Subklinické tyreopatie Dotaz Zobrazit nápovědu
Subclinical thyreopathies are pathological states of the thyroid gland that show no corresponding clinical symptoms, yet may be detected sporadically by laboratory examination or screening methods. They represent a novel diagnostic entity (analogous to glucose tolerance impairment--IGT or impaired fasting glycemia--IFG), which appeared due to innovations in laboratory diagnostics (sensitive TSH detection methods) and recent focus on pre-clinical stages of manifestative diseases. From a wider point of view, subclinical thyreopathies include subclinical hypothyroidism, subclinical hyperthyrodism, thyroid volume or structure changes found accidentally by sonography, initial stages of malignancy--accidental detection of a microcarcinoma and subclinical forms of thyroiditis. Controversy remains concerning exact definition, epidemiological issues, therapeutic intervention, evaluation of risk and gain implied in treatment of these borderline clinical stages and, last but not least, early screening of risk groups if necessary.
Importance of subclinical thyroid disease (STh) is now a matter of discussion. Definition of this unit is laboratory: in presence of normal level of thyroxine (T4) TSH value is changed: in lower TSH level the subclinical hyperthyroidism (STx) in increase TSH levels subclinical hypothyroidism (SH) is present. Risk of clinical manifestation is two three times highter in comparison with persons with normal TSH level. Clinical importance STh is still not evaluated definitively. SH caused disturbance of lipid metabolism, elasticity of vessels and endothelial function and therefore increases risk of atherosclerosis. STx causes electrical instability of myocardium with increased risk of arythmias, increases risk of osteoporosis and other changes. Most important are effects of STh in cardiology, reproductive medicine and gynecology. Clinical significance of these effects is not definitively evaluated.
- MeSH
- hypertyreóza krev komplikace diagnóza etiologie MeSH
- hypotyreóza krev komplikace diagnóza etiologie MeSH
- komplikace těhotenství krev diagnóza etiologie MeSH
- lidé MeSH
- nemoci štítné žlázy krev komplikace diagnóza etiologie MeSH
- referenční hodnoty MeSH
- těhotenství MeSH
- thyreotropin krev MeSH
- thyroxin krev MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- thyreotropin MeSH
- thyroxin MeSH
Subclinical thyroids disease (STD) is recently defined term in clinical thyroidology, which includes mainly functional disorders. Basic diagnostic signs are: normal values of thyroid hormones (fT4, fT3) and elevated TSH level (subclinical hypothyroidism) or suppresed TSH level (subclinical hyperthyroidism). In a category of STD may be included subclinical autoimunne thyroiditis (elevated level of thyroid antigens antibodies and/or hypoechogenity in sonographic screen, increased volume of the thyroid without clinical symptoms and/or autoimminity) and microscopic lesions of papillary thyroid carcinoma. Subclinical hypothyroidism may be dangerous for tendency to development of manifest hypothyroidism and for risk of disorders of lipid profile and development of atherosclerosis and its organ complication (esp. myocardial infarction). Subclinical hyperthyroidism is a risk factor of cardiac arythmias and probably can increase a risk of cardiovascular mortality) as well for osteoporosis (esp. in peri- and post-climacteric women), and last but not least for degenerative diseases of brain (?). Indication of treatment of STD is a matter of controversies. Recomendations of experts, varied from "no therapy, monitoring only" to "treat always". Treatment of risk groups (esp. pregnant women) is probably nowadays a most rationale recommendations since results of sofisticated prospective studies will be available.
- MeSH
- hypertyreóza komplikace diagnóza terapie MeSH
- hypotyreóza komplikace diagnóza terapie MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
