Hypothyroidism: Difference between revisions
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! align="center" style="background:#DCDCDC;" |[[Serum glucose]] | ! align="center" style="background:#DCDCDC;" |[[Serum glucose]] | ||
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=== Symptoms === | === Symptoms === | ||
cold intolerance | {| class="wikitable" | ||
! | |||
!Constituitional | |||
!Local | |||
!Reproductive | |||
!Neuropsysiological | |||
!Others | |||
!Physical exam | |||
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|cold intolerance | |||
puffiness | puffiness | ||
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coarse skin | coarse skin | ||
obstructive sleep apnea (secondary to macroglossia) | hypothermia | ||
Fever if accompanied by thyroiditis | |||
weight gain | |||
coarse, brittle, straw like hair with hair loss | |||
|obstructive sleep apnea (secondary to macroglossia) | |||
|Females can present with galactorrhea and menstrual disturbances | |||
|depression | |||
|paresthesia and nerve entrapment syndromes | |||
|decreased systolic blood pressure | |||
increased diastolic blood pressure | |||
bradycardia | |||
pericardial effusion | |||
abdominal distension | |||
ascites (uncommon) | |||
non-pitting edema (myxedema) | |||
pitting edema of lower extremities | |||
hyporeflexia with delayed relaxation | |||
ataxia | |||
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|fullness and pain in the throat and neck | |||
|infertility | |||
|emotional lability | |||
|constipation | |||
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* hoarseness | * hoarseness | ||
* sore throat | * sore throat | ||
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|blurred vision | |||
|macroglossia | |||
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|goiter | |||
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|Attention deficit | |||
|periorbital puffiness; | |||
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|slowed speech and movements | |||
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* Metabolic abnormalities associated with hypothyroidism include: | * Metabolic abnormalities associated with hypothyroidism include: | ||
** anemia, | ** anemia, |
Revision as of 14:53, 10 July 2017
For patient information click here
Hypothyroidism Main page |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]
Synonyms and keywords: Myxedema; myxoedema; thyroid activity decreased; hypothyroid
Overview
Classification
- Primary hypothyroidism
- Congenital hypothyroidism 17512233
- Autoimmune (Hashimoto's) thyroiditis
- Iodine deficeincy
- Drug induced thyroiditis
- Amiodarone
- Lithium
- Thionamide
- Iodine
- Iterferon
- Sunitinib
- Rifampicin
- Thalidomide
- Thyroidectomy
- Radioiodine therapy
- Transient hypothyroidism 9294788
- Subacute (de Quervain’s) thyroiditis
- Postpartum thyroiditis
Secondary hypothyroidism
Tertiary hypothyroidism
Differential diagnosis
Disease | History and symptoms | Laboratory findings | Additional findings | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Serum glucose | Urinary Glucose | Urine PH | Serum Sodium | Urinary Glucose | 24 hrs cortisol level | C-peptide level | Serum glucagon | |||||||
Primary hypothyroidism | + | + | + | + | - | ↑ | ↑ | Normal | Normal | N/↑ | Normal | ↓ | Normal | Auto antibodies present
(Anti GAD-65 and anti insulin anti bodies) |
Transient hypothyroidism | + | + | + | + | - | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | ↑ | Acanthosis nigricans |
+ | + | + | - | + | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | N | - | |
+ | + | - | - | - | Normal | Normal | Normal | ↓ | Normal | Normal | Normal | Normal | - | |
+ | + | - | - | - | Normal | Normal | Normal | ↑ | Normal | Normal | Normal | Normal | - | |
Transient hyperglycemia | - | - | - | - | - | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | N/↑ | In hospitalized patients especially in ICU and CCU |
Steroid therapy | + | - | - | - | + | ↑ | ↑ | Normal | Normal | ↑ | ↑ | N/↑ | N/↑ | Acanthosis nigricans, |
RTA 1 | - | - | - | + | - | Normal | Normal | ↑ | Normal | ↑ | Normal | Normal | Normal | Hypokalemia, nephrolithiasis |
Glucagonoma | - | - | - | - | - | ↑ | Normal | Normal | Normal | - | Normal | Normal | ↑ | Necrolytic migratory erythema |
Cushing syndrome | - | - | - | - | + | ↑ | - | Normal | ↓ | N/↑ | ↑ | Normal | Normal | Moon face, obesity, buffalo hump, easy bruisibility |
General feature
Symptoms
Constituitional | Local | Reproductive | Neuropsysiological | Others | Physical exam | |
---|---|---|---|---|---|---|
cold intolerance
puffiness decreased sweating coarse skin hypothermia Fever if accompanied by thyroiditis weight gain coarse, brittle, straw like hair with hair loss |
obstructive sleep apnea (secondary to macroglossia) | Females can present with galactorrhea and menstrual disturbances | depression | paresthesia and nerve entrapment syndromes | decreased systolic blood pressure
increased diastolic blood pressure bradycardia pericardial effusion abdominal distension ascites (uncommon) non-pitting edema (myxedema) pitting edema of lower extremities hyporeflexia with delayed relaxation ataxia | |
fullness and pain in the throat and neck | infertility | emotional lability | constipation | |||
|
blurred vision | macroglossia | ||||
goiter | Attention deficit | periorbital puffiness; | ||||
slowed speech and movements |
- Metabolic abnormalities associated with hypothyroidism include:
- anemia,
- dilutional hyponatremia,
- hyperlipidemia,
- reversible increase in creatinine
Complications
Myxedema coma
Rare, severe form of hypothyroidism, a life-threatening condition
- Altered mental status,
- hypothermia,
- bradycardia,
- hypercarbia, and
- hyponatremia.
- Cardiomegaly,
- pericardial effusion,
- cardiogenic shock, and
- ascites
- commonly occurs in individuals with undiagnosed or untreated hypothyroidism who is subjected to an external stress, such as low temperature, infection, or medical intervention (e.g., surgery or hypnotic drugs)