Hyperthyroidism: Difference between revisions
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**Palmar erythema | **Palmar erythema | ||
**Onycholysis | **Onycholysis | ||
==Differential Diagnosis== | |||
==Diagnosis== | ==Diagnosis== | ||
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*Increased free T3 | *Increased free T3 | ||
== | ==Management== | ||
*Beta-antagonists | *Beta-antagonists | ||
*Methimazole | *Methimazole | ||
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===In Pregnancy=== | ===In Pregnancy=== | ||
*Propylthiouracil - 1st Trimester<ref>http://www.womenshealth.gov/publications/our-publications/fact-sheet/graves-disease.html*f</ref> | *Propylthiouracil - 1st Trimester<ref name="WH">http://www.womenshealth.gov/publications/our-publications/fact-sheet/graves-disease.html*f</ref> | ||
*Methimazole - 2nd Trimester and on<ref | *Methimazole - 2nd Trimester and on<ref name="WH" /> | ||
==Disposition== | |||
==See Also== | ==See Also== | ||
*[[Thyroid | *[[Thyroid storm]] | ||
*[[Thyroid ( | *[[Thyroid (Main)]] | ||
== | ==References== | ||
<references/> | |||
<references/> | |||
[[Category:Endo]] | [[Category:Endo]] | ||
Revision as of 03:14, 11 August 2015
Background
- Hyperthyroidism: Excess circulating hormone resulting from thyroid gland hyperfunction
- Thyrotoxicosis: Excess circulating thyroid hormone originating from any cause
Causes
- Primary Hyperthyroidism
- Graves disease (toxic diffuse goiter)
- Most common cause (85% of cases)
- Associated with diffuse goiter, ophthalmopathy, local dermopathy
- Toxic multinodular goiter
- 2nd most common cause
- Toxic nodular (adenoma) goiter
- Enlarged thyroid gland w/ small nodules that overproduce thyroid hormone
- Graves disease (toxic diffuse goiter)
- Secondary Hyperthyroidism
- Thyrotropin-secreting pituitary adenoma
- Thyroiditis
- Hashimoto thyroiditis
- Initially gland is overactive (hyperthyroidism state) followed by hypothyroidism
- Subacute painful thyroiditis (de Quervain thyroiditis)
- Subacute painless thyroiditis
- Radiation thyroiditis
- Other causes
- Metastatic thyroid cancer
- Iodine-induced thyrotoxicosis
- Amiodarone (contains iodine)
Clinical Features
- Constitutional
- Lethargy
- Diaphoresis
- Weakness
- Fever
- Heat intolerance
- Weight loss
- Neuropsychiatric
- Emotional lability
- Fine tremor
- Anxiety
- Muscle wasting
- Confusion
- Hyperreflexia
- Coma
- Periodic paralysis
- Psychosis
- Ophthalmologic
- Diplopia
- Lid lag
- Eye irritation
- Exophthalmos
- Ophthalmoplegia
- Endocrine
- Neck fullness/tenderness (thyroid gland)
- Cardiorespiratory
- Dyspnea
- Widened pulse pressure
- Palpitations
- Systolic hypertension
- Chest pain
- Sinus tachycardia
- A-fib/flutter
- CHF
- GI
- Diarrhea
- Hyperactive bowel sounds
- Reproductive
- Oligomenorrhea
- Gynecomastia
- Telangiectasia
- Gynecologic
- Menorrhagia
- Sparse pubic hair
- Hematologic
- Anemia
- Leukocytosis
- Dermatologic
- Hair loss
- Pretibial myxedema
- Warm, moist skin
- Palmar erythema
- Onycholysis
Differential Diagnosis
Diagnosis
Workup
- Decreased TSH
- Increased free T4
- Increased free T3
Management
- Beta-antagonists
- Methimazole
- Propylthiouracil
- Radioactive iodine
- Surgery