Download Thyroid Disorders Basic Science and Clinical Practice PDF

TitleThyroid Disorders Basic Science and Clinical Practice
TagsHypothyroidism Hyperthyroidism Thyroid Thyroid Stimulating Hormone Thyroid Disease
File Size7.5 MB
Total Pages327
Table of Contents
                            Preface
Acknowledgments
Editors
Contents
Contributors
Part I: Fundamental Concepts
	1: Thyroid: A General Overview
		Introduction
		Thyroid Gland: Basic Structure
		Thyroid Dysfunction: Distribution and Burden
		Classification of Thyroid Dysfunction
		Thyroid Dysfunction and Health Issues
		Screening for Thyroid Disorders
		Accuracy of Screening Tests
		The USPSTF: Summary of Recommendation
		Recommendations of Other Authorities
		Conclusion
		References
	2: Functions of Thyroid Hormones
		Introduction
		Thyroid Hormone Synthesis
			Steps Involved in Synthesis of Thyroid Hormones
			Role of Iodine in Thyroid Hormone Synthesis and Function
				Wolff- Chiakoff Effect
			Central Regulation of Thyroid Hormone Synthesis: The ‘Hypothalamic –Pituitary- Thyroid Axis’
				Production of TRH
				Hypophysiotropic and Non-­hypophysiotropic Neurons
				Role of Autonomic Nervous System in Regulation of Thyroid Function
				Inactivation of Secreted TRH
				Negative Feedback Regulation of Hypophysiotropic TRH Neurons
				Deiodinases and Their Role in Negative Feedback Regulation
			Role of Thyroid Hormone Transporters in Secretion of Ths
		Thyroid Hormones- Mechanism of Action
			Genomic Pathways
			Non-genomic Pathways
		Thyroid Hormone Functions
			Role in Brain Development
			Effect on Myocardium
			Effect on Bone
			Effect on Adipose Tissue
			Effect on Liver
			Effect on Pituitary
			Effect on Fetal Growth and Maturation
				Effect on Growth
				Effect on Fetal Metabolism (Oxygen (O2) Consumption)
				Effect on Fetal Tissue Maturation
				Effect on Lung Maturation
				Effect on Fetal Heart and Cardiovascular System
			Other Important Effects
		Conclusion
		References
	3: Iodine and the Thyroid
		Introduction
		Epidemiology
		Definition of IDD and Its Impact on Health and on the Population
		Iodine Chemistry
		Iodine Ecology and Cycle
		Food Sources of Iodine
		Iodine Metabolism
		Toxic Effects of Iodine Excess
		Diagnosis of Iodine Deficiency
		IDD Prevention and Treatment
		Impact of Iodine Supplementation in Deficient Populations
		Conclusion
		References
	4: The Role of Thyroid Hormones in Neural Development
		Introduction
		Thyroid Hormone Synthesis and Secretion
		Thyroid Hormone Transport, Uptake and Metabolism
		Disruption of Brain Development by Thyroid Hormone Depletion
		Effects of Thyroid Hormones on Neural Cell Proliferation and Differentiation
		Non-genomic and Mitochondrial Effects of Thyroid Hormones
		Conclusion
		References
	5: Autoimmune Thyroid Disease (Flajani-Parry-Graves-von Basedow Disease): Etiopathogenesis, Clinical Manifestations and Diagnosis
		Introduction
		Background and History
		Epidemiology
		Genetics and Etiopathogenesis
		Clinical Manifestations
		Clinical Diagnosis
		Laboratory Diagnosis
		Imaging Diagnosis
		Histopathological Diagnosis
		Conclusions
		Bibliography
Part II: Thyroid Dysfunction and Clinical Application
	6: Thyroiditis
		Introduction
		Thyroiditis Without Thyroid Pain and Tenderness
			Hashimoto’s Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Painless Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Postpartum Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Amiodarone-Associated Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Thyroiditis Induced by Other Drugs
			Lithium
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features, Diagnostic Evaluation and Differential Diagnosis
				Treatment
			Interferon-alpha
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features, Diagnostic Evaluation and Differential Diagnosis
				Treatment
			Interleukin-2
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features, Diagnostic Evaluation and Differential Diagnosis
				Treatment
			Tyrosine Kinase Inhibitors
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features, Diagnostic Evaluation, Differential Diagnosis
				Treatment
			Riedel’s Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Infiltrative Thyroid Disorders
		Thyroiditis with Thyroid Pain and Tenderness
			Subacute Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Suppurative Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Radiation-Induced Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
			Palpation or Trauma-Induced Thyroiditis
				Epidemiology
				Etiology and Pathogenesis
				Clinical Features
				Diagnostic Evaluation
				Differential Diagnosis
				Treatment
		Conclusion
		References
	7: Hypothyroidism
		Introduction
		Historical
		Definitions
		Epidemiology
		Etiology
			Primary Hypothyroidism
				Hashimoto’s Thyroiditis
				Iodine Deficiency
				Iodine Excess
				Iatrogenic
				Drugs
				Thyroid Infiltration and Infections
				Transient Hypothyroidism
				Primary Congenital Hypothyroidism
			Central Hypothyroidism
				Acquired Pituitary and Hypothalamic Disorders
				Central Congenital Hypothyroidism
				Drugs
			Other Disorders
				Resistance to Thyroid Hormone
				Consumptive Hypothyroidism
		Clinical Features
			Skin and Appendages
			Cardiovascular
			Respiratory
			Gastrointestinal
			Neurologic
			Musculoskeletal
			Renal
			Hematopoietic
			Endocrine
			Reproductive
			Energy Metabolism
		Course of the Disease
			Primary Hypothyroidism
			Central Hypothyroidism
			Hypothyroidism in Infants and Children
		Screening
			Congenital Hypothyroidism
			Acquired Hypothyroidism
		Diagnosis
		Differential Diagnosis
			Primary Hypothyroidism
			Central Hypothyroidism
		Treatment
			Primary Overt Hypothyroidism
				L-T4 Monotherapy
				Combination T4 and T3 Therapy
				L-T3 Monotherapy
				Desiccated Thyroid
				Compounded Thyroid Hormones
				Dietary Supplements, Nutraceuticals and Other Over-the-Counter Products
			Central Hypothyroidism
			Congenital Hypothyroidism
		Conclusion
		References
	8: Hyperthyroidism
		Introduction
		Etiology
			Graves Disease
				Epidemiology
				Pathophysiology and Genetic Interplay
				Other Associated Autoimmune Diseases
				Graves Ophthalmopathy
			Other Causes of Hyperthyroidism
				Toxic Multinodular Goiter (Plummer Disease)
				Toxic Adenoma
				Thyroiditis
				Drug-Induced Hyperthyroidism
				Tumors Induced Hyperthyroidism
				TSH-Secreting Pituitary Adenoma
				Hyperthyroidism Secondary to Thyroid Hormone Resistance
				Hyperthyroidism due to TSH-Receptor Mutations
		Clinical Features
			Features Related to Other Causes of Hyperthyroidism
			Apathetic Hyperthyroidism
		Diagnostic Modalities
			Hormonal Assays
			Antibodies
			Other Relevant Investigations
			Ultrasound
			Radioisotope Thyroid Scan
			Radioisotope Findings
			MRI/CT Scan
		Treatment
			Symptomatic Relief
			Diet and Activity
			Antithyroid Medications
			Adverse Effects of Thioamide Antithyroid Medications
			Radioactive Iodine 131 Ablation (RAI131)
			Other Less Commonly Used Antithyroid Medications
			Thyroidectomy
			Indications for Thyroidectomy
			Preparation for Thyroidectomy
			Adverse Effects of Thyroidectomy
				Postoperative Bleeding
				Infection
				Injury to the Recurrent Laryngeal Nerve
				Injury to the Superior Laryngeal Nerve
				Hypoparathyroidism
				Hypothyroidism
				Thyrotoxic Storm
			Follow up After Thyroid Surgery
			Cause-Specific Treatment
		Future Directions
		Conclusion
		References
	9: Autoimmune Thyroid Disease (Flajani-Parry-Graves-von Basedow Disease): An Overview of Treatment
		Introduction
		Anti-thyroid Medications
			Doses and Follow-up Regimes
			Adverse Reactions
		Radioactive Iodine Treatment
			I-131 Adverse Effects and Risk of Malignancy
		Surgical Treatment for GD
		Special Conditions
			Pregnancy
			Graves’ Eye Disease
			Pretibial Myxedema
		Conclusions
		Bibliography
	10: Subclinical Hyperthyroidism
		Introduction
			Causes
			Exogenous Subclinical Hyperthyroidism
			Endogenous Subclinical Hyperthyroidism
		Epidemiology and Natural History
		Clinical Findings
			Cardiovascular Mortality Risk
			Atrial Fibrillation
			Coronary Heart Disease, Heart Failure, and Other Cardiac Factors
			Cardiovascular Mortality
			Bone and Mineral Metabolism
			Dementia Cognitive Function
			Quality of Life
		Evaluation
		Diagnosis
		Pregnancy
		Screening Guidelines
		Management
			Patients on T4 for the Treatment of Hypothyroidism
			Patients on Suppressive Levothyroxine Therapy
			Endogenous Subclinical Hyperthyroidism
			Patients at High Risk for Complications
			Patients at Low Risk for Complications
			Treatment Options
		Conclusion
		References
	11: Subclinical Hypothyroidism
		Introduction
		Epidemiology
		Etiology
		Screening for Subclinical Hypothyroidism
		Diagnosis
		What Is the Upper Limit of Normal for the Serum TSH Level?
		Differential Diagnosis
		Evaluation
		Consequences of Subclinical Hypothyroidism
			Systemic Symptoms of Hypothyroidism
			Progression to Overt Hypothyroidism
			Cardiovascular Disease
			Cardiovascular Mortality
			Non-alcoholic Fatty Liver Disease
			Neuropsychiatric Symptoms
			Neuromuscular Dysfunction
			Potential Consequences
			Pregnancy
		Effects of Thyroid Hormone Replacement
			Hypothyroid Signs and Symptoms
			Cardiovascular Disease
			Serum Lipid and Apoprotein Concentrations
			Other Benefits
		Management of Subclinical Hypothyroidism
			Serum TSH Concentration of 3–5 mlu/l
			Serum TSH Concentration of 5.1–10 mlu/l
			Serum TSH Concentration Greater Than 10 mlu/l
			Candidates for T4 Replacement
			Thyroid Peroxidase Antibodies
			Arguments for Treatment
			Arguments Against Treatment
			Goals of Treatment
			Dose Modification Strategy
		Conclusion
		References
	12: Thyroid Emergencies
		True Thyroid Emergencies
			Thyroid Storm
				Pathophysiology
				Signs/Symptoms
				Establishing Diagnosis
				Scoring System
				Treatment
				Do and Don’ts/Things Not to Be Missed
				Follow Up of Patients
			Myxedema Coma
				Pathophysiology
				Establishing Diagnosis
				Signs/Symptoms
				Treatment
				Do and Don’t/What Not to Miss
				Follow Up of Patients
		Thyroid Dysfunction Requiring Urgent Measures
			Thyroid Dysfunction During Pregnancy
				Hyperthyroidism
				Hypothyroidism
			Neurological Presentation of Thyroid Disease
				Cognitive Disorders and Seizures
			Neuromuscular Emergencies
			Cardiovascular Emergencies
		Medication Exposure and Thyroid Emergencies
			Acute Iodine Exposure: Jod-Basedow Phenomenon/Wolff-Chaikoff Effect
			Lithium Intoxication
			Amiodarone-Induced Thyroid Emergencies
			Post RAI
			Thyroxine Overdose
		Conclusion
		References
	13: Thyroid Nodule
		Introduction
			Epidemiology
			Clinical Problem
		Clinical Evaluation
			History
			Physical Examination
				High Suspicion for Malignancy
				Moderate Suspicion for Malignancy
		Investigations
			Indications for Evaluation [22]
		Biochemical Tests
			Serum TSH
			Serum Thyroglobulin
			Serum Calcitonin
		Imaging
			Radionuclide Scanning
				Thyroid Ultrasound
			Other Imaging Studies
			Fine Needle Aspiration
		Treatment
		Overview of Treatment Options for Solitary Thyroid Nodules
			Surgery
			Radio-Iodine
			Percutaneous Ethanol Injection
			Levothyroxine
		Conclusion
		References
	14: Thyroid Cancer
		Introduction
		Calcification
		Differentiated Thyroid Cancers
			Papillary Cell Carcinoma
				Epidemiology
				Pathology
			Follicular Thyroid Carcinoma
				Epidemiology
				Pathology
				Molecular Biology of Differentiated Thyroid Cancer
				Diagnosis
				Investigations
				Treatment of Differentiated Thyroid Cancer
				Surgery
				Radioactive Iodine (RAI)
				TSH Suppression Therapy
				Long Term Management
				Treatment Options for Advanced DTC
				Novel Therapies
		Medullary Thyroid Cancer
			Epidemiology and Pathology
			Presentation and Diagnosis
			Treatment
		Anaplastic Thyroid Carcinoma
		Melignant Thyroid Lymphoma
		Conclusion
		References
	15: Thyroid Dysfunction and Mental Disorders
		Introduction
		Basic Concepts and Terminology
		Neurophysiology of Psychiatric Disorders
		Mood Disorders
		Antidepressant Effects on Thyroid Function
		Psychosis
		Cognitive Changes
		Anxiety Disorders
		Mechanism of Psychiatric Disorders Associated with Thyroid Dysfunction
		Psychiatric Management
		Outcome of Mental Disturbances
		Conclusion
		References
	16: Thyroid Dysfunction and Arrhythmias
		Introduction
		Genomic Action of Thyroid Hormone on Heart
		Non Genomic Action of Thyroid Hormone on Heart
			Electrophysiology and Mechanism of Action of T3 on the Atria
			Electrophysiology and Mechanism of Action of T3 on the Ventricles
		Relation Between Thyroid Hormone and Adrenergic System
		Mechanism Underlying the Effect of Thyroid Hormone (TH) on the Arrhythmogenesis
			Effects of Thyroid Hormones Excess on the Atrias
			Effects of Thyroid Hormones Excess on the Ventricles
		Supraventricular Arrhythmia
			Atrial Arrhythmia
				Hyperthyroidism
				Subclinical Hyperthyroidism and Atrial Fibrillation
				Hypothyroidism and Subclinical Hypothyroidism
				Euthyroid Range in Older Adults
				Should We Anticoagulate and Attempt Cardioversion in Those with AF?
				Arrhythmia and Amiodarone-Induced Hyperthyroidism
			Other Supraventricular Arrhythmia
		Ventricular Arrhythmia
			Hyperthyroidism
			Subclinical Hyperthyroidism
			Hypothyroidism
			Subclinical Hypothyroidism
		Conclusion
		References
Part III: Pregnancy and Thyroid Dysfunction
	17: Pregnancy and Hypothyroidism
		Introduction
			Physiologic Changes in Thyroid Function During Pregnancy
			Thyroid Function and the Fetus
			Subclinical Hypothyroidism During Pregnancy
			Thyroid Autoimmunity and Subclinical Hypothyroidism
			Hypothyroidism in Pregnancy
			Feto-maternal Risk
			Screening
		Diagnosis
			Indications for Thyroid Testing in Pregnancy [28]
		Treatment
			Thyroxine Replacement
			Iodine Replacement
			Monitoring Thyroid Status During Pregnancy
			Prognosis
			Preconception Counseling
		Conclusion
		References
	18: Pregnancy and Hyperthyroidism
		Introduction
		Clinical Features of Hyperthyroidism During Pregnancy
		Impact of Hyperthyroidism During Pregnancy
		Diagnosis of Hyperthyroidism During Pregnancy
		Establishing the Cause of Hyperthyroidism During Pregnancy
		Gestational Transient Thyrotoxicosis
		Graves’ Disease
			Pre-pregnancy Counseling
				Radioactive Iodine Ablation or Surgery
				Antithyroid Drugs [4, 6, 29]
				Incidence of Hyperthyroidism During Pregnancy
			Treating Graves’ Disease in Pregnancy
				Monitoring a Pregnant Woman on ATDs (Table 18.5)
				Natural Course of Graves’ Disease During Pregnancy
				Thyroidectomy for Graves’ Disease During Pregnancy
			Metarnal TRAb and Its Impact on the Fetus
			Fetal and Neonatal Hyperthyroidism
				Fetal Monitoring in a Woman with Graves’s Disease
			ATDs Use in Lactation
			Graves’ Disease in Post-partum Period
		Conclusion
		References
Index
                        

Similer Documents