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Modern endocrinological diagnostics of thyroid gland disorders

Publication at Second Faculty of Medicine |
2010

Abstract

Thyroid disorders represent 5-7% of all human diseases, but more than 90% of endocrine diseases and women are affected 4-6-times for often than men. From clinical point of view thyreopathies are distinguished to disorders of hormonal production and to morphological defects.

The diagnosis of thyroid function disorder is based on the determination of levels of thyroid hormones fT3, fT4 and TSHss in serum. Primary hypothyreosis is characterized by decreased fT4 and elevated TSH.

The syndrome of low T3 belongs to protective reactions of the organism with the conversion of T4 by peripheral deiodinase (Type III) to hormonally ineffective reverse triiodothyronine (rT3). In primary hypothyreosis we observed higher fT3, fT4 and even unmeasurably low level of TSH.

Acute thyroiditis: signs of inflammation ad normal thyroidal function, anti-TPO and anti-TG are not elevated. Subacute thyroiditis is characterized with inflammation, normal anti-TPO, anti-TGL, hyperthyreosis may also be present.

Chronic thyroiditis, Hashimoto struma belongs to the most frequent causes of hypothyreosis in our conditions and it is usually recognized due to high levels of anti-TPO and anti-TG and higher TSHss. Thyroidal adenomas and carcinomas are usually clinically of euthyroid character.

The determination of tumor markers is necessary - thyreoglobulin in papillary and follicular tumor and calcitonin in medullar carcinoma, where a genetic examination (determination of germline point mutations, most often by PCR method) is required.