Enfermedad Graves-Basedow. Fisiopatología y Diagnóstico
Palabras clave:
Hipertiroidismo, bocio, TSH, oftalmopatía, dermopatía, yodo radioactivo, tionamidas, tiroides, Hyperthyroidism, goiter, ophtalmopathy, dermopathy, radioactive iodine, thyonamides, thyroid.Resumen
RESUMENSe realizó una revisión narrativa rigurosa de la literatura inglesa y en español sobre diferentes aspectos de la Enfermedad de Graves-Basedow, causa de cerca del 80% de todos los casos de hipertiroidismo. Esta patología –parte de la llamada “enfermedad tiroidea autoinmune”- se produce como consecuencia de la presencia de anticuerpos circulantes que se unen y activan al receptor de tirotropina, desencadenándose generalmente el hipertiroidismo en asociación con un estrés agudo. En este artículo describimos la metodología usada para elaborar un estado del arte del bocio difuso tóxico presente en adultos, en relación con sus antecedentes históricos, fisiopatología y diagnóstico, tanto semiológico como imagenológico, patológico y por laboratorio. Los aspectos –tanto del manejo de hipertiroidismo como el de problemas especiales- son motivo de otra publicación.
Palabras clave: Hipertiroidismo, bocio, TSH, oftalmopatía, dermopatía, yodo radioactivo, tionamidas, tiroides
PHYSIOPATHOLOGY AND DIAGNOSIS OF GRAVES-BASEDOW´S HYPERTHYROIDISMABSTRACTA strict narrative review of english and spanish literature on different aspects concerning Graves- Basedow´s Disease –cause of about 80% of cases of hyperthyroidism- was carried out. This is one of the pathologies seen in the so-called “autoimmune thyroid disease”, it is associated with presence of thyrotropin-receptor antibodies and is usually triggered by an acute stressful event. We describe the methodology used to structure this State-of-the Art paper of diffuse toxic goiter seen in adult patients, in relation to historical information, physiopathology and diagnosis of Graves-Basedow´s Disease, either physical or by imagenology, pathology and laboratory. Management of hyperthyroidism and of some special associated problems is matter of discussion in another publication.
Key words: Hyperthyroidism, goiter, TSH, ophtalmopathy, dermopathy, radioactive iodine, thyonamides, thyroid.
Biografía del autor/a
Hernando Vargas-Uricoechea, Departamento de Medicina Interna, Facultad Ciencias de la Salud, Universidad del Cauca, Popayán-Cauca.
Carlos Hernán Sierra-Torres, Facultad Ciencias de la Salud, Universidad del Cauca, Popayán-Cauca.
Ivonne Alejandra Meza-Cabrera, Departamento de Patología. Facultad Ciencias de la Salud, Universidad del Cauca, Popayán-Cauca.
Referencias bibliográficas
REFERENCIAS
Flajani G, 1802 Sopra un tumor freddonell’anterior parte del collo broncocele (Osservazione LXVII).
Collezioned’osservazioni e reflessioni di chirurgia, Rome, Milano, A Ripa Presso Lino Contedini 3:270-273 2. Testa AG.Dellemalattie del cuore, loro cagioni, specie, segni e cura. Bologna, secondaedizione. 3 volumes, 1810.
Parry CH 1825 Enlargement of the thyroid gland in connection with enlargement or palpitations of the heart. In: Collections from the unpublished medical writings of H. Parry, London; pp, 111-129.
Graves RJ, 1835 New observed affection of the thyroid gland in females. London Medical and Surgical Journal. 7:516-517.
Basedow C A. March 28th 1840 Exophthalmos durch Hypertrophie des Zellgewebes in der Augenhöhle. Wochenschrift fur die gesammte Heilkunde Berlin. 6:197-220.
Young P, Finn BC, Bruetman JE. La enfermedad de Graves, signos y síntomas. An Med Interna (Madrid) 2007;24:505-508.
McKenna TJ. Graves’ disease. Eponym. Lancet 2001; 357:1793-1796.
McLeod Donald SA, Cooper DS. The incidence and prevalence of thyroid autoimmunity.Endocrine 2012; 42:252-265.
Baltisberger B, Minder C, Burgi H. Decrease of incidence of toxic nodular goitre in a region of Switzerland after full correction of mild iodine deficiency. Eur J Endocrinol.1995; 132:546-549.
Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW. Prevalence and Incidence of Endocrine and Metabolic Disorders in the United States: A Comprehensive Review.J Clin Endocrinol Metab. 2009; 94:1853-1878.
Abraham-Nordling M, Torring O, Lantz M, Hallengren B, Ohrling H, Lundell GJ, et al. Incidence of hyperthyroidism in Stockholm, Sweden, 2003-2005. Eur J Endocrinol. 2008; 158(6):823-827.
Manji N, Carr-Smith JD, Boelaert K, Allahabadia A, Armitage M, Chatterjee VK, et al. Influences of age, gender, smoking, and family history on autoimmune thyroid disease phenotype. J Clin Endocrinol Metab 2006; 91:4873-4880.
Ploski R, Szymanski K, Bednarczuk T. The GeneticBasis of Graves’ Disease.Current Genomics. 2011; 12:542-563.
Ban Y. “Genetic Factors of Autoimmune Thyroid Diseases in Japanese,” Autoimmune Diseases, vol. 2012, Article ID 236981, 9 pages, 2012. doi:10.1155/2012/236981.
Davies TF, Latif R, Yin X, “New Genetic Insights fromAutoimmune Thyroid Disease, “Journal of Thyroid Research, vol. 2012, Article ID 623852, 6 pages, 2012. doi:10.1155/2012/623852.
Clayton DG, McKeigue PM. Epidemiological methods for studying genes and environmental factors in complex diseases. Lancet. 2001; 358:1357-1360.
Lohmueller KE, Pearce CL, Pike M, Lander ES, Hirschhorn JN. “Meta-analysis of genetic association studies supports a contribution of common variants to susceptibility to common disease”. Nat Genet. 2003; 33:177-182.
Weetman AP. The genetics of autoimmune thyroid disease. Horm Metab Res. 2009 41(6):421-425.
Gu LQ, Zhu W, Zhao SX, Zhao L, Zhang MJ, Cui B, Song HD, Ning G, Zhao YJ. Clinical associations of the genetic variants of CTLA-4, Tg, TSHR, PTPN22, PTPN12 and FCRL3 in patients with Graves’ disease. ClinEndocrinol (Oxf). 2010;72(2):248-55.
Sibarani RP. Genetics of Graves’ disease: the lost concept. Acta Med Indones. 2009;41(1):37-40.
Brand OJ, Gough SCL. Immunogenetic Mechanisms Leading to Thyroid Autoimmunity: Recent Advances in Identifying Susceptibility Genes and Regions. Curr Genomics. 2011; 12(8): 526–541.
Holm IA, Manson JE, Michels K, et al. Smoking and Other Lifestyle Factors and the Risk of Graves’ Hyperthyroidism. Arch Intern Med. 2005; 165:1606-1611.
Ando T, Imaizumi M, Graves PN, Unger P, Davies TF. Intrathyroidal Fetal Microchimerism in Graves’ Disease. J Clin Endocrinol Metab. 2002; 87: 3315-3320.
Brent GA, “Clinical practice. Graves’ disease,” NEngJMed. 2008; 358(24): 2594-2605.
Fadel BM, Ellahham S, Ringel MD, Lindsay J, Wartofsky L, Burman KD. Hyperthyroid heart disease. Clin Cardiol.2000; 23:402-408.
Mansourian AR. A review of literature on the AdverseEffects of Hyperthyroidism on the Heart Functional Behavior. Pakistan Journal of Biological Sciences.2012; 15:164-176.
Ebert EC, “The thyroid and the gut”. J ClinGastroenterol. 2010; 44(6):402-406.
Maser C, Toset A, Roman S. Gastrointestinal manifestations of endocrine disease.World J Gastroenterol. 2006; 12 (20):3174-3179
Burman KD, McKinley-Grant L. “Dermatologic aspects of thyroid disease”. Clinics in Dermatology. 2006; 24(4):247-255.
Doshi DN, Blyumin ML, Kimball AB. “Cutaneous manifestations of thyroid disease”. Clinics in Dermatology. 2008; 26(3):283-287.
Niepomniszcze H, Amad RH. Skin disorders and thyroid diseases. J Endocrinol Invest. 2001; 24(8):628-638.
Yudiarto FL, Muliadi L, Moeljanto D, Hartono B. Neuropsychological findings in hyperthyroid patients. Acta Med Indones. 2006; 38(1):6-10.
Canton A, de Fabregas O, Tintore M, Mesa J, Codina A, Simo R. Encephalopathy associated to autoimmune thyroid disease: a more appropriate term for an underestimated condition? . J Neurol Sci. 2000; 176:65-69.
Doherty C. Neurologic Manifestations of Thyroid Disease. The Neurologist.2001; 7:147-157.
Wiersinga WM, Smit T, van der Gaag R, Mourits M, Koornneef L. Clinical presentation of Graves’ ophthalmopathy. Ophthalmic Res.1989; 21:73-82.
Pérez Moreiras JV, Prada Sánchez MC, Coloma J,et al. Oftalmopatía distiroidea. En: Pérez Moreiras JV, Prada Sánchez C. Patología orbitaria. Exploración, diagnóstico y cirugía. Barcelona: Edika Med 2002; 2: 940-990.
Gaddipati RV, MeyerDR. Eyelid Retraction, Lid Lag, Lagophthalmos, and von Graefe’s Sign. Quantifying the Eyelid Features of Graves’ Ophthalmopathy. Ophthalmol. 2008;115:1083-1088.
Fernández-Hermida RV, Pinar S, Muruzábal N. Manifestaciones clínicas de la oftalmopatía tiroidea. An. Sist. Sanit. Navar. 2008; 31 (Supl. 3): 45-56.
Li JH, Safford RE, Aduen JF, Heckman MG, Crook JE, Burger CD. Pulmonary Hypertension and Thyroid Disease. CHEST.2007;132(3):793-797.
Armigliato M, Paolini R, Aggio S, Zamboni S, Galasso MP, Zonzin P, Cella G. Hyperthyroidism as a cause of pulmonary arterial hypertension: a prospective study. Angiology. 2006; 57(5):600-606.
Mariani LH, Berns JS. The Renal Manifestations of Thyroid Disease. JASN. 2012; 23(1): 22-26.
Dhanwal DK. Thyroid disorders and bone mineral metabolism. Indian J Endocrinol Metab.2011; 15:S107-112.
Mosekilde L, Eriksen EF, Charles P. Effects of thyroid hormones on bone and mineral metabolism. EndocrinolMetabClin North Am.1990; 19:35-63.
Kendall-Taylor P. Thyrotoxicosis. In: Grossman A, ed. Clinical endocrinology. Oxford, England: Blackwell Science, 1998:328-358.
Trzepacz PT, Klein I, Roberts M, Greenhouse J, Levey GS. Graves’ disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms. Am J Med.1989; 87:558-561.
Hegazi MO, Ahmed S, “Atypical Clinical Manifestationsof Graves’ Disease: An Analysis in Depth,” Journal of Thyroid Research, vol. 2012, Article ID 768019, 8 pages, 2012. doi:10.1155/2012/768019.
Kalra S, Khandewal SK, Goyal A. Clinical Scoring Scales in Thyroidology: A Compendium. Indian J Endocrinol Metab. 2011; 15(Suppl 2):S89-S94.
Klein I. Clinical, metabolic and organ-specific indices of thyroid function. Endocrinol Metab Clin N Am. 2001; 30(2):415-427.
Klein I, Trzepacz PT, Roberts M, Levey GS. Symptom rating scale for assessing hyperthyroidism. Arch Intern Med. 1988; 148:387-390.
Nayak B, Hodak SP. Hyperthyroidism. Endocrinol Metab Clin N Am. 2007; 36(3):617-656.
Ross DS. Serum Thyroid-Stimulating Hormone Measurement for Assessment of Thyroid Function and Disease. Endocrinol Metab Clin N Am. 2001;30(2):245-264.
Dufour RD. Laboratory Tests of Thyroid Function: Uses and Limitations. Endocrinol Metab Clin N Am. 2007; 36:579–594.
Kamath C, Adlan MA, Premawardhana LD. The Role of Thyrotrophin Receptor Antibody Assays in Graves’ disease. J Thyr Res Vol 2012, Article ID 525936, 8 pages doi:10.1155/2012/525936.
Lytton SD, Kahaly GJ. “Bioassays for TSH-receptor autoantibodies: an update,” Autoimmunity Reviews. 2010; 10(2):116-122.
Soto GD, Halperin I, Squarcia M, Lomeña F, Domingo MP. Update in thyroid imaging. The expanding world of thyroid imaging and its translation to clinical practice. Hormones (Athens). 2010; 9(4):287-298.
Chaudhary V, Bano S. Imaging of the Thyroid: Recent Advances. Indian J Endocr Metab.2012; 16:371-376.
Meller J, Becker W. The continuing importance of thyroid scintigraphy in the era of high-resolution. Ultrasound. Eur J Nucl Med.2002; 29(Suppl 2):425-438.
Piga M, Cocco MC, Serra A, Boi F, Loy M, Mariotti S. The usefulness of 99mTc-sestaMIBI thyroid scan in the differential diagnosis and management of amiodarone-induced thyrotoxicosis. Eur J Endocrinol. 2008; 159(4):423-429.
Iagaru A, McDougall IR. Treatment of thyrotoxicosis. J Nucl Med. 2007; 48:379-389.
Intenzo C, Jabbour S, Miller JL, Ahmed I, Furlong K, Kushen M, Kim SM, Capuzzi DM. Subclinical hyperthyroidism: current concepts and scintigraphic imaging. ClinNucl Med. 2011;36(9):e107-113.
Brahma A, BeadsmooreC, DhatariyaK.The Oldest Case of Marine Lenhart
syndrome?J R Soc Med Sh Rep. 2012; 3:21.
LiVolsi VA. The pathology of autoimmune thyroid disease: a review. Thyroid. 1994;4:333-339.
Kumarasinghe MP, De Silva S. Pitfalls in cytological diagnosis of autoimmune thyroiditis. Pathol 1999;31:1-8.
Baloch Z, LiVolsi VA. Pathology of the Thyroid Gland. Philadelphia, PA: Churchill Livingstone; 2002:61-88.
Cómo citar
Descargas
Descargas
Publicado
Número
Sección
Licencia
Copyright
ANM de Colombia
Los autores deben declarar revisión, validación y aprobación para publicación del manuscrito, además de la cesión de los derechos patrimoniales de publicación, mediante un documento que debe ser enviado antes de la aparición del escrito. Puede solicitar el formato a través del correo revistamedicina@anmdecolombia.org.co o descargarlo directamente Documento Garantías y cesión de derechos.docx
Copyright
ANM de Colombia
Authors must state that they reviewed, validated and approved the manuscript's publication. Moreover, they must sign a model release that should be sent.
