Thyroid function disorders

Mirjana Stojković

doi:10.5937/arhfarm72-39952

Mirjana Stojković Univerzitet u Beogradu – Medicinski fakultet; Univerzitetski klinički centar Srbije, Klinika za endokrinologiju, dijabetes i bolesti metabolizma

DOI: https://doi.org/10.5937/arhfarm72-39952

Ključne reči: hipertireoza, tirotoksikoza, hipotireoza, Hašimoto tiroiditis, Grejvsova bolest

Sažetak

Poremećaji funkcije štitaste žlezde su najčešći endokrini poremećaji kod ljudi. Dijagnoza se postavlja često, sa prevalencom 2-6% i značajno su češći kod žena nego kod muškaraca, sa odnosom žene: muškarci i do 10:1. Poremećaji funkcije štitaste žlezde u užem smislu predstavljaju njenu hiperaktivnost ili smanjenu aktivnost, mada postoje stanja koja dovode do povećanja koncentracije tiroidnih hormona u krvi, bez povećane aktivnosti štitaste žlezde. Najčešći uzrok kako hipertireoze tako i hipotireoze u jod suficitnim regionima je autoimunska tiroidna bolest. Najčešći uzrok hipertireoze je Grejvsova bolest sa tipičnim simptomima i znacima hipermetabolizma. Dijagnoza hipertireoze se postavlja na osnovu suprimovanog TSH i povišenih vrednosti fT4, a za diferencijalnu dijagnozu, povišena TSH-receptorska-antitela (TRAt) su ključna za dijagnozu Grejvsove bolesti. Lečenje Grejvsove bolesti se zasniva na tri jednako efektivna pristupa: medikamentno lečenje, ablativna terapija radioaktivnim jodom ili tiroidektomija. Hašimoto tiroiditis je najčešći uzrok hipotireoze u jod suficitnim regionima. Simptomi i znaci hipotireoze su nespecifični i odgovaraju simptomima i znacima hipometabolizma. Dijagnoza se postavlja na osnovu povišenih vrednosti TSH uz snižen fT4, a u diferencijalnoj dijagnozi od značaja su antitela na tiroksin peroksidazu (TPOAt) i tiroglobulinska antitela (TgAt), mada se ponekad i u Hašimoto tiroiditisu mogu naći povišena TRAb. Lečenje se sprovodi supstitucionom terapijom levotiroksinom.

Reference

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Poremećaji funkcije štitaste žlezde

Sažetak

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