Title Dijagnoza i terapija hipotireoze
Title (english) Diagnosis and treatment of hypothyroidism
Author Dora Franceschi
Mentor Zvonko Kusić (mentor)
Committee member Zlatko Giljević (predsjednik povjerenstva)
Committee member Nikola Đaković (član povjerenstva)
Committee member Zvonko Kusić (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Clinical Oncology) Zagreb
Defense date and country 2014-07-15, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Oncology
Abstract Hipotireoza je poremećaj hipometabolizma nastao zbog smanjene funkcije štitnjače
ili izostanka učinka hormona štitnjače u ciljnim stanicama. To je najčešći poremećaj funkcije
štitnjače uz učestalost 1-2% u žena i 0,2% u muškaraca. Prevalencija supkliničke hipotireoze
iznosi čak 5-20% u starijih žena. S obzirom na vrijeme nastanka hipotireoza može biti
kongenitalna ili stečena tijekom života, obzirom na endokrinu disfunkciju može biti
primarna, sekundarna ili tercijarna, a s obzirom na kliničku sliku može biti izražena, blaga ili
supklinička. Klinički simptomi i znakovi hipotireoze posljedica su smanjenog učinka
hormona štitnjače u perifernim tkivima. Opći simptomi i znakovi hipotireoze posljedica su
usporenog metabolizma, a to su osjećaj hladnoće, smanjeno znojenje, porast tjelesne težine,
opstipacija, slabost, iznemoglost, pospanost, usporeni pokreti i govor. Najčešći uzrok
hipotireoze jest kronični autoimuni tireoiditis ili Hashimotov tireoiditis. To je autoimuna
bolest štitnjače koja se manifestira limfocitnom infiltracijom i destrukcijom tkiva štitnjače.
Učestalost je veća u žena nego muškaraca (6 do 15 puta), životne dobi između 30 i 60 godina,
a rjeđa u djece i starijoj životnoj dobi. Određivanje tireotropina (TSH) u serumu prvi je test
za otkrivanje hipotireoze koji predlažu smjernice Hrvatskog društva za štitnjaču, kao i
smjernice drugih nacionalnih društava. TSH je najosjetljiviji test za otkrivanje blagog
(supkliničkog) poremećaja funkcije štitnjače, ali i odličan test probira na hipotireozu. U
Hrvatskoj se, kao i u većini zemalja, provodi novorođenački probir na hipotireozu
određivanjem vrijednosti TSH iz krvi pupkovine. Na taj je način riješen problem
kongenitalne hipotireoze i prateće fizičke i mentalne zaostalosti. Hipotireoza je trajno stanje
bez obzira na uzrok i zato zahtijeva doživotnu supstitucijsku terapiju. U liječenju hipotireoze
primjenjuju se preparati L-tiroksina u količini koja zadovoljava metaboličke potrebe,
najčešće u dozi 50-200 μg dnevno.
Abstract (english) Hypothyroidism is a common endocrine disorder caused by reduced thyroid
function, or lack of effect of thyroid hormone in target cells. An estimated 1-2% of women
and 0.2% of men have this common thyroid function disorder. The prevalence of subclinical
hypothyroidism is as high as 5-20% in older women. Women are six to fifteen times more
likely to develop hypothyroidism than men men. Occurence is less frequent in children and
the elderly. Hypothyroidism can be congenital or acquired during life. Due to endocrine
dysfunction it can be primary, secondary or tertiary, and according to the clinical picture
hypothyroidism presents as prominent, mild or subclinical. Clinical signs and symptoms of
hypothyroidism are caused by the decreased effect of thyroid hormones in peripheral tissues.
General symptoms and signs of include chills, decreased sweating, weight gain, constipation,
weakness, exhaustion, drowsiness, slowed movements and speech. The most common cause
of hypothyroidism is chronic autoimmune thyroiditis or Hashimoto's thyroiditis. It is an
autoimmune thyroid disease characterized by lymphocytic infiltration and destruction of
thyroid tissue. Measurement of serum thyrotropin (TSH) levels is the first test for the
detection of hypothyroidism according to Croatian Thyroid Society guidelines, as well as
other national guidelines. TSH is the most sensitive test for detecting mild (subclinical)
thyroid dysfunction, and an excellent screening test for hypothyroidism. In Croatia, as in
most countries, newborn screening for hypothyroidism is conducted by measuring TSH from
umbilical cord blood. This has led to the early identification of many cases and thus the
prevention of developmental delay. Hypothyroidism is a permanent condition, regardless of
cause, and therefore requires lifelong substitution therapy. Hypothyroidism is treated with Lthyroxine
in amounts which meet metabolic needs. Doses range from 50-200 mg daily and
are adjusted according to symptoms and normalization of thyroxine and TSH levels.
Keywords
štitnjača
hipotireoza
tireotropin
levotiroksin
Keywords (english)
thyroid
hypothyroidism
thyrotropin
L-thyroxine
Language croatian
URN:NBN urn:nbn:hr:105:608448
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2015-10-12 09:03:02