Hipotiroidismo

Hipotiroidismo
Hipotiroidismo
Estrutura molecular da tiroxina, cuja deficiência causa os sintomas de hipotiroidismo
Sinónimos Tiroide hipoativa
Especialidade Endocrinologia
Sintomas Diminuição da tolerância ao frio, cansaço, obstipação, depressão, aumento de peso[1]
Complicações Durante a gravidez pode resultar em cretinismo no bebé[2]
Início habitual > 60 anos de idade[1]
Causas Deficiência de iodo, tiroidite de Hashimoto[1]
Método de diagnóstico Análises ao sangue (hormona estimulante da tiroide, tiroxina)[1]
Condições semelhantes Depressão, demência, insuficiência cardíaca, síndrome da fadiga crónica[3]
Prevenção Sal iodado[4]
Tratamento Levotiroxina[1]
Frequência 0,3–0,4% (EUA)[5]
Classificação e recursos externos
CID-10 E03.9
CID-9 244.9
CID-11 1722092627
DiseasesDB 6558
MedlinePlus 000353
eMedicine med/1145
MeSH D007037
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Hipotiroidismo (português europeu) ou hipotireoidismo (português brasileiro) é uma doença do sistema endócrino em que a glândula tiroide não produz hormonas da tiroide em quantidade suficiente.[1] A condição pode causar uma série de sintomas, como a falta de tolerância ao frio, fadiga, obstipação, depressão e ganho de peso.[1] Em alguns casos pode ocorrer aumento de volume da parte da frente do pescoço devido a um bócio.[1] Se o hipotiroidismo durante a gravidez não for tratado, pode causar atrasos no crescimento e desenvolvimento intelectual do bebé, uma condição denominada cretinismo.[2]

A causa mais comum de hipotiroidismo na generalidade do mundo é a deficiência de iodo na dieta.[5][6] Nos países com iodo suficiente na dieta, a principal causa da doença é uma doença autoimune denominada tiroidite de Hashimoto.[1] Entre as causas menos comuns estão um tratamento anterior com iodo radioativo, lesões no hipotálamo ou na adenoipófise, determinados medicamentos, hipotiroidismo congénito ou uma anterior cirurgia à tiroide.[1][7] A suspeita de um diagnóstico de hipotiroidismo pode ser confirmada com análises ao sangue, que avaliam os valores de hormona estimulante da tiroide (TSH) e tiroxina.[1] O hipotiroidismo sub-clínico é uma forma pouco grave de hipotiroidismo caracterizada por valores de tiroxina normais e valores de TSH acima do normal.[5]

A prevenção ao nível da população em geral tem sido feita com a iodização do sal.[4] O hipotiroidismo pode ser tratado com a hormona sintética levotiroxina. A dose é ajustada de acordo com os sintomas e da normalização dos valores da tiroxina e de TSH. A medicação para a tiroide é segura durante a gravidez. Embora seja importante alguma quantidade de iodo na dieta, o iodo em excesso pode agravar determinados tipos de hipotiroidismo.[1]

Estima-se que em todo o mundo haja mil milhões de pessoas com deficiência de iodo. No entanto, desconhece-se qual a percentagem que resulta em hipotiroidismo.[8] Nos Estados Unidos, o hipotiroidismo afeta 0,3–0,4% das pessoas.[5] Estima-se que o hipotiroidismo sub-clínico ocorra em 4,3–8,5% das pessoas nos Estados Unidos.[5] O hipotiroidismo é mais comum entre mulheres do que em homens.[1] As pessoas com mais de 60 anos são afetadas com maior frequência.[1] A doença também ocorre em cães e, em casos raros, gatos e cavalos.[9] O termo "hipotiroidismo" tem origem no grego hypo- ("diminuído"), thyreos ("escudo") e eidos ("forma)"[10]

Ver também

Referências

  1. a b c d e f g h i j k l m n «Hypothyroidism». National Institute of Diabetes and Digestive and Kidney Diseases. Março de 2013. Consultado em 5 de março de 2016 
  2. a b Preedy, Victor (2009). Comprehensive Handbook of Iodine Nutritional, Biochemical, Pathological and Therapeutic Aspects. Burlington: Elsevier. p. 616. ISBN 9780080920863 
  3. Ferri, Fred F. (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders 2nd ed. Philadelphia, PA: Elsevier/Mosby. p. Chapter H. ISBN 978-0323076999 
  4. a b Syed, S (Abril de 2015). «Iodine and the "near" eradication of cretinism.». Pediatrics. 135 (4): 594–6. PMID 25825529. doi:10.1542/peds.2014-3718 
  5. a b c d e Garber, JR; Cobin, RH; Gharib, H; Hennessey, JV; Klein, I; Mechanick, JI; Pessah-Pollack, R; Singer, PA; et al. (Dezembro de 2012). «Clinical Practice Guidelines for Hypothyroidism in Adults» (PDF). Thyroid. 22 (12): 1200–1235. PMID 22954017. doi:10.1089/thy.2012.0205 
  6. Chakera, AJ; Pearce, SH; Vaidya, B (2012). «Treatment for primary hypothyroidism: current approaches and future possibilities». Drug Design, Development and Therapy (Review). 6: 1–11. PMC 3267517Acessível livremente. PMID 22291465. doi:10.2147/DDDT.S12894 
  7. Persani, L (Setembro de 2012). «Clinical review: Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges». The Journal of Clinical endocrinology and Metabolism (Review). 97 (9): 3068–78. PMID 22851492. doi:10.1210/jc.2012-1616 
  8. Cooper, DS; Braverman LE, eds. (2012). Werner & Ingbar's the thyroid : a fundamental and clinical text 10th ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. p. 552. ISBN 145112063X 
  9. «Hypothyroidism». Merck Veterinary Manual, 10th edition (online version). 2012. Consultado em 25 de dezembro de 2013 
  10. Mosby's Medical Dictionary 9 ed. [S.l.]: Elsevier Health Sciences. 2013. p. 887. ISBN 9780323112581 

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