Navegando por Palavras-chave "Hipertiroidismo"

Agora exibindo 1 - 2 de 2
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Adenomas hipofisários secretores de TSH: revisão da casuística (1989-2016) em um centro de referência
    (Universidade Federal de São Paulo (UNIFESP), 2018-01-18) Nazato, Debora Maria [UNIFESP]; Abucham Filho, Julio Zaki [UNIFESP]; Castro, Marise Lazaretti [UNIFESP]; http://lattes.cnpq.br/8253870907570489; http://lattes.cnpq.br/8325290942943257; http://lattes.cnpq.br/8381499248151076; Universidade Federal de São Paulo (UNIFESP)
    Purpose: TSH-secreting pituitary adenomas are among the less prevalent pituitary tumors, corresponding to 0.9-1.5% of all pituitary adenomas in surgical series. Methods: A series of 11 patients with TSH-secreting and cosecreting adenomas diagnosed and treated in the last 25 years in a single center is described. Results: The mean age at diagnosis was 37 years (range 18-80 years; median 23 years); the ratio of male-to-female patients was similar (6M:5F). Only three patients was the correct diagnosis established shortly after the initial medical evaluation. Other four patients were initially diagnosed with other pituitary adenomas (prolactinoma, acromegaly, and non-secreting pituitary tumor) and another four diagnosed with primary hyperthyroidism. There was a mean diagnostic delay of 6.0 years (range 0.5-25 years; median 2 years). Nine patients had macroadenomas and two patients had microadenomas. Seven patients underwent pituitary surgery which controlled the disease in only two (one micro- and one noninvasive macroadenoma). The other treatments were directed to the thyroid gland (surgery or 131I radiotherapy), pituitary radiotherapy, and somatostatin analog. Conclusion: In spite of its relatively straightforward diagnosis, which includes clinical/subclinical hyperthyroidism with or without goiter, increased free thyroxine and nonsuppressed TSH levels, and pituitary mass, the diagnosis of TSH-secreting and cosecreting adenomas was frequently unrecognized and thus much delayed. Serum alpha-subunit levels were high in nearly all patients with TSH-secreting adenomas and useful in excluding other conditions in the differential diagnosis. Proper indication and interpretation of simple laboratory tests should be emphasized in medical education to improve diagnostic accuracy.
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    Injeção percutânea de etanol no tratamento de nódulos tiroidianos sólidos, císticos e autônomos
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2003-10-01) Bianchini, Elizabeth X. [UNIFESP]; Ikejiri, Elza S. [UNIFESP]; Mamone, Maria Conceição [UNIFESP]; Paiva, Elias R. [UNIFESP]; Maciel, Rui Monteiro de Barros [UNIFESP]; Furlanetto, Reinaldo P. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Percutaneous ethanol injection (PEI) guided by ultrasound has been used for the treatment of cystic, solid and autonomous thyroid nodules. We present our experience in the treatment of 50 patients with thyroid nodules: 26 solid, 17 cystic and 7 autonomous (AN). Patients were evaluated 1 week, 1, 3, and 6 months and 1 year after PEI. After one year, solid nodules showed a mean 74% volume reduction, and cysts a volume reduction of 92%, with no recurrences. After one year, 5 patients with AN reached clinical and laboratory euthyroidism; the other 2 also became euthyroid, but with subnormal TSH. Recurrence of thyrotoxicosis was not observed and mean nodular reduction was 66%. The procedure was well tolerated by all patients. The results confirm that PEI is a good therapeutic alternative for reduction of solid and cystic thyroid nodules and for the treatment of autonomous nodules.