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Graves' Disease pp 39–51Cite as

Laboratory and Clinical Assessment of Hyperthyroidism

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Abstract

Hyperthyroidism is common in clinical practice. In this condition, there is excessive synthesis and/or secretion of thyroid hormones into the circulation. This excess in thyroid hormone levels is often accompanied by suppressed serum TSH concentrations and a wide variety of clinical manifestations that often involve many organ systems. Graves’ disease, an autoimmune condition, is the most common cause of hyperthyroidism in the United States (80 % of cases), but various other conditions can result in a similar clinical picture, including toxic nodular thyroid disease, the very rare TSH-producing pituitary adenoma, thyroiditis, medication side effects, or exogenous thyrotoxicosis due to excessive ingestion of thyroid hormone (iatrogenic or factitious). This chapter focuses on the clinical, laboratory, and radiological evaluation of the patient presenting with hyperthyroidism, in order to determine its etiology and define an appropriate treatment plan.

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References

  1. Brent GA. Clinical practice. Graves’ disease. N Engl J Med. 2008;358(24):2594–605.

    Article  CAS  PubMed  Google Scholar 

  2. Hollowell JG et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489–99.

    Article  CAS  PubMed  Google Scholar 

  3. Tunbridge WMG et al. The spectrum of thyroid disease in a community: the Wickham survey. Clin Endocrinol (Oxf). 1977;7(6):481–93.

    Article  CAS  Google Scholar 

  4. Cooper DS. Hyperthyroidism. Lancet. 2003;362(9382):459–68.

    Article  CAS  PubMed  Google Scholar 

  5. Parma J et al. Diversity and prevalence of somatic mutations in the thyrotropin receptor and Gs alpha genes as a cause of toxic thyroid adenomas. J Clin Endocrinol Metab. 1997;82(8):2695–701.

    CAS  PubMed  Google Scholar 

  6. Laurberg P et al. Environmental iodine intake affects the type of nonmalignant thyroid disease. Thyroid. 2001;11(5):457–69.

    Article  CAS  PubMed  Google Scholar 

  7. Beck-Peccoz P et al. Thyrotropin-secreting pituitary tumors. Endocr Rev. 1996;17(6):610–38.

    CAS  PubMed  Google Scholar 

  8. Trzepacz PT et al. Graves’ disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms. Am J Med. 1989;87(5):558–61.

    Article  CAS  PubMed  Google Scholar 

  9. Trivalle C et al. Differences in the signs and symptoms of hyperthyroidism in older and younger patients. J Am Geriatr Soc. 1996;44(1):50–3.

    Article  CAS  PubMed  Google Scholar 

  10. Boelaert K et al. Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study. J Clin Endocrinol Metab. 2010;95(6):2715–26.

    Article  CAS  PubMed  Google Scholar 

  11. Cappola AR et al. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006;295(9):1033–41.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Carlson HE. Gynecomastia. N Engl J Med. 1980;303(14):795–9.

    Article  CAS  PubMed  Google Scholar 

  13. Woeber KA. Thyrotoxicosis and the heart. N Engl J Med. 1992;327(2):94–8.

    Article  CAS  PubMed  Google Scholar 

  14. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263–77.

    CAS  PubMed  Google Scholar 

  15. Bahn RS. Graves’ ophthalmopathy. N Engl J Med. 2010;362(8):726–38.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Wiersinga WM, Bartalena L. Epidemiology and prevention of Graves’ ophthalmopathy. Thyroid. 2002;12(10):855–60.

    Article  PubMed  Google Scholar 

  17. Schwartz KM et al. Dermopathy of Graves’ disease (pretibial myxedema): long-term outcome. J Clin Endocrinol Metab. 2002;87(2):438–46.

    CAS  PubMed  Google Scholar 

  18. Spencer CA et al. Applications of a new chemiluminometric thyrotropin assay to subnormal measurement. J Clin Endocrinol Metab. 1990;70(2):453–60.

    Article  CAS  PubMed  Google Scholar 

  19. Bahn RS et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Endocr Pract. 2011;17(3):456–520.

    Article  PubMed  Google Scholar 

  20. Rajatanavin R, Braverman LE. Euthyroid hyperthyroxinemia. J Endocrinol Invest. 1983;6(6):493–505.

    Article  CAS  PubMed  Google Scholar 

  21. Cohen-Lehman J et al. Effects of amiodarone therapy on thyroid function. Nat Rev Endocrinol. 2010;6(1):34–41.

    Article  CAS  PubMed  Google Scholar 

  22. Socin HV et al. The changing spectrum of TSH-secreting pituitary adenomas: diagnosis and management in 43 patients. Eur J Endocrinol. 2003;148(4):433–42.

    Article  CAS  PubMed  Google Scholar 

  23. Clarke MJ et al. Thyroid-stimulating hormone pituitary adenomas. J Neurosurg. 2008;109(1):17–22.

    Article  PubMed  Google Scholar 

  24. Brucker-Davis F et al. Genetic and clinical features of 42 kindreds with resistance to thyroid hormone. The National Institutes of Health Prospective Study. Ann Intern Med. 1995;123(8):572–83.

    Article  CAS  PubMed  Google Scholar 

  25. Massart C, Orgiazzi J, Maugendre D. Clinical validity of a new commercial method for detection of TSH-receptor binding antibodies in sera from patients with Graves’ disease treated with antithyroid drugs. Clin Chim Acta. 2001;304(1–2):39–47.

    Article  CAS  PubMed  Google Scholar 

  26. Marcocci C. Thyroid directed antibodies. In: Braverman LE, Utiger RD, editors. Werner’s and Ingbar’s the thyroid. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005. p. 361–71.

    Google Scholar 

  27. Seigel SC, Hodak SP. Thyrotoxicosis. Med Clin North Am. 2012;96(2):175–201.

    Article  CAS  PubMed  Google Scholar 

  28. Becker D et al. Procedure guideline for thyroid scintigraphy: 1.0. Society of Nuclear Medicine. J Nucl Med. 1996;37(7):1264–6.

    CAS  PubMed  Google Scholar 

  29. Camacho PM, Gharib H, Sizemore GW, editors. Thyroid disorders. Evidence-based endocrinology. 3rd ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2012. p. 412.

    Google Scholar 

  30. Cooper DS et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214 [Erratum appears in Thyroid. 2010 Jun; 20(6):674–5].

    Article  PubMed  Google Scholar 

  31. Reschini E et al. The trapping-only nodules of the thyroid gland: prevalence study. Thyroid. 2006;16(8):757–62.

    Article  PubMed  Google Scholar 

  32. Ota H et al. Quantitative measurement of thyroid blood flow for differentiation of painless thyroiditis from Graves’ disease. Clin Endocrinol (Oxf). 2007;67(1):41–5.

    Article  Google Scholar 

  33. Borst GC, Eil C, Burman KD. Euthyroid hyperthyroxinemia. Ann Intern Med. 1983;98(3):366–78.

    Article  CAS  PubMed  Google Scholar 

  34. Stockigt JR et al. Specific methods to identify plasma binding abnormalities in euthyroid hyperthyroxinemia. J Clin Endocrinol Metab. 1986;62(1):230–3.

    Article  CAS  PubMed  Google Scholar 

  35. Persani L. Central hypothyroidism: pathogenic, diagnostic, and therapeutic challenges. J Clin Endocrinol Metabol. 2012;97(9):3068–78.

    Article  CAS  Google Scholar 

  36. Beck-Peccoz P et al. Decreased receptor binding of biologically inactive thyrotropin in central hypothyroidism. Effect of treatment with thyrotropin-releasing hormone. N Engl J Med. 1985;312(17):1085–90.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    M. Regina Castro M.D.

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  1. M. Regina Castro M.D.
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Correspondence to M. Regina Castro M.D. .

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Editors and Affiliations

  1. Mayo Clinic College of Medicine, Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, Minnesota, USA

    Rebecca S. Bahn

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Castro, M.R. (2015). Laboratory and Clinical Assessment of Hyperthyroidism. In: Bahn, R. (eds) Graves' Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2534-6_4

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  • DOI: https://doi.org/10.1007/978-1-4939-2534-6_4

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2533-9

  • Online ISBN: 978-1-4939-2534-6

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