Hyperthyroidism - PowerPoint PPT Presentation

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Hyperthyroidism

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Hyperthyroidism is a very common name, when it comes to lifestyle diseases. Often a deeper and holistic approach towards your health will help you find long term solution, and hence you will be able to recognize your symptoms of Hyperthyroidism. Your thyroid gland, when starts secreting more amount of hormone, the condition is referred as hyperthyroidism. Thereby speeding up the bodily functions, including metabolism. – PowerPoint PPT presentation

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Title: Hyperthyroidism


1
HYPERTHYROIDISM
2
INTRODUCTION
  • Hyperthyroidism, also known as Thyrotoxicosis, is
    the clinical syndrome that results from elevated
    concentrations of free thyroid hormone in the
    plasma, associated with clinical evidence of
    hypermetabolism.

3
CAUSES
4
GRAVES DISEASE (GD)
  • GD is overall the most common cause of
    Hyperthyroidism. GD is caused by a generalized
    over activity of the entire thyroid gland
    (Hyperthyroidism).
  • GD is an autoimmune disorder in which Thyroid
    Receptor Antibodies (TRAbs) stimulate the TSH
    receptor, increasing thyroid hormone production.

5
Prevalance
  • Women are more frequently affected by Graves
    Disease than men by a 51 ratio. TRAbs are
    present in 70-100 of Graves Disease (85-100
    for activating antibodies and 75-96 for blocking
    antibodies).
  • The prevalence of hyperthyroidism has been
    studied in several studies in India.
  • In an epidemiological study from Cochin,
    Subclinical and Overt Hyperthyroidism were
    present in 1.6 and 1.3 of subjects
    participating in a community survey.
  • In a hospital-based study of women from
    Pondicherry, Subclinical and Overt
    Hyperthyroidism were present in 0.6 and 1.2 of
    subjects.

6
Pathogenesis
  • The Hyperthyroidism of Graves Disease is caused
    by Thyroid stimulating immunoglobulin that are
    synthesised in the thyroid gland as well as in
    bone marrow and lymphnodes. A combination of
    environmental and genetic factors, including
    polymorphism in HLA- DR, CTLA-4, CD25, PTPN22
    TSH-R contribute to Graves Disease
    susceptibility. Cytokines appear to play a major
    role in thyroid-associated opthalmopathy.

7
Clinical Manifestations
8
Laboratory Evaluations
  • In Graves Disease, the TSH level is suppressed
    total and unbound thyroid hormone levels are
    increased. In 2-5 of patients, only T3 is
    increased (T3 toxicosis).
  •  Measurement of Thyroid receptor antibodies is
    the most reliable diagnostic method if the
    diagnosis is unclear clinically.

9
A SCHEME FOR EVALUATING SUSPECTEDHYPERTHYROIDISM
10
(No Transcript)
11
HYPERTHYROIDISM IN PREGNANCY
  • Graves disease is the most common cause of
    autoimmune hyperthyroidism in pregnancy,
    occurring in 0.11 (0.4 clinical and 0.6
    subclinical) of all pregnancies. More frequent
    than Graves disease as the cause of
    thyrotoxicosis is the syndrome of gestational
    hyperthyroidism defined as transient
    hyperthyroidism, limited to the first half of
    pregnancy characterized by elevated FT4 and
    suppressed or undetectable serum TSH, in the
    absence of serum markers of thyroid
    autoimmunity . It is diagnosed in about 13
    of pregnancies, depending on the geographic area
    and is secondary to elevated hCG
    levels. Determination of TSH receptor antibody
    (TRAb) is indicated for differentiating
    gestational hyperthyroidism from Graves
    hyperthyroidism in pregnancy.

12
Fetal risks for women with active Graves
hyperthyroidism are
  • 1) fetal hyperthyroidism
  • 2) neonatal hyperthyroidism
  • 3) fetal hypothyroidism
  • 4) neonatal hypothyroidism
  • 5) central hypothyroidism

13
Recommendation
  • If the patient has a past or present history of
    Graves disease, a maternal serum determination
    of TRAb should be obtained at 2024 weeks
    gestation for determining the risk of Neonatal
    Thyrotoxicosis.

TEST RANGE AVAILABLE
14
CLINICAL REFERENCE
  • Harrisons Principles of internal Medicine,
    18th Edition
  • Guidelines of the American Thyroid Association
    for the Diagnosis and Management of Thyroid
    disease during Pregnancy Postpartum, 2011
  • Tietz Textbook of Clinical Biochemistry, Fifth
    Edition
  • For more information about Health Disease visit
    https//www.lalpathlabs.com/
  • HYPOTHYROIDISM

15
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