika za razvoj postpartalnih poremećaja funkcije štitnjače.
Abstract (english) Hyperthyroidism in pregnancy manifests as a hypermetabolic condition caused by increased production of thyroid hormones. The most common causes of hyperthyroidism in pregnancy are autoimmune thyroid disease, such as Graves’ disease, or a transient increase in hCG levels in early pregnancy known as gestational transient thyrotoxicosis. Less common causes include multinodular goiter, toxic adenoma, functional thyroid cancer metastases, struma ovarii, and thyrotropinoma. Elevated thyroid hormone levels can also be caused by subacute thyroiditis and exogenous hormone intake. Diagnosis is made based on clinical examination and laboratory tests. Assessment of thyroid activity includes measurement of serum concentrations of TSH and thyroid hormones, thyroxine, and triiodothyronine. Thyroid hormones are an important factor for normal fetal growth and development. Early detection and treatment of hyperthyroidism reduces the risk of complications and adverse pregnancy outcomes. Antithyroid drugs, methimazole and propylthiouracil, are the gold standard in the treatment of hyperthyroidism in pregnancy. Decisions on which medication to use are based on gestational age, with consideration of both teratogenicity and side effects. Surgical treatment is considered when there are contraindications to the use of antithyroid drugs and is usually performed in the second trimester. Pregnancy, like breastfeeding, is an absolute contraindication to treatment with radioactive iodine. Treatment and follow-up of patients should be continued in the postpartum period due to the increased risk of developing postpartum hyperthyroidism.
Keywords
hipertireoza
trudnoća
štitnjača
Keywords (english)
hyperthyroidism
pregnancy
thyroid
Language croatian URN:NBN urn:nbn:hr:105:460683 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-05-06 11:38:22
