Syndrome of inappropriate antidiuretic hormone (SIADH) is caused by excessive antidiuretic hormone (ADH) production despite low plasma osmolality or large plasma volume. It is characterised by euvolemic hyponatremia – dilutional hyponatremia with no evidence of extracellular fluid overload. The diagnosis…
Thyroid eye disease affects 25 – 50% of patients with Graves’ disease. Severe thyroid eye disease is not related to the degree of thyrotoxicosis
Antithyroid Drugs Drug Action Propylthiouracil (PTU) Inhibits thyroid peroxidase and blocks iodine organification. Also inhibits the peripheral conversion of T4 to T3 Methimazole Large doses of steroids inhibit the peripheral conversion of T4 to T3 and inhibit hormone production Beta-blockers…
Myxoedema coma is an extreme form of hypothyroidism that has a high mortality. It is rare, but it can occur in patients with undiagnosed or undertreated hypothyroidism.
Thyroid storm is a life-threatening, severe physiologic reaction to uncontrolled hyperthyroidism.
Subclinical hyperthyroidism occurs in an asymptomatic patient with normal T4 and T3.
Subclinical hypothyroidism occurs in an asymptomatic patient with a TSH > 4 mU/L with normal T4 and T3. Subclinical hypothyroidism is common in older patients. 10% of patients more than 55 years old have elevated TSH. The risk of progression…
Diagnosis TSH Free T4 Nota bene Thyrotoxicosis Low High Free T4 is normal in T3 thyrotoxicosis Primary hypothyroidism High Low Secondary hypothyroidism Low Low Steroids should be given before replacing thyroxine Sick euthyroid syndrome (non-thyroidal illness) Low (may be normal)…
Maturity-onset diabetes of the young (MODY) is an autosomal dominant form of diabetes that presents before the age of 25. It is caused by mutations in genes that play a role in beta-cell function. Some of these genes include HNF1A,…
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