Harrisons Principles of Internal Medicine, 19Ed.

Harrisons Principles of
Internal Medicine, 19Ed.
UpToDate 2017
 Diagnosis of
hyperthyroidism.
UpToDate 2017.
aDiffusegoiter, positive TPO
antibodies or TRAb,
ophthalmopathy, dermopathy.
bCan be confirmed by radionuclide

scan.
 T3-L y/o T4-L: => Hipertiroidismo Clnico
TSH
T3-L y T4-L: N => Hipertiroidismo Sub-Clnico

T3-L: TSH: N o => Adenoma Pituitario; Resistencia

& parcial al feedback de T4 y T3 (defecto en
T4-L: receptor nuclear de T3).
Harrison 19th ed.
UpToDate 2017
 Piel de naranja

Enfermedad de Graves.
A. Oftalmopata (25-50%): retraccin palpebral,
edema periorbitario, injeccin conjunctival,
marcada proptosis.
B. Dermopata Tiroidea (<5%).
C. Acropaquia Tiroidea (<1%).
Graves Disease. N Engl J Med 2016;375:1552-65.