Ross D S
Thyroid Unit, Massachusetts General Hospital, Boston, Massachusetts, USA.
Endocrinol Metab Clin North Am. 1998 Mar;27(1):169-85. doi: 10.1016/s0889-8529(05)70305-4.
It is very important to diagnose correctly the etiology of thyrotoxicosis, because the course and treatment of thyrotoxicosis with low radioactive iodine uptake differ significantly from that of hyperthyroidism due to Graves' disease or toxic nodular goiter. Many causes of subacute thyroiditis have been identified producing a characteristic course of transient hyperthyroidism, followed by hypothyroidism, and usually recovery. Ectopic hyperthyroidism includes factitious thyroid hormone ingestion, struma ovarii, and, rarely, large deposits of functioning thyroid cancer metastases. Iodine-induced hyperthyroidism may be associated with low radioiodine uptakes. Amiodarone-associated hyperthyroidism may be the result of subacute thyroiditis or iodine-induced hyperthyroidism; assessment and treatment can be quite challenging.
正确诊断甲状腺毒症的病因非常重要，因为放射性碘摄取低的甲状腺毒症的病程和治疗与格雷夫斯病或毒性结节性甲状腺肿所致的甲状腺功能亢进症有显著差异。已确定亚急性甲状腺炎的许多病因会产生短暂性甲状腺功能亢进、继而甲状腺功能减退且通常会恢复的特征性病程。异位甲状腺功能亢进包括人为摄入甲状腺激素、卵巢甲状腺肿，以及很少见的大量功能性甲状腺癌转移灶。碘致甲状腺功能亢进症可能与放射性碘摄取低有关。胺碘酮相关性甲状腺功能亢进症可能是亚急性甲状腺炎或碘致甲状腺功能亢进症的结果；评估和治疗颇具挑战性。
