New concepts for Medical Management of Hyperthyroidism
New concepts for
Medical Management
of Hyperthyroidism
Fereidoun Azizi
Research Institute for Endocrine Sciences
Shahid Beheshti University of Medical Sciences
12th ICED, Tehran, Iran, Nov. 14-16, 2018
CONTENT
- Causes
- Symptomatic treatment
- Management of thyrotoxicosis
- Side effects of antithyroids
- Choice of antithyroid drugs
- Graves’ orbitopathy
- Factors affecting relapse
- Long-term antithyroid treatment
- Conclusion
Causes of Thyrotoxicosis
- Thyrotoxicosis associated with a normal or elevated RAI uptake over the neck
Graves’ Disease
TA or TMNG
Trophoblastic disease
TSH-producing pituitary adenomas
Resistance to thyroid hormone (T3 receptor β mutation)
- Thyrotoxicosis associated with a near-absent RAI uptake over the neck
Painless (silent) thyroiditis
Aminodarone-induced thyroiditis
Subacute (granulomatous, de Quervain’s) thyroiditis
Palpation thyroiditis
Iatrogenic thyrotoxicosis
Factitious ingestion of thyroid hormone
Struma ovarii
Acute thyroiditis
Extensive metastases from follicular thyroid cancer
TSH receptor antibody functionality in GD
- TSAb, like TSH, bind primarily to the large amino terminal ectodomain of the TSH-R and activate the cAMP signal transduction pathway leading to stimulation of thyroid hormone production and proliferation of thyrocytes.
