Sterling Pc

Subclinical Hyperthyroidism Cheryl P. Sterling, MD, MPH VCU/MCV Hospitals February 20, 2003

Case Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Question ,[object Object],[object Object]

The Thyroid ,[object Object],[object Object],[object Object],[object Object]

Common Signs/Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Subclinical Hyperthyroidism Goiter Exophthalmos

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Shrier, D.K., Burman, K.D. American Family Physician , 2002; 65(3). Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705.

Biochemical Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ladneson, et al. Arch Intern Med , 2000; 160: 1573-1575. Supit, et al. South Med J , 2002; 95(5):481-485.

Diagnostic Assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagram of thyroid testing www.medscape.com/viewarticle/433852

Evidence-based Research? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Toft, A.D. New England Journal of Medicine , 2001; 345(7):512–516. Shrier, D.K., Burman, K.D. American Family Physician , 2002; 65(3).

Short/Long-term Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705. Shrier, D.K., Burman, K.D. American Family Physician , 2002; 65(3).

Adverse Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705. Kalmijn, S., Mehta, K.M., et al. Clinical Endocrinology (Oxf) , 2000; 53: 733-737.

Journal Article ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sawin, C.T., Geller, A., et al. New England Journal of Medicine , 1994; 331(19): 1249-1252.

Results Sawin, C.T., Geller, A., et al. New England Journal of Medicine , 1994; 331(19): 1249-1252.

Journal Article ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705.

Results Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705. ,[object Object],[object Object],[object Object],[object Object]

Conclusions ,[object Object],[object Object],[object Object],Biondi, B., et al. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705.

Subclinical Hyperthyroidism Prevention of atrial fibrillation and osteoporosis are the main potential benefits of treating subclinical hyperthyroidism. Treatment options include: - Beta-blockers - Antithyroid medications - Radioactive iodine ( 131 I) - Surgery - Close clinical follow-up

Subclinical Hyperthyroidism ,[object Object],[object Object],[object Object],[object Object],Toft, A.D. New England Journal of Medicine , 2001; 345(7):512–516. Ladneson, et al. Arch Intern Med , 2000; 160: 1573-1575. Helfand, M., Redfern, C.C. Annals of Internal Medicine , 15 July 1998. 129:141-143, 144-158.

Subclinical Hyperthyroidism ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Shrier, D.K., Burman, K.D. American Family Physician , 2002; 65(3).

The Answer (To My Clinical Question) ,[object Object],[object Object],[object Object],[object Object],[object Object]

References Biondi, B., Palmieri, E.A., Fazio, S., et al. Endogenous Subclinical Hyperthyroidism Affects Quality of Life and Cardiac Morphology and Function in Young and Middle-Aged Patients. Journal of Clinical Endocrinology and Metabolism , 2000; 85(12):4701-4705. Helfand, M., Redfern, C.C. Screening for Thyroid Disease: An Update (Parts 1 & 2). Annals of Internal Medicine , 15 July 1998. 129:141-143, 144-158. Kalmijn, S., Mehta, K.M., Pols, H.A.P., Hofman, A., et al. Subclinical hyperthyroidism and the risk of dementia. The Rotterdam Study. Clinical Endocrinology (Oxf) , 2000; 53: 733-737. Ladneson, et al. ATA guidelines for Detection of Thyroid Dysfunction. Archives of Internal Medicine , 2000; 160: 1573-1575. Sawin, C.T., Geller, A., Wolf, P.A., Belanger, A.J., et al. Low Serum Thyrotropin Concentrations as a Risk Factor for Atrial Fibrillation in Older Persons. New England Journal of Medicine , 1994; 331(19): 1249-1252.

References Shrier, D.K., Burman, K.D. Subclinical Hyperthyroidism: Controversies in Management. American Family Physician , 2002; 65(3). Supit, et al. Interpretation of Laboratory Thyroid Function Tests for the Primary Care Physician. Southern Medical Journal , 2002; 95(5):481-485. Toft, A.D. Subclinical hyperthyroidism. New England Journal of Medicine , 2001; 345(7):512–516. Utiger, R.D. Subclinical Hyperthyroidism – Just a Low Serum Thyrotropin Concentration, or Something More? New England Journal of Medicine , 1994; 331(19): 1302-1303.

Sterling Pc

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (6)

Similar to Sterling Pc

Similar to Sterling Pc (20)

More from MedicineAndHealthCancer

More from MedicineAndHealthCancer (20)

Recently uploaded

Recently uploaded (20)

Sterling Pc