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Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control [1] wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.
Subacute lymphocytic thyroiditis, also called painless or silent thyroiditis, occurs in individuals with underlying autoimmune disease or after pregnancy. [2] [4] [5] It is considered to be a variant of Hashimoto's thyroiditis. When subacute lymphocytic thyroiditis occurs up to 12 months postpartum, it is called postpartum thyroiditis.
[3] [5] Regardless of the severity of the disease or the type of treatment used, 20–56% of adult patients experienced transient hypothyroidism a few weeks after the hyperthyroid period. [27] Though it only happens in 5–15% of cases, persistent hypothyroidism can develop years after the diagnosis.
Subclinical hyperthyroidism is a milder form of hyperthyroidism characterized by low or undetectable serum TSH level, but with a normal serum free thyroxine level. [32] Although the evidence for doing so is not definitive, treatment of elderly persons having subclinical hyperthyroidism could reduce the number of cases of atrial fibrillation. [33]
The most common type of hyperthyroidism, Graves' disease, may additionally cause eye problems (Graves' ophthalmopathy) and skin changes of the legs (pretibial myxedema). [6] Thyroid disease may also cause muscle weakness in the form of thyrotoxic myopathy, but this is constant rather than episodic. [5]
Thyroid diseases are highly prevalent worldwide, [10] [11] [12] and treatment varies based on the disorder. Levothyroxine is the mainstay of treatment for people with hypothyroidism, [13] while people with hyperthyroidism caused by Graves' disease can be managed with iodine therapy, antithyroid medication, or surgical removal of the thyroid ...
Sub-clinical hyperthyroidism has been reported in 63% of euthyroid Graves' disease, [56] but only in 4% of cases where Graves' disease was in remission. [57] Subclinical hyperthyroidism has an 8% risk of converting to overt hyperthyroidism at 1 year, and a 26% risk at 5 years. [50]
Subclinical hypothyroidism is a biochemical diagnosis characterized by an elevated serum TSH level, but with a normal serum free thyroxine level. [48] [49] [50] The incidence of subclinical hypothyroidism is estimated to be 3-15% and a higher incidence is seen in elderly people, females and those with lower iodine levels. [48]
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