Medical Management of Thyroid Disease (Clinical Guides to by David S. Cooper

By David S. Cooper

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Extra info for Medical Management of Thyroid Disease (Clinical Guides to Medical Management)

Sample text

24 Sherman Additional tests are occasionally useful in establishing the diagnosis and etiology of thyrotoxicosis. , resting energy expenditure, systolic time intervals, angiotensin-converting enzyme, sex hormone–binding globulin, and cholesterol. Once the diagnosis is certain, the clinical presentation of hyperthyroidism may suggest the need for ancillary testing. In a patient with a tender goiter and hyperthyroidism of short duration, an elevated erythrocyte sedimentation rate is characteristic of subacute thyroiditis.

Hand tremor and generalized proximal muscle weakness are common. Rarely, hypokalemic periodic paralysis may occur, most frequently in Asian males (41–43). 4 mmol/L. Hypophosphatemia was present initially in 12 (80%) of 15 episodes. No patient had a recurrent episode of paralysis after becoming euthyroid. The precise pathophysiology of these events is unknown. The central nervous system (CNS) manifestations of Graves’ hyperthyroidism are varied but include restlessness, irritability, nervousness, and impatience.

Refetoff S, Weiss RE, Usala SJ. The syndromes of resistance to thyroid hormone. Endocr Rev 1993; 14:348–399. Helfand M, Crapo L. Screening for thyroid disease. Ann Intern Med 1990; 112: 840–849. Helfand M, Redfern CC. Clinical guideline, part 2. Screening for thyroid disease: an update. Ann Intern Med 1998; 129:144–158. Vanderpump MP, Tunbridge WM, French JM, Appleton D, Bates D, Clark F, Grimley Evans J, Hasan DM, Rodgers H, Tunbridge F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey.

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