Nhiễm độc giáp ở bệnh nhân mang thai và không mang thai

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Tác giả: Nguyễn Thế Thành

Ngôn ngữ: Vie

Ký hiệu phân loại: 616.4 Diseases of hematopoietic, lymphatic, glandular systems Diseases of endocrine system

Thông tin xuất bản: Tạp chí Nội tiết và Đái tháo đường 2021

Mô tả vật lý: 69-75

Bộ sưu tập: Metadata

ID: 398481

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Chủ đề

Qua hồi cứu mô tả 9 trường hợp nhiễm độc giáp từ năm 2016 đến năm 2020 chúng tôi ghi nhận một số nhận xét như sau: Ở bốn bệnh nhân mang thai được chần đoán nhiễm độc giáp tạm thời do thai: Nhiễm độc giáp tạm thời do thai thường xảy ra trong tam cá nguyệt đầu của thai kỳ. Chẩn đoán dựa vào TSH thấp dưới 0,1 mIU/L và FT4 tăng cao, kèm với beta HCG >
50.000 UI/L, không có tiền sử cường giáp trước đó, các xét nghiệm miễn dich như AntiTPO và TRAb âm tính. Bệnh thường không cần điều tri với kháng giáp tổng hợp và thường ổn đinh ở tam cá nguyệt thứ 2. Ở nhóm năm bệnh nhân không mang thai được chẩn đoán nhiễm độc giáp tạm thời do viêm tuyến giáp: Nhiễm độc giáp do viêm tuyến giáp có thể xảy ra ở viêm giáp Hashimoto và viêm tuyến giáp bán cấp De Quervain. Chẩn đoán dựa vào TSH dưới 0.1 mIU/L và FT4 bình thường hay tăng cao, AntiTPO hay AntiTg dương tính ở viêm giáp Hashimoto, cả AntiTPO và AntiTg đều âm tính ở viêm tuyến giáp bán cấp De Quervain , nhưng cả hai loại viêm giáp này đều có TSI dưới 0.1 mIU/L. Không cần điều tri kháng giáp tổng hợp nếu nặng chỉ cần điều trị triệu chứng. Diễn tiến chức năng tuyến giáp ở viêm giáp bán cấp thường trở về bình thường trong khi viêm giáp Hashimoto dễ qua suy giáp., Tóm tắt tiếng anh, We have some conclusions from retrospective descriptive 9 transient thyrotoxicosis from 2016 to 2020. In group of four pregnant women were diagnosed withgestational transient thyrotoxicosis: Gestational transient thyrotoxicosis often happens on the first trimester of pregnancy. Diagnosis based on TSH50000UI/L, without history of previous hyperthyroidism, and AntiTPO and TRAb are negative. Patients don't need to be treated with antithyroid synthesis drugs. The thyrotoxicosis is often stable on the second trimester of pregnancy. In group of five non pregnant women were diagnosed with thyroiditis transient thyrotoxicosis: Thyrotoxicosis due to thyroiditis may happen in both Hashimoto and De Quervain thyroiditis. Diagnosis based on TSH<
0.1mIU/L and high FT4 or normal FT4 with AntiTg and or AntiTPO are positive in Hashimoto thyroiditis and negative in De Quervain thyroiditis. Both two kinds have TSI <
0.1mIU/L. Patients don't need to be treated with antithyroid synthesis drugs, they only need symptomatic treatment. Thyroid function of De Queirvain thyroiditis often returns to normal whereas thyroid function of Hashimoto often has evolution to hypothyroidism

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