Problemi non correnti
Ipotiroidismo subclinico: dalla teoria alla pratica
SUBCLINICAL HYPOTHYROIDISM: FROM THEORY TO PRACTICE
CHIARA LOCATELLI, MARCO BENSA, MAURO POCECCO
Unitŕ Operativa di Pediatria, Ospedale “M. Bufalini”, Cesena
Marzo 2005 - pagg. 165 -168
Abstract
Subclinical hypothyroidism is a biochemical state characterized by an elevated serum TSH level
with concomitant normal FT4 value. While in adults it frequently progresses to clinically
evident hypothyroidism, in children it may be a benign and remitting process. L-thyroxine therapy
should therefore be recommended only in selected conditions, considering the potential
risks of treatment.
Classificazione MeSH
Bibliografia
1. Cooper DS. Subclinical Hypothyroidism. N
Engl J Med 2001;345(4):260-5.
2. Fatourechi V. Subclinical thyroid disease. Mayo Clin Proc 2001;76:413-7.
3. Rivolta G, Cerutti R, Colombo R, et al. Prevalence of subclinical hypothyroidism in a population living in the Milan metropolitan area. J Endocrinol Invest 1999;22(9):693-7.
4. Alemzadeh R, Friedman S, Fort P, et al. Is there compensated hypothyroidism in infancy? Pediatrics 1992; 90(2):207-11.
5. Chu JW, Crapo LM. The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab 2001;86(10):4591-9.
6. McDermott MT, Ridgway C. Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001;86(10):4585-90.
7. Alberti L, Proverbio MC, Costagliola S, et al. Germline mutations of receptor gene as cause of nonautoimmune subclinical hypothyroidism. J Clin Endocrinol Metab 2002;87(6):2549-55.
8. Refetoff S. Resistance to thyrotropin. J Endocrinol Invest 2003;26(8):770-9.
9. Park SM, Clifton-Bligh RJ, Betts P, et al. Congenital hypothyroidism and apparent athyreosis with compond heterozygosity or compensated hypothyroidism with probable hemizygosity for inactivating mutations of the TSH receptor. Clin Endocrinol 2004; 60(2):220-7.
10. Calaciura F, Motta RM, Miscio G, et al. Subclinical hypothyroidism in early childhood: a frequent outcome of transient neonatal hyperthyrotropinemia. J Clin Endocrinol Metab 2002;87:3209-14.
11. Daliva AL, Linder B, Di Martino-Nardi J, et al. Three-year follow-up of borderline congenital hypothyroidism. J Pediatr 2000;136: 53-6.
12. Moore DC. Natural course of ‘subclinical’ hypothyroidism in childhood and adolescence. Arch Pediatr Adolesc Med 1996;150:293-7.
13. Jaruratanasirikul S, Leethanaporn K, Khuntigij P, et al. The clinical course of Hashimoto’s thyroiditis in children and adolescents: 6 years longitudinal follow-up. J Pediatr Endocrinol Metab 2001;14:177-84.
14. Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526-34.
15. Lock RJ, Marden NA, Kemp HJ, et al. Subclinical hypothyroidism: a comparision of strategies to achieve adherence to treatment guidelines. Ann Clin Biochem 2004;41:197- 200.
16. Huber G, Staub JJ, Meier C, et al. Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve and thyroid antibodies. J Clin Endocrinol Metab 2002; 87(7):3221-6.
17. Adlin V. Subclinical hypothyroidism: deciding when to treat. Am Fam Physician 1998;57(4):776-80.
18. Benediktsson R. Management of the unexpected result: compensated hypothyroidism. Postgrad Med J 1998;74(878):729-32.
19. Cooper DS, Halpern R, Wood LC. L-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial. Ann Intern Med 1984;101:18-24.
20. Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291(2):228-38.
21. Greenspan SL, Greenspan FS. The effect of thyroid hormone on skeletal integrity. Ann Intern Med 1999;130:750-8.
22. Jaeschke R, Guyatt G, Gerstein H, et al. Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? J Gen Intern Med 1996;11:744-9.
23. Biondi B, Fazio S, Carella C, et al. Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine. J Clin Endocrinol Metab 1993;77:334-8.
24. Rovet JF, Daneman D, Bailey JD. Psychologic and psychoeducational consequences of thyroxine therapy for juvenile acquired hypothyroidism. J Pediatr 1993;122(4):543-9.
25. Elder J, McLelland A, O’Reilly DS, et al. The relationship between serum cholesterol and serum thyrotropin, thyroxine and tri-iodothyronine concentrations in suspected hypothyroidism. Ann Clin Biochem 1990;27: 110-3.
26. Ladenson PW, Wilson MC, Gardin J, et al. Relationship of subclinical hypothyroidism to cardiovascular risk factors and disease in an elderly population. Thyroid 1994;4:S18.
27. Vanderpump MPJ, Tunbridge WMG, French JM, et al. The development of ischemic heart disease in relation to autoimmnune thyroid disease in a 20-year follow-up study of an English community. Thyroid 1996;6:155-60.
28. Hak AE, Pols HAP, Visser TJ, et al. Subclinical hypothyroidism is an indipendent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270-8.
29. Ineck BA, Ng TM. Effects of subclinical hypothyroidism and its treatment on serum lipids. Ann Pharmacother 2003;37(5):725-30.
30. Monzani F, Caraccio N, Kozakowa M, et al. Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo-controlled study. J Clin Endocrinol Metab 2004;89(5):2099-106.
31. Meier C, Roth CB, Huber G, et al. Clinical and metabolic effects of thyroxine replacement in patients with mild thyroid failure: results from a double-blind placebo-controlled study. Proceedings of the 82nd Annual Meeting of the Endocrine Society. Toronto, Canada, 2000:2372-3.
32. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? J Clin Endocrinol Metab 2000;85(11):3975-87.
33. Gharib H, Cobin RH, Dickey RA. Subclinical hypothyroidism during pregnancy: position statement from the American Association of Clinical Endocrinologists. Endocr Pract 1999;5(6):367-8.
2. Fatourechi V. Subclinical thyroid disease. Mayo Clin Proc 2001;76:413-7.
3. Rivolta G, Cerutti R, Colombo R, et al. Prevalence of subclinical hypothyroidism in a population living in the Milan metropolitan area. J Endocrinol Invest 1999;22(9):693-7.
4. Alemzadeh R, Friedman S, Fort P, et al. Is there compensated hypothyroidism in infancy? Pediatrics 1992; 90(2):207-11.
5. Chu JW, Crapo LM. The treatment of subclinical hypothyroidism is seldom necessary. J Clin Endocrinol Metab 2001;86(10):4591-9.
6. McDermott MT, Ridgway C. Subclinical hypothyroidism is mild thyroid failure and should be treated. J Clin Endocrinol Metab 2001;86(10):4585-90.
7. Alberti L, Proverbio MC, Costagliola S, et al. Germline mutations of receptor gene as cause of nonautoimmune subclinical hypothyroidism. J Clin Endocrinol Metab 2002;87(6):2549-55.
8. Refetoff S. Resistance to thyrotropin. J Endocrinol Invest 2003;26(8):770-9.
9. Park SM, Clifton-Bligh RJ, Betts P, et al. Congenital hypothyroidism and apparent athyreosis with compond heterozygosity or compensated hypothyroidism with probable hemizygosity for inactivating mutations of the TSH receptor. Clin Endocrinol 2004; 60(2):220-7.
10. Calaciura F, Motta RM, Miscio G, et al. Subclinical hypothyroidism in early childhood: a frequent outcome of transient neonatal hyperthyrotropinemia. J Clin Endocrinol Metab 2002;87:3209-14.
11. Daliva AL, Linder B, Di Martino-Nardi J, et al. Three-year follow-up of borderline congenital hypothyroidism. J Pediatr 2000;136: 53-6.
12. Moore DC. Natural course of ‘subclinical’ hypothyroidism in childhood and adolescence. Arch Pediatr Adolesc Med 1996;150:293-7.
13. Jaruratanasirikul S, Leethanaporn K, Khuntigij P, et al. The clinical course of Hashimoto’s thyroiditis in children and adolescents: 6 years longitudinal follow-up. J Pediatr Endocrinol Metab 2001;14:177-84.
14. Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526-34.
15. Lock RJ, Marden NA, Kemp HJ, et al. Subclinical hypothyroidism: a comparision of strategies to achieve adherence to treatment guidelines. Ann Clin Biochem 2004;41:197- 200.
16. Huber G, Staub JJ, Meier C, et al. Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve and thyroid antibodies. J Clin Endocrinol Metab 2002; 87(7):3221-6.
17. Adlin V. Subclinical hypothyroidism: deciding when to treat. Am Fam Physician 1998;57(4):776-80.
18. Benediktsson R. Management of the unexpected result: compensated hypothyroidism. Postgrad Med J 1998;74(878):729-32.
19. Cooper DS, Halpern R, Wood LC. L-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial. Ann Intern Med 1984;101:18-24.
20. Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004;291(2):228-38.
21. Greenspan SL, Greenspan FS. The effect of thyroid hormone on skeletal integrity. Ann Intern Med 1999;130:750-8.
22. Jaeschke R, Guyatt G, Gerstein H, et al. Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? J Gen Intern Med 1996;11:744-9.
23. Biondi B, Fazio S, Carella C, et al. Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine. J Clin Endocrinol Metab 1993;77:334-8.
24. Rovet JF, Daneman D, Bailey JD. Psychologic and psychoeducational consequences of thyroxine therapy for juvenile acquired hypothyroidism. J Pediatr 1993;122(4):543-9.
25. Elder J, McLelland A, O’Reilly DS, et al. The relationship between serum cholesterol and serum thyrotropin, thyroxine and tri-iodothyronine concentrations in suspected hypothyroidism. Ann Clin Biochem 1990;27: 110-3.
26. Ladenson PW, Wilson MC, Gardin J, et al. Relationship of subclinical hypothyroidism to cardiovascular risk factors and disease in an elderly population. Thyroid 1994;4:S18.
27. Vanderpump MPJ, Tunbridge WMG, French JM, et al. The development of ischemic heart disease in relation to autoimmnune thyroid disease in a 20-year follow-up study of an English community. Thyroid 1996;6:155-60.
28. Hak AE, Pols HAP, Visser TJ, et al. Subclinical hypothyroidism is an indipendent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270-8.
29. Ineck BA, Ng TM. Effects of subclinical hypothyroidism and its treatment on serum lipids. Ann Pharmacother 2003;37(5):725-30.
30. Monzani F, Caraccio N, Kozakowa M, et al. Effect of levothyroxine replacement on lipid profile and intima-media thickness in subclinical hypothyroidism: a double-blind, placebo-controlled study. J Clin Endocrinol Metab 2004;89(5):2099-106.
31. Meier C, Roth CB, Huber G, et al. Clinical and metabolic effects of thyroxine replacement in patients with mild thyroid failure: results from a double-blind placebo-controlled study. Proceedings of the 82nd Annual Meeting of the Endocrine Society. Toronto, Canada, 2000:2372-3.
32. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? J Clin Endocrinol Metab 2000;85(11):3975-87.
33. Gharib H, Cobin RH, Dickey RA. Subclinical hypothyroidism during pregnancy: position statement from the American Association of Clinical Endocrinologists. Endocr Pract 1999;5(6):367-8.