Hyperthyroidism and Other Causes of Thyrotoxicosis: Management Guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists

医学 亚临床感染 甲状腺 病因学 甲状腺肿 放射性碘 循证医学 内科学 甲状腺切除术 工作队 儿科 格雷夫斯病 重症监护医学 替代医学 病理 公共行政 政治学
作者
Rebecca S. Bahn,Henry B. Burch,David S. Cooper,Jeffrey R. Garber,M. Carol Greenlee,Irwin Klein,Peter Laurberg,I. Ross McDougall,Víctor M. Montori,Scott A. Rivkees,Douglas S. Ross,Julie Ann Sosa,Marius N. Stan
出处
期刊:Endocrine Practice [Elsevier]
卷期号:17 (3): 456-520 被引量:573
标识
DOI:10.4158/ep.17.3.456
摘要

ObjectiveThyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition.MethodsThe development of these guidelines was commissioned by the American Thyroid Association in association with the American Association of Clinical Endocrinologists. The American Thyroid Association and American Association of Clinical Endocrinologists assembled a task force of expert clinicians who authored this report. The task force examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to develop the text and a series of specific recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group.ResultsClinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves’ hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves’ disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves’ ophthalmopathy; and management of other miscellaneous causes of thyrotoxicosis.ConclusionsOne hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.
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