甲亢英文讲课课件.ppt

Hyperthyroidism Department of endocrinology and metabolism Renji Hospital Hyperthyroidism Definition: A clinical syndrome is brought about by thyroid hormone overproduction of various causes. Graves disease Thyroid hormone overproduction AutoImmune (TSI - TSH-R Ab) mediated Graves disease Featured as: Hyperthyroidism Autoimmune mediated Diffuse goiter Exophthalmos Pretibial myexedema Graves disease Thyroid manifestations of Graves disease diffuse toxic goiter Extrathyroidal manifestations of Graves disease Ophthalmopathy Dermopathy Clinical Manifestations Hyperthyroidism - common to any cause of thyrotoxicosis Autoimmune mediated - specific for Graves disease Diffuse goiter Exophthalmos Pretibial myexedema Clinical Manifestations The clinical presentation depends on the severity of thyrotoxicosis, the duration of the disease, individual susceptibility to excess thyroid hormone, and the age of the patient. Symptoms of hypermetabolism unexplained weight loss, despite an enhanced appetite sweating and heat intolerance, particularly during warm weather, Symptoms of sympathetic hyperactivity hyperactivity, nervousness, and irritability Insomnia and impaired concentration Fine tremor hyperreflexia, muscle wasting, and proximal myopathy without fasciculation. Gastrointestinal : Gastrointestinal transit time is decreased, leading to increased stool frequency, often with diarrhea and occasionally mild steatorrhea. Sex: Women frequently experience oligomenorrhea or amenorrhea; in men there may be impaired sexual function and, rarely, gynecomastia. bone: osteopenia in long-standing thyrotoxicosis cardiovascular manifestation palpitations (sinus tachycardia, supraventricular tachycardia, Atrial fibrillation ) a bounding pulse, widened pulse pressure, and an aortic systolic murmur (due to high cardiac output ) worsening of angina or heart failure in the elderly or those with preexisting heart disease. Diffuse goiter Thyroid is usual