Clinical Presentation of Spontaneous Primary Hypothyroidism in Adults

Al-Sultan, Ali Ibrahim; Larbi, E.; Magbool, Gady; Karima, Talal M.; Bagshi, Mahmoud

doi:10.5144/0256-4947.1995.143

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…In the current series, common physical signs obtained during the first visit were dry and course skin, present in 30 (60%) cases. This was similar to the study of Al-Sultan et al 11 In a few of the cases, major variations of physical presentations were observed, which might be due to the duration of symptoms. Among the 50 cases of the present series, only 4% were diabetic.…”

Section: Discussionsupporting

confidence: 92%

“…With a mean of 0.59 nmol/l. This was also consistent with the findings of Al-Sultan et al 11 The range of serum total T4 in the current series was found to vary from 0.93 to 69.00 nmol/l with a mean of 21.45 nmol/l. Significant elevation of serum TSH levels was found in the study patients and a negative correlation was found between serum TSH levels and T4 and T3 levels.…”

Section: Limitationssupporting

confidence: 94%

“…7 The male: female ratio in the present study was 4:1, which was almost similar to the findings of the Saudi-Arabian study. 11 In this series, spontaneous primary hypothyroidism (idiopathic) was the main cause of hypothyroidism, observed in 45 patients (90%).Two patients (4%) developed hypothyroidism after total thyroidectomy due to thyroid malignancy and another 2 patients (4.0%) developed hypothyroidism to radioiodine therapy. In this series, only one patient (2%) developed hypothyroidism due to treatment with anti-thyroid drugs.…”

Section: Discussionmentioning

confidence: 64%

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Clinical presentation of hypothyroidism: a study of 50 cases

Hanif

Hoque²,

Habib

et al. 2022

Int J Res Med Sci

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Background: When the thyroid gland does not produce and release enough thyroid hormone into your circulation, it is known as hypothyroidism. Your metabolism becomes slower as a result. Hypothyroidism, also known as an underactive thyroid, can make you feel exhausted, put-on weight, and have trouble with cold weather. In utero, throughout infancy, during youth, or even during maturity, it may begin to develop. The frequency of unanticipated overt hypothyroidism varies from 1 to 18 cases per thousand persons when accompanied by biochemical and clinical symptoms of hypothyroidism. The aim of the study was to observe the various clinical presentations of hypothyroidismMethods: This cross-sectional observational case-based study was conducted at the institute of nuclear medicine, Dhaka medical college hospital, Dhaka, Bangladesh. The study duration was 6 months, from January 2005 to July 2005. A total of 50 patients attended at the study place during the study period who were biochemically hypothyroid were included in the study.Results: The age range of the patients was 13 months to 54 years with a mean age of 29.5 years in this series. The majority of the patients were between 20 to 49 years of age. Female comprises 80.0% in comparison to 20.0% of male cases of hypothyroidism. Spontaneous primary (idiopathic) hypothyroidism (90.0%), post-radioiodine therapy, and post-ablative hypothyroidism were the most important causes of hypothyroidism in this series. Most typical symptoms and signs of hypothyroidism were found in this study. The most common symptoms were generalized weakness, lethargy, slowness of activities, impairment of memory, loss of scalp hair, somnolence, dry skin, puffiness of the face, constipation, weight gain, hoarseness of voice, swelling of the body, decreased sweating and paraesthesia. Cases of idiopathic hypothyroidism and other types had similar symptoms. The mean duration of symptoms before medical consultation was 2.9 years. Dry and coarse skin topped the list of physical findings and was present in 60.0% of the cases. Other findings in order of frequency include goiter (56.0%), puffiness of the face (38.0%), cold and thick skin (44.0%), thick tongue (24.0%), peripheral edema (24.0%), Anemia (20.0%), pallor of the face (12.0%), bradycardia (08.0%), thick lips (4.0%), ascites (2.0%) and pericardial effusion (2.0%).Conclusions: Although in the present series a limited number of patients were included, it encompassed varieties of cases. Moreover, an attempt was made to evaluate the common presentation, age incidence, sex distribution, and laboratory status of hypothyroidism in our country, giving more emphasis on clinical findings.

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Section: Discussionsupporting

confidence: 92%

Section: Limitationssupporting

confidence: 94%

Section: Discussionmentioning

confidence: 64%

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Clinical presentation of hypothyroidism: a study of 50 cases

Hanif

Hoque²,

Habib

et al. 2022

Int J Res Med Sci

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“…Melanose colica é uma pigmentação peculiar da mucosa do cólon que é observada em alguns pacientes no momento da colonoscopia e indica o uso crônico de antraquinona como laxante (54) . A função tireoidiana limítrofe é comum na população em geral, mas raramente se apresenta como constipação na ausência de outras características da doença da tireóide, como a letargia, a intolerância ao frio e o ganho de peso (55) . A hipercalcemia também está associada à constipação, embora raramente na ausência de outros sintomas da doença de base, como dor nas costas ou anemia em uma pessoa com mieloma (56) .…”

Section: Figura 3 Constipação Crônicaunclassified

[No Title Available]

Spiller

Thompson²

2012

Arq. Gastroenterol.

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Os principais sintomas de origem intestinal são: dor abdominal ou desconforto, hábito intestinal alterado, distensão abdominal e borborigmos. Dor abdominal/desconfortoAs características da dor abdominal incluem a localização, a irradiação (se houver), o caráter (ardor, em pontadas, cólicas), padrão e duração (desde o início e a duração da crise) e fatores precipitantes e de alívio. Dor abdominal ou desconforto de origem gastrointestinal funcional surge da estimulação dos nervos viscerais: normalmente é difusa e mal localizada, muitas vezes no abdome inferior ou central. Quando perguntado para demonstrá-la, o paciente pode usar uma mão estendida, colocada sobre a área. Dados que sugerem a origem gastrointestinal da dor abdominal incluem exacerbação ao comer e alívio por defecação, sendo esta última parte dos critérios diagnósticos para síndrome do intestino irritável (SII). No entanto, apesar da alimentação aumentar a motilidade do cólon, pode produzir desconforto por meia hora depois , sendo característica de muitas doenças gastrointestinais. Portanto, a dor após refeições não faz parte dos critérios diagnósticos para a SII.Em contraste, quando doença visceral está associada com a estimulação dos neurônios somáticos, a dor é localizada mais precisamente. Diverticulite e apendicite são exemplos de doença intra-abdominal que, inicialmente são mal localizados, porque uma leve inflamação afeta apenas os neurônios viscerais. No entanto, quando a inflamação progride e atinge o peritônio parietal, a dor abdominal somática mais precisamente localizada é experimentada. Outros exemplos incluem a irradiação para as costas, que é típica de doença pancreática ou de úlcera duodenal penetrante.Dor em parede abdominal devida à hérnia de Spigelian (hérnia através da fáscia aponeurótica lateral ao músculo retoabdominal), lesão no músculo reto ou síndrome de dor em costelas é também localizada com mais precisão. Dor de tais causas pode ser identificada pelo teste do Carnett, no qual o paciente dobra seus braços sobre o peito e levanta sua cabeça contra a resistência suave. Exacerbação da dor por enrijecer os músculos retos desta forma, indica um distúrbio de parede abdominal (1) . Dor na caixa torácica é também precisamente localizada e agravada pela pressão local ou compressão. Reconhecimento precoce destas fontes somáticas menos comuns de dor abdominal pode evitar muita investigação fútil (2) . A dor abdominal da SII é visceral por natureza e geralmente episódica e imprevisível. Períodos de dor reaparecem durante uma mediana (intervalo) de 3 dias (2)(3)(4)(5)(6)(7)(8) , intercalados com alguns dias sem dor (3) . No entanto, em alguns casos, períodos dolorosos podem ser mais prolongados. Uma característica crucial da dor abdominal de SII é a associação temporal com hábito intestinal alterado. Uma alteração na frequên-cia e consistência das evacuações simultânea com a dor é um fenômeno usado nos critérios de Manning. Para a SII, esses recursos têm sensibilidade de SII desde 0,39 -0.6 e uma especificidade de 0,66 -0,77 com relação ...

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“…[8] A study conducted among hypothyroid patients in King Fahad Hospital of the University (KFHU) during 1995 found the prevalence of depression as the first manifestation of hypothyroidism to be 18%. [9]…”

Section: Introductionmentioning

confidence: 99%