Subclinical Hyperthyroidism, an Under-Recognized Entity

S. Igala, M. Machado, B. Neugaard, P. Foulis, J. Gomez-Daspet
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Abstract

Purpose: Determine the medical evaluation completed and the clinical progression observed in subjects with Endogenous Subclinical Hyperthyroidism (ESCH).Method: This is a single site retrospective chart review of subjects who visited the Ambulatory Care Clinics at the James A. Haley VA Hospital (JAHVA), Tampa, Florida. Subjects were selected and charts reviewed using the automatic data mining tool. Inclusion criteria encompassed subjects’ low thyroid stimulating hormone (TSH) and normal T4 and T3 levels.Results: 95 subjects met criteria for inclusion. At the end of one year, 48 (51%) had normal thyroid function tests (TFTs), 43 (45%) had persistent ESCH and 4 (4%) had overt hyperthyroidism. A radioiodine thyroid uptake/scan was completed in 32 (33%) subjects. Only 9 (10%) had thyroid stimulating Immunoglobulin (TSI) or anti-thyroid peroxidase antibody (anti-TPO) studies. A bone density study was not completed. Conclusions: Out of the 95 subjects with ESCH, at the end of one year 51% had normal TFTs, 45% had persistent ESCH and 4% had hyperthyroidism. Less than 50% of the subjects received further tests. It is recommended that subjects with ESCH be followed periodically with TFTs and further evaluation may be required to assess cause, severity, risk of complications and need for treatment.
亚临床甲状腺功能亢进,一个未被认识的实体
目的:了解内源性亚临床甲状腺功能亢进(ESCH)患者的医学评估完成情况和临床进展情况。方法:这是一个单站点回顾性图表回顾的对象谁访问了詹姆斯a.哈利VA医院(JAHVA),佛罗里达州坦帕的门诊护理诊所。使用自动数据挖掘工具选择受试者并审查图表。纳入标准包括受试者的低促甲状腺激素(TSH)和正常的T4和T3水平。结果:95例受试者符合纳入标准。一年后,48例(51%)甲状腺功能检查(TFTs)正常,43例(45%)持续ESCH, 4例(4%)有明显的甲状腺功能亢进。32名(33%)受试者完成了放射性碘甲状腺摄取/扫描。只有9例(10%)有促甲状腺免疫球蛋白(TSI)或抗甲状腺过氧化物酶抗体(抗tpo)的研究。骨密度研究尚未完成。结论:在95例ESCH患者中,一年后51% tft正常,45% ESCH持续,4%甲状腺功能亢进。不到50%的受试者接受了进一步的测试。建议ESCH患者定期进行tft随访,可能需要进一步评估病因、严重程度、并发症风险和治疗需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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