Hipotiroidismo / Hypothyroidism

Julio 21, 2017. No. 2756

Hipotiroidismo subclínico y su asociación con el aumento de la mortalidad cardiovascular: Llamado a la acción. Sub-Clinical Hypothyroidism and Its Association With Increased Cardiovascular Mortality: Call for Action. Hassan A1, Altamirano-Ufion A1, Zulfiqar B1, Boddu P2. Cardiol Res. 2017 Apr;8(2):31-35. doi: 10.14740/cr524w. Epub 2017 May 3. Abstract Thyroid hormones play an important role in regulating different functions regarding metabolism and performance in multiple organs. Any change in the thyroid hormones axis can lead to profound effect on the vital organ stability especially the cardiovascular system. Hypothyroidism is classified according to the clinical presentation as overt and subclinical. Currently, there exists a paucity of evidence on the beneficial effects of thyroxine hormone replacement on cardiovascular mortality outcomes in subclinical hypothyroidism. Also, the clinical relevance of measuring and treating supra-normal thyroid-stimulating hormone levels in newly diagnosed heart failure patients with preserved ejection fraction requires further study. Here we review the current evidence regarding the prognostic significance of sub-clinical hypothyroidism in patients with heart failure with preserved ejection fraction. KEYWORDS: Cardiovascular mortality; Heart failure with preserved ejection fraction; Sub-clinical hypothyroidism PDF Deficiencia de iodo. Manifestaciones clínicas Iodine deficiency: Clinical implications. Niwattisaiwong S1, Burman KD2, Li-Ng M3. Cleve Clin J Med. 2017 Mar;84(3):236-244. doi: 10.3949/ccjm.84a.15053. Abstract Iodine is crucial for thyroid hormone synthesis and fetal neurodevelopment. Major dietary sources of iodine in the United States are dairy products and iodized salt. Potential consequences of iodine deficiency are goiter, hypothyroidism, cretinism, and impaired cognitive development. Although iodine status in the United States is considered sufficient at the population level, intake varies widely across the population, and the percentage of women of childbearing age with iodine deficiency is increasing. Physicians should be aware of the risks of iodine deficiency and the indications for iodine supplementation, especially in women who are pregnant or lactating. PDF Avances recientes en enfermedades autoinmunes de la tiroides Recent Advances in Autoimmune Thyroid Diseases. Yoo WS1, Chung HK2. Endocrinol Metab (Seoul). 2016 Sep;31(3):379-385. doi: 10.3803/EnM.2016.31.3.379. Epub 2016 Aug 26. Abstract Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs. PDF Manejo de enfermedades endocrinológicas. Hiponatremia asociada a hipotiroidismo: mecanismos, implicaciones y manejo MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment. Liamis G1, Filippatos TD2, Liontos A1, Elisaf MS1. Eur J Endocrinol. 2017 Jan;176(1):R15-R20. Epub 2016 Aug 2. Abstract SUMMARY: The aim of this short review is the presentation of the mechanisms of hyponatremia and of the available data regarding its implications and treatment in patients with hypothyroidism. Hypothyroidism is one of the causes of hyponatremia, thus thyroid-stimulating hormone determination is mandatory during the evaluation of patients with reduced serum sodium levels. The main mechanism for the development of hyponatremia in patients with chronic hypothyroidism is the decreased capacity of free water excretion due to elevated antidiuretic hormone levels, which are mainly attributed to the hypothyroidism-induced decrease in cardiac output. However, recent data suggest that the hypothyroidism-induced hyponatremia is rather rare and probably occurs only in severe hypothyroidism and myxedema. Other possible causes and superimposed factors of hyponatremia (e.g. drugs, infections, adrenal insufficiency) should be considered in patients with mild/moderate hypothyroidism. Treatment of hypothyroidism and fluid restriction are usually adequate for the management of mild hyponatremia in patients with hypothyroidism. Patients with possible hyponatremic encephalopathy should be urgently treated according to current guidelines. CONCLUSIONS: Severe hypothyroidism may be the cause of hyponatremia. All hypothyroid patients with low serum sodium levels should be evaluated for other causes and superimposed factors of hyponatremia and treated accordingly. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information

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