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Thyreopathy in primary care


Authors: P. Vlček
Authors‘ workplace: Klinika nukleární medicíny a endokrinologie 2. lékařské fakulty UK a FN Motol Praha, přednosta doc. MUDr. Petr Vlček, CSc.
Published in: Vnitř Lék 2011; 57(9): 786-790
Category: 65th birthday Mudr. Jany Laciné and and 60th birthday Milana Tržila

Overview

Thyroid gland disorders, as the core of all endocrinopathies, affect 5–7% of the population of the Czech Republic, with women being affected 6–8 times more often than men. Clinically, thyreopathies are divided into hormonal production disorders and morphology disorders. Thyroid hormones fT3, fT4 and TSH serum levels determine the diagnosis of a thyroid gland disorder. Primary hypothyreosis is characterized by reduced fT4 and increased TSH. Low T3 syndrome is a protective reaction of the organism and is associated with conversion of T4 into hormonally inactive triiodothyronine (rT3). Primary hyperthyreosis is characterized by higher fT4 and low TSH levels. Acute thyreoiditis: Inflammatory signs and normal thyroid function, anti-TPO as well as anti-TG are not elevated. Subacute thyreoiditis is manifested as an inflammation, normal anti-TPO and anti-TG, sometimes also hyperthyreosis. Chronic thyreoiditis, Hashimoto‘s struma is among the most frequent causes of hypothyreosis in the Czech Republic and it is diagnosed through high anti-TPO and anti-TG levels and higher TSH. Thyreoidal adenomas and carcinomas are clinically usually euthyroid. Determination of tumour markers – thyreoglobulines in papillary and follicular carcinomas and calcitonin in medullar carcinoma that requires genetic assessment (determination of germinal mutations, usually with PCR) – is essential.

Key words:
thyroid gland – hypothyreosis – hyperthyreosis – thyroxin – TSH – fT4 – inflammation – tumours


Sources

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Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 9

2011 Issue 9

Most read in this issue
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