Hyperthyroidism

(Thyrotoxicosis)

Hyperthyroidism is characterized by hypermetabolism and increased levels of free nozzle plate hormones. The varied symptoms include tachycardia, fatigue, weight loss, nervousness and tremor. The diagnosis is made clinically and by laboratory tests. Treatment depends on the cause.

Hyperthyroidism is characterized by hypermetabolism and increased levels of free nozzle plate hormones. The varied symptoms include tachycardia, fatigue, weight loss, nervousness and tremor. The diagnosis is made clinically and by laboratory tests. Treatment depends on the cause.

(See illustration of thyroid function.) Hyperthyroidism is characterized by hypermetabolism and increased levels of free nozzle plate hormones. The varied symptoms include tachycardia, fatigue, weight loss, nervousness and tremor. The diagnosis is made clinically and by laboratory tests. Treatment depends on the cause. The forms of hyperthyroidism can u. a. be distinguished and the presence or absence of thyroid stimulators (see Table: Results of thyroid function tests in different clinical situations): on the thyroid uptake of radioactive iodine (the schilddrüsensonographischen image Editor’s note). Etiology Hyperthyroidism arises due to an increased synthesis and secretion of thyroid hormones (thyroxine [T4] and triiodothyronine [T3]), which is either due to thyroid stimulators in the blood or by an autonomous hyperthyroidism. Another cause may be an excessive release of thyroid hormones without increased synthesis. Such a release is often caused by the destructive changes in the various forms of thyroiditis. Various clinical syndromes also cause hyperthyroidism. The most common causes are Graves ‘thyroiditis multinodular goiter individual, autonomous, hyperfunctional “hot” nodes Graves’ disease (diffuse toxic goiter), as the most common cause of hyperthyroidism in countries with sufficient nutritive iodine intake, is characterized by a hyperthyroidism and one or more of the following symptoms: goiter exophthalmos Infiltrative dermopathy Graves’ disease is caused by autoantibodies against thyroid receptor for thyroid stimulating hormone (TSH); unlike most other autoantibodies, have an inhibitory, these autoantibodies is stimulating, so that a continuous synthesis and secretion of T3 and T4 is caused. Graves’ disease (as well as Hashimoto’s thyroiditis) occasionally occurs with other autoimmune diseases such. As type 1 diabetes mellitus, vitiligo, premature graying of the hair, pernicious anemia, connective tissue diseases and the polyglandular deficiency syndrome. An increased risk of Graves’ disease is hereditary, although the genes involved are still unknown. The pathogenesis of infiltrative ophthalmopathy (responsible for the exophthalmos in Graves’ disease) is poorly understood, but may be due to immunoglobulins directed against the TSH receptors in the orbital fibroblasts and fat, arise, leading to a release of proinflammatory cytokines, inflammation and accumulation of glycosaminoglycans leads. An eye disease may become manifest before the occurrence of hyperthyroidism, but also many years later. You deteriorates frequently or disappears regardless of the clinical course of hyperthyroidism. A typical eye disease with normal thyroid function is euthyroid Graves’ disease called. Eye manifestations of Graves ‘disease exophthalmos © Springer Science + Business Media var model = {thumbnailUrl:’ /-/media/manual/professional/images/73_graves_disease_slide_6_springer_high_de.jpg?la=de&thn=0&mw=350 ‘imageUrl:’ / – / media /manual/professional/images/73_graves_disease_slide_6_springer_high_de.jpg?la=de&thn=0 ‘, title:’ Eye manifestations of Graves ‘exophthalmus’ description: ” credits ‘© Springer Science + Business Media’, hideCredits: false, hideTitle : false, hideFigure: false, hideDescription: true}; var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘image-element-panel.’). ko.applyBindings (model, panel.get (0)); Inadequate TSH secretion is a rare cause. Patients with hyperthyroidism have not measurable TSH levels in the rule. An exception are patients with TSH-secreting pituitary tumors or pituitary resistance to thyroid hormone. The TSH levels are high and TSH produced in both diseases is more biologically active than normal TSH. An increase in the alpha subunit of TSH in the blood are found in patients with a TSH-secreting pituitary adenoma. Hydatid moles, choriocarcinoma, and hyperemesis gravidarum produce high levels of human chorionic gonadotropin (hCG) in serum, a weak stimulator of thyroid. The hCG levels are in the first trimester of pregnancy at the highest and occasionally lead to a lowering of serum TSH and a slight increase in free serum T4. The increased thyroid stimulation may be due to the increased levels of partially desialiertem hCG, an hCG-variant, which is apparently a stronger stimulator of thyroid than ordinary hCG. The hyperthyroidism in molar pregnancies, choriocarcinoma and hyperemesis gravidarum is transient. A normal thyroid function turns on again when the molar pregnancy removed, treated choriocarcinoma, and hyperemesis gravidarum is abated. The non-autoimmune autosomal dominant hyperthyroidism manifests itself in childhood. It is caused by mutations in the TSH receptor gene, which require a continuous thyroid stimulation. Toxic mono- or multinodular goiter (Plummer’s disease) is mutations which cause a continuous thyroid activation of the TSH receptor, triggered. Patients with toxic nodular goiter show autoimmune symptoms or circulating antibodies, as one can observe in Graves’ disease. In contrast to Graves’ disease toxic mono or multinodular goiters show remission. In Germany, the hyperthyroidism is due in about half of all patients on these functional autonomies. Inflammatory thyroid diseases (thyroiditis), the subacute granulomatous thyroiditis, Hashimoto’s thyroiditis and subclinical lymphocytic thyroiditis, a variant of Hashimoto’s thyroiditis. Hyperthyroidism resulting from the destructive changes in the gland, and increased hormone release, not of an increased synthesis. Hypothyroidism can follow. A drug-induced hyperthyroidism may be the result of amiodarone and interferon alpha, which can cause thyroiditis with hyperthyroidism or other disorders of the thyroid. Although it often causes hyperthyroidism, lithium can sometimes also cause hyperthyroidism. Patients receiving these drugs should be monitored closely. Hyperthyreosis one factitianennt hyperthyroidism, which is caused by a deliberate or accidental overdose of thyroid hormones. Excessive Jodaufnahmeverursacht u. U. hyperthyroidism, which is characterized by a low absorption of radioactive iodine into the thyroid gland. This occurs most often in older patients who have nodosa a nontoxic goiter and those drugs are administered that contain iodine (eg. As amiodarone, iodine-containing expectorants) or iodine for radiological examination contrast agents receive. The reason is probably here that the high iodine intake as a substrate for functionally autonomous thyroid tissue (which is not regulated by TSH) acts and excessive hormone can be produced. Hyperthyroidism usually lasts as long as the iodine compound remains in the bloodstream. Metastatic thyroid carcinoma is a very rare possible cause. Very rarely, by functionally intact tissue of a follicular, metastatic thyroid carcinoma to the overproduction of thyroid hormone. This occurs particularly in lung metastases. A goiter ovariikann develop when ovarian teratomas contain enough thyreoidales tissue to cause a real hyperthyroidism. It shows an absorption of radioactive iodine in the pelvic area, and the inclusion in the thyroid itself is suppressed. Pathophysiology of hyperthyroidism, serum T3 normally increases more strongly than T4, presumably due to the increased secretion of T3 and the increased conversion of T4 to T3 in the periphery. In some patients, T3 is only increased (T3 -Toxikose). A T3 -Hyperthyreose can with any disorder that causes hyperthyroidism such. B. Graves’ disease, nodular goiter and autonomous thyroid nodules occur. If the T3Hyperthyreose is not treated, the patient develops the typical hyperthyroidism laboratory values ??such. B. increased T4 and increased uptake 123I. The various forms of thyroiditis usually have a hyperthyroid phase is followed by a hypothyroid phase. Symptoms and signs Most symptoms and complaints are the same regardless of the cause. An exception are the infiltrative ophthalmopathy and dermopathy, which occur only in Graves’ disease. Tips and risks Elderly patients may have symptoms that resemble depression or dementia. The clinical presentation can be dramatic or subtle. Goitre or a node may occur. Most symptoms of hyperthyroidism are similar to the symptoms in excess adrenergic such. As nervousness, palpitations, hyperactivity, increased sweating, increased sensitivity to heat, increased appetite, weight loss, insomnia, weakness and increased stool frequency up to diarrhea. A hypomenorrhea can be made. The clinical signs may be hot and clammy skin, tremors, tachycardia, increased pulse amplitude and atrial fibrillation. Graves ‘disease (enlarged thyroid gland) © Springer Science + Business Media var model = {thumbnailUrl:’ /-/media/manual/professional/images/71_graves_disease_slide_12_alternative_springer_high_de.jpg?la=de&thn=0&mw=350 ‘imageUrl:’ / – / media /manual/professional/images/71_graves_disease_slide_12_alternative_springer_high_de.jpg?la=de&thn=0 ‘, title:’ Graves’ disease (thyroid enlarged) ‘, description:’ u003Ca id = “v37895520 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eBei this patient with Graves’ disease

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