Via practica 4/2015

Hyperthyroidism from the perspective of clinician

Thyroid diseases affect at least 4 times more women than men. The patients represent over 80% of those searching for the outpatient care. Part of them suffer from some type of chronic inflammatory process, better the autoimmune, chronic thyroiditis, also known as the lymphocytic thyroiditis, the goiter of Hashimoto. A substantial percentage of the affected patients meet the criteria of the standard protocol as for the normal function. Scrutinizing laboratory parameters one can record suppressed TSH levels not exceptionally accompanied by increased levels of free thyroid hormones. Sometimes there might appear a danger of being stuck at an impasse due to inappropriately simplified differential-diagnostic approach. The possibility of inaccurate classification of the thyroid disease always exists with the resulting problems. We will try to outline the crucial issues of hyperthyroidism in the following lines with emphasis on the need for very careful diagnostic assessment. The end product of that process must be the correct and fair treatment plan including the timing of the final solution.

Keywords: thyrotropin (tsh), free thyroxin (ft4), free triiodothyronine (FT3), thyroperoxidase antibodies (anti-TPO), thyroglobulin antibodies (anti-hTG), TSH receptor antibodies (anti-rTSH), ulstrasonography (USG).