Hyperthyroidism is classified according to symptoms into:
- Subclinical (latent) hyperthyroidism – asymptomatic (with no apparent symptoms).
- Clinical hyperthyroidism – hyperthyroidism associated with symptoms.
Hyperthyroidism is classified according to the location of the disorder into:
- Primary hyperthyroidism – “true” hyperthyroidism.
- Manifest form – elevation of free triiodothyronine (fT3) and/or free thyrosine (fT4) above the upper normal range and concomitant TSH decrease (= suppressed basal thyroid-stimulating hormone (TSH)).
- Subclinical (latent) form – isolated TSH depression.
- Secondary hyperthyroidism – this is an excessive stimulation by increased TSH activity (eg, in hormone-forming tumors of the pituitary gland (pituitary gland)).
Akamizu criteria for assessing the likelihood of thyrotoxic crisis.
Main criterion 1 | Main criterion 2 | Secondary criterion 1 | Secondary criterion 2 |
Elevated fT4 or fT3 levels. |
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Definite thyrotoxic crisis | Both major criteria and one of the minor criteria 1 or major criterion 1 and at least 3 of the minor criteria 1 | ||
Suspicion of thyrotoxic crisis | Major criterion 1 and exactly 2 of minor criteria 1 or major criterion 2 and one of minor criteria 1 and all of minor criteria 2 or so super accurate in my sense at least 3 of minor criteria 1 and all of minor criteria 2 |
Forms of amiodarone-induced thyrotoxicosis (AMT).
Type I | Type II | |
Pathogenesis (disease development) | Iodine induced in existing thyroid disease (Graves’ disease or autonomy. | Destructive thyroiditis (inflammation of the thyroid gland). |
ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), interleukin-6. | mostly normal | mostly elevated |
Color duplex ultrasonography (ultrasound procedure that simultaneously assesses vessel walls and visualizes blood flow in a vessel) | Perfusion increased | Perfusion decreased |
TcTU (technetium uptake) in scintigraphy. | Unchanged or increased | reduced |
Therapy | Thyrostatic agents, lithium if necessary | NSAIDs (nonsteroidal anti-inflammatory drugs) or steroids |