Hyperthyroidism - Revision history

Danbot: Strip excess bold

2026-03-22T09:37:20Z

Strip excess bold

← Older revision		Revision as of 09:37, 22 March 2026
Line 4:		Line 4:

	===Causes===		===Causes===
	~~'''~~Primary Hyperthyroidism~~'''~~		Primary Hyperthyroidism
	*Graves disease (toxic diffuse goitre)		*Graves disease (toxic diffuse goitre)
	**Most common cause of hyperthyroidism (85% of cases)		**Most common cause of hyperthyroidism (85% of cases)
Line 19:		Line 19:


	~~'''~~Secondary Hyperthyroidism~~'''~~		Secondary Hyperthyroidism
	*Thyrotropin-secreting pituitary adenoma		*Thyrotropin-secreting pituitary adenoma
	*Thyroiditis		*Thyroiditis
Line 50:		Line 50:
	***Usually have pre-existing thyroid disorder and immune compromise		***Usually have pre-existing thyroid disorder and immune compromise
	**Radiation thyroiditis		**Radiation thyroiditis
	~~'''~~Other causes:~~'''~~		Other causes:
	*Apathetic thyrotoxicosis (elderly, masking comorbidities)		*Apathetic thyrotoxicosis (elderly, masking comorbidities)
	*Metastatic thyroid cancer		*Metastatic thyroid cancer
Line 67:		Line 67:
	[[File:PMC3742527 OL-06-01-0144-g00.png\|thumb\|Enlarged and homogeneous thyroid.]]		[[File:PMC3742527 OL-06-01-0144-g00.png\|thumb\|Enlarged and homogeneous thyroid.]]
	[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]		[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]
	~~'''~~Constitutional signs:~~'''~~		Constitutional signs:
	*[[Lethargy]]		*[[Lethargy]]
	*Diaphoresis		*Diaphoresis
Line 74:		Line 74:
	*Heat intolerance		*Heat intolerance
	*Weight loss		*Weight loss
	~~'''~~Neuropsychiatric:~~'''~~		Neuropsychiatric:
	*Emotional lability		*Emotional lability
	*Fine [[tremor]]		*Fine [[tremor]]
Line 84:		Line 84:
	*[[Thyrotoxic periodic paralysis\|Periodic paralysis]]		*[[Thyrotoxic periodic paralysis\|Periodic paralysis]]
	*Psychosis		*Psychosis
	~~'''~~Ophthalmologic:~~'''~~		Ophthalmologic:
	*[[Diplopia]]		*[[Diplopia]]
	*Lid lag		*Lid lag
Line 90:		Line 90:
	*Exophthalmos		*Exophthalmos
	*Ophthalmoplegia		*Ophthalmoplegia
	~~'''~~Endocrine:~~'''~~		Endocrine:
	*Neck fullness/tenderness (thyroid gland)		*Neck fullness/tenderness (thyroid gland)
	~~'''~~Cardiorespiratory:~~'''~~		Cardiorespiratory:
	*[[Dyspnea]]		*[[Dyspnea]]
	*Widened pulse pressure		*Widened pulse pressure
Line 103:		Line 103:
	*[[Atrial flutter]]		*[[Atrial flutter]]
	*[[CHF]]		*[[CHF]]
	~~'''~~GI:~~'''~~		GI:
	*[[Diarrhea]]		*[[Diarrhea]]
	*Hyperactive bowel sounds		*Hyperactive bowel sounds
	~~'''~~Reproductive:~~'''~~		Reproductive:
	*Oligomenorrhea		*Oligomenorrhea
	*Gynecomastia		*Gynecomastia
	*Telangiectasia		*Telangiectasia
	~~'''~~Gynecologic:~~'''~~		Gynecologic:
	*Menorrhagia		*Menorrhagia
	*Sparse pubic hair		*Sparse pubic hair
	~~'''~~Hematologic:~~'''~~		Hematologic:
	*[[Anemia]]		*[[Anemia]]
	*[[Leukocytosis]]		*[[Leukocytosis]]
	~~'''~~Dermatologic:~~'''~~		Dermatologic:
	*[[alopecia\|Hair loss]]		*[[alopecia\|Hair loss]]
	*Pretibial myxedema		*Pretibial myxedema
Line 122:		Line 122:
	*Palmar erythema		*Palmar erythema
	*Onycholysis		*Onycholysis
	~~'''~~Apathetic hyperthyroidism:~~'''~~ (elderly patients)<ref>Rehman SU et al. Thyroid Disorders in Elderly Patients. South Med J. 2005;98(5):543-549.</ref>		Apathetic hyperthyroidism: (elderly patients)<ref>Rehman SU et al. Thyroid Disorders in Elderly Patients. South Med J. 2005;98(5):543-549.</ref>
	*Placid apathetic facies		*Placid apathetic facies
	*Depression		*Depression

Rossdonaldson1: /* Differential Diagnosis (Tachycardia) */

2023-11-01T15:41:11Z

Differential Diagnosis (Tachycardia)

← Older revision		Revision as of 15:41, 1 November 2023
Line 133:		Line 133:
	*[[Agitation]] and [[confusion]]		*[[Agitation]] and [[confusion]]

	==Differential Diagnosis (Tachycardia)==		==Differential Diagnosis==
			===Tachycardia===
	*[[Anemia]]		*[[Anemia]]
	*[[Dehydration]]		*[[Dehydration]]

Rossdonaldson1: /* Differential Diagnosis (Tachycardia) */

2023-11-01T15:38:07Z

Differential Diagnosis (Tachycardia)

← Older revision		Revision as of 15:38, 1 November 2023
Line 157:		Line 157:
	*Pain		*Pain
	*Psych (anger, fear)		*Psych (anger, fear)

			{{Palpitations DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Clinical Features */

2019-12-17T23:23:54Z

Clinical Features

← Older revision		Revision as of 23:23, 17 December 2019
Line 65:		Line 65:
	==Clinical Features==		==Clinical Features==
	[[File:PMC5384127 TJO-47-94-g6.png\|thumb\|Bilateral infiltrative thyroid-associated exophthalmos]]		[[File:PMC5384127 TJO-47-94-g6.png\|thumb\|Bilateral infiltrative thyroid-associated exophthalmos]]
			[[File:PMC3742527 OL-06-01-0144-g00.png\|thumb\|Enlarged and homogeneous thyroid.]]
	[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]		[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]
	'''Constitutional signs:'''		'''Constitutional signs:'''

Rossdonaldson1: /* Clinical Features */

2019-12-17T23:16:47Z

Clinical Features

← Older revision		Revision as of 23:16, 17 December 2019
Line 64:		Line 64:

	==Clinical Features==		==Clinical Features==
			[[File:PMC5384127 TJO-47-94-g6.png\|thumb\|Bilateral infiltrative thyroid-associated exophthalmos]]
	[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]		[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]
	'''Constitutional signs:'''		'''Constitutional signs:'''

Rossdonaldson1: /* Clinical Features */

2019-12-17T23:07:10Z

Clinical Features

← Older revision		Revision as of 23:07, 17 December 2019
Line 64:		Line 64:

	==Clinical Features==		==Clinical Features==
	[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). ~~Occurs~~ in about 5% of hyperthyroid patients.]]		[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Abnormal nail findings occurs in about 5% of hyperthyroid patients.]]
	'''Constitutional signs:'''		'''Constitutional signs:'''
	*[[Lethargy]]		*[[Lethargy]]

Rossdonaldson1: /* Clinical Features */

2019-12-17T23:06:41Z

Clinical Features

← Older revision		Revision as of 23:06, 17 December 2019
Line 64:		Line 64:

	==Clinical Features==		==Clinical Features==
			[[File:PMC3371544 IJD-57-247-g002.png\|thumb\|"Plummer's nail" demonstrating onycholysis (separation of the nail from the nail bed). Occurs in about 5% of hyperthyroid patients.]]
	'''Constitutional signs:'''		'''Constitutional signs:'''
	*[[Lethargy]]		*[[Lethargy]]

Rossdonaldson1: /* Evaluation */

2019-12-17T22:37:03Z

Evaluation

← Older revision		Revision as of 22:37, 17 December 2019
Line 160:		Line 160:
	*Free T4 (↑)		*Free T4 (↑)
	*Free T3 (↑)		*Free T3 (↑)

			===Diagnosis===
			[[File:thyroid studies.JPG\|px200]]

	==Management==		==Management==

Rossdonaldson1 at 22:32, 17 December 2019

2019-12-17T22:32:44Z

← Older revision		Revision as of 22:32, 17 December 2019
Line 60:		Line 60:
	**Drug-induced thyroiditis may also occur with interleukin-2, [[Interferon-α]], [[lithium]], tyrosine kinase inhibitors, HAART		**Drug-induced thyroiditis may also occur with interleukin-2, [[Interferon-α]], [[lithium]], tyrosine kinase inhibitors, HAART
	*[[Molar pregnancy]]		*[[Molar pregnancy]]

			{{Thyroid gen background}}

	==Clinical Features==		==Clinical Features==

ClaireLewis at 16:16, 28 September 2019

2019-09-28T16:16:44Z

← Older revision		Revision as of 16:16, 28 September 2019
Line 1:		Line 1:
	==Background==		==Background==
	*Hyperthyroidism: Excess circulating hormone resulting from thyroid gland hyperfunction		*Hyperthyroidism: Excess circulating hormone resulting from thyroid gland hyperfunction
	*Thyrotoxicosis: Excess circulating thyroid hormone originating from any cause		*[[Thyrotoxicosis]]: Excess circulating thyroid hormone originating from any cause

	===Causes===		===Causes===
Line 51:		Line 51:
	**Radiation thyroiditis		**Radiation thyroiditis
	'''Other causes:'''		'''Other causes:'''
	*[[Apathetic thyrotoxicosis]] (elderly, masking comorbidities)		*Apathetic thyrotoxicosis (elderly, masking comorbidities)
	*Metastatic thyroid cancer		*Metastatic thyroid cancer
	*Iodine-induced thyrotoxicosis		*Iodine-induced thyrotoxicosis
	*Amiodarone-induced thyroiditis <ref>Thiessen, M. (2018). Thyroid and Adrenal Disorders. Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders </ref>		*[[Amiodarone]]-induced thyroiditis <ref>Thiessen, M. (2018). Thyroid and Adrenal Disorders. Rosen's emergency medicine: Concepts and clinical practice (9th ed.). Philadelphia, PA: Elsevier/Saunders </ref>
	**Possible mechanisms:		**Possible mechanisms:
	***Drug-induced destructive thyroiditis		***Drug-induced destructive thyroiditis
	***Hyperthyroidism caused by iodine load (amiodarone contains a large amount of iodine)		***Hyperthyroidism caused by iodine load (amiodarone contains a large amount of iodine)
	**Drug-induced thyroiditis may also occur with interleukin-2, ~~interferon alpha~~, lithium, tyrosine kinase inhibitors, HAART		**Drug-induced thyroiditis may also occur with interleukin-2, [[Interferon-α]], [[lithium]], tyrosine kinase inhibitors, HAART
	*[[Molar pregnancy]]		*[[Molar pregnancy]]

	==Clinical Features==		==Clinical Features==
	'''Constitutional signs:'''		'''Constitutional signs:'''
	*Lethargy		*[[Lethargy]]
	*Diaphoresis		*Diaphoresis
	*Weakness		*[[Weakness]]
	*Fever		*[[Fever]]
	*Heat intolerance		*Heat intolerance
	*Weight loss		*Weight loss
	'''Neuropsychiatric:'''		'''Neuropsychiatric:'''
	*Emotional lability		*Emotional lability
	*Fine tremor		*Fine [[tremor]]
	*Anxiety		*[[Anxiety]]
	*Muscle wasting		*Muscle wasting
	*Confusion		*[[Confusion]]
	*Hyperreflexia		*Hyperreflexia
	*Coma		*[[Coma]]
	*Periodic paralysis		*[[Thyrotoxic periodic paralysis\|Periodic paralysis]]
	*Psychosis		*Psychosis
	'''Ophthalmologic:'''		'''Ophthalmologic:'''
Line 88:		Line 88:
	*Neck fullness/tenderness (thyroid gland)		*Neck fullness/tenderness (thyroid gland)
	'''Cardiorespiratory:'''		'''Cardiorespiratory:'''
	*Dyspnea		*[[Dyspnea]]
	*Widened pulse pressure		*Widened pulse pressure
	*Palpitations		*[[Palpitations]]
	*Systolic hypertension		*Systolic [[hypertension]]
	*[[Chest pain]]		*[[Chest pain]]
	*Sinus tachycardia		*[[Sinus tachycardia]]
	*[[Atrial fibrillation]]		*[[Atrial fibrillation]]
	**Occurs in 10-20% of patients and can revert to sinus rhythm when hyperthyroidism treated		**Occurs in 10-20% of patients and can revert to sinus rhythm when hyperthyroidism treated
Line 109:		Line 109:
	*Sparse pubic hair		*Sparse pubic hair
	'''Hematologic:'''		'''Hematologic:'''
	*Anemia		*[[Anemia]]
	*Leukocytosis		*[[Leukocytosis]]
	'''Dermatologic:'''		'''Dermatologic:'''
	*Hair loss		*[[alopecia\|Hair loss]]
	*Pretibial myxedema		*Pretibial myxedema
	*Warm, moist skin		*Warm, moist skin
Line 118:		Line 118:
	*Onycholysis		*Onycholysis
	'''Apathetic hyperthyroidism:''' (elderly patients)<ref>Rehman SU et al. Thyroid Disorders in Elderly Patients. South Med J. 2005;98(5):543-549.</ref>		'''Apathetic hyperthyroidism:''' (elderly patients)<ref>Rehman SU et al. Thyroid Disorders in Elderly Patients. South Med J. 2005;98(5):543-549.</ref>
	*Placid ~~apaethetic~~ facies		*Placid apathetic facies
	*Depression		*Depression
	*Lethargy		*Lethargy
	*Muscular weakness and wasting		*Muscular weakness and wasting
	*Excessive weight loss		*Excessive weight loss
	*Cardiac ~~dysrrhythmias~~		*Cardiac [[dysrhythmias]]
	*Absent or small goiter		*Absent or small goiter
	*Absence of ocular symptoms		*Absence of ocular symptoms
	*Agitation and confusion		*[[Agitation]] and [[confusion]]

	==Differential Diagnosis (Tachycardia)==		==Differential Diagnosis (Tachycardia)==
	*Anemia		*[[Anemia]]
	*Dehydration		*[[Dehydration]]
	*[[Fever]]		*[[Fever]]
	*~~Drug intoxication~~		*[[Infection]], [[Sepsis]]
	*Drug withdrawal		*[[Anion gap acidosis]]
	*Pain
	*Infection
	*Anion gap acidosis
	*[[Sepsis]]
	*[[Hyperthyroid]]		*[[Hyperthyroid]]
	*Psych (anger, fear)
	*[[Arrhythmia]]		*[[Arrhythmia]]
	*[[PE]]		*[[PE]]
	*[[CHF]]		*[[CHF]]
			*[[MI]]
	*[[Tamponade]]		*[[Tamponade]]
	*[[Myocardial contusion]]		*[[Myocardial contusion]]
	*Cardiac valvular disease		*Cardiac [[valvular emergencies\|valvular disease]]
	*Hyper/[[hypoglycemia]]		*Hyper/[[hypoglycemia]]
	*~~AMI~~		*[[drug overdose\|Drug intoxication]]
			*Drug withdrawal
	*Toxicity		*Toxicity
	**ASA		**[[salicylate toxicity\|ASA]]
	**TCA		**[[TCA toxicity\|TCA]]
	**Anticholinergic		**[[Anticholinergic toxicity\|Anticholinergic]]
	**Theophylline		**[[Theophylline toxicity\|Theophylline]]
			*Pain
			*Psych (anger, fear)

	==Evaluation==		==Evaluation==