Kannan C R, Seshadri K G
Department of Medicine, Rush University, Chicago, Illinois, USA.
Dis Mon. 1997 Sep;43(9):601-77.
Thyrotoxicosis is a clinical syndrome caused by circulation of excess thyroid hormones. Classic hyperkinetic thyrotoxicosis is readily recognizable. Atypical presentations, however, can lead to diagnostic dilemmas. The sensitive thyroid-stimulating hormone assay has become an invaluable tool in the diagnosis of thyrotoxicosis. Causes of thyrotoxicosis include Graves' disease, toxic multinodular goiter, toxic adenoma, thyroiditis, inappropriate secretion of thyroid-stimulating hormone, trophoblastic tumor, exposure to iodine, and use of drugs. Increased uptake of radioidine by the thyroid gland differentiates true hyperthyroidism from other causes of thyrotoxicosis. Graves' disease is the most common cause of hyperthyroidism. It is caused by antibodies to the thyroid-stimulating hormone receptor that are stimulatory in nature. Extrathyroidal manifestations of Graves' disease include orbitopathy, dermopathy, and acropachy. Therapy includes thionamides, radioactive iodine, surgical intervention, and other adjunctive modalities. Thyroid storm is a medical emergency that necessitates prompt and aggressive therapy.
甲状腺毒症是一种由过量甲状腺激素循环引起的临床综合征。典型的运动亢进型甲状腺毒症很容易识别。然而，非典型表现可能导致诊断困境。敏感的促甲状腺激素检测已成为诊断甲状腺毒症的一项宝贵工具。甲状腺毒症的病因包括格雷夫斯病、毒性多结节性甲状腺肿、毒性腺瘤、甲状腺炎、促甲状腺激素分泌不当、滋养细胞瘤、碘暴露和药物使用。甲状腺对放射性碘摄取增加可将真正的甲状腺功能亢进与其他甲状腺毒症病因区分开来。格雷夫斯病是甲状腺功能亢进最常见的病因。它由本质上具有刺激性的促甲状腺激素受体抗体引起。格雷夫斯病的甲状腺外表现包括眼病、皮肤病和杵状指。治疗方法包括硫代酰胺类药物、放射性碘、手术干预和其他辅助治疗手段。甲状腺危象是一种医疗急症，需要迅速且积极的治疗。
