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ipofiza(sauglanda pituitar) este oglandendocrin mic (500 mg), situat median labazacreieruluintr-o cavitate aosului sfenoiddenumit aua turceasc, posterior de chiasmaoptic.

Are trei lobi: anterior, intermediar i posterior. Lobul anterior sau adenohipofiza reprezinta 75% dinmasa glandei, lobul intermediar 2% (redus la o simpl lam epitelial aderent la cel posterior),

iar cel posterior sau neurohipofiza, restul. Adenohipofiza i lobul intermediar au origineembriologic comun, epitelial, iar neurohipofiza are origine nervoas ca ihipotalamusuldecare se leag. Neurohipofiza are rolul de a eliberahormoniisecretai de nucleii anteriori aihipotalamusului.

Cuprins

[ascunde]

1Alctuire

o 1.1Adenohipofiza

o 1.2Lobul intermediar hipofizar

o 1.3Neurohipofiza

2Reglarea hipofizei

3Hormonii hipofizei

4Acromegalia

o 4.1Tablou clinic

o 4.2Diagnostic paraclinic

o 4.3Tratament

5Adenomul secretant de PRL

o 5.1Tablou clinic

o 5.2Diagnostic paraclinic

o 5.3Tratament

6Adenomul secretant ACTH

7Bibliografie

Alctuire[modificare|modificare surs]

Hipofiza este alctuir din trei lobi: adenohipofiza, lobul intermediar i neurohipofiza.

Adenohipofiza[modificare|modificare surs]

https://ro.wikipedia.org/wiki/Gland%C4%83https://ro.wikipedia.org/wiki/Gland%C4%83https://ro.wikipedia.org/wiki/Creierhttps://ro.wikipedia.org/wiki/Creierhttps://ro.wikipedia.org/wiki/Osul_sfenoidhttps://ro.wikipedia.org/wiki/Osul_sfenoidhttps://ro.wikipedia.org/wiki/Hipotalamushttps://ro.wikipedia.org/wiki/Hipotalamushttps://ro.wikipedia.org/wiki/Hipotalamushttps://ro.wikipedia.org/wiki/Hormonhttps://ro.wikipedia.org/wiki/Hormonhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83https://ro.wikipedia.org/wiki/Hipofiz%C4%83https://ro.wikipedia.org/wiki/Hipofiz%C4%83https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Alc.C4.83tuirehttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenohipofizahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Lobul_intermediar_hipofizarhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Neurohipofizahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Reglarea_hipofizeihttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Hormonii_hipofizeihttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Acromegaliahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tablou_clinichttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Diagnostic_paraclinichttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tratamenthttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenomul_secretant_de_PRLhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tablou_clinic_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Diagnostic_paraclinic_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tratament_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenomul_secretant_ACTHhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Bibliografiehttps://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=1https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=1https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=2https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=2https://ro.wikipedia.org/wiki/Creierhttps://ro.wikipedia.org/wiki/Osul_sfenoidhttps://ro.wikipedia.org/wiki/Hipotalamushttps://ro.wikipedia.org/wiki/Hormonhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Alc.C4.83tuirehttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenohipofizahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Lobul_intermediar_hipofizarhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Neurohipofizahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Reglarea_hipofizeihttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Hormonii_hipofizeihttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Acromegaliahttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tablou_clinichttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Diagnostic_paraclinichttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tratamenthttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenomul_secretant_de_PRLhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tablou_clinic_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Diagnostic_paraclinic_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Tratament_2https://ro.wikipedia.org/wiki/Hipofiz%C4%83#Adenomul_secretant_ACTHhttps://ro.wikipedia.org/wiki/Hipofiz%C4%83#Bibliografiehttps://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=1https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=1https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=2https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=2https://ro.wikipedia.org/wiki/Gland%C4%83

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Secret:

hormoni non-glandulotropi (nontropi)- hormonul de cretere -STH (GH), prolactina - LTH

hormoni glandulotropi ( tropi) - adrenocorticotropul (ACTH),

gonadotropii (FSH-foliculostimulant i LH-luteinizant), tireotrop(TSH).

Lobul intermediar hipofizar[modificare|modificare surs]

Secret:

hormonul melanocitostimulator (MSH)

Neurohipofiza[modificare|modificare surs]

Depoziteaz:

hormonul antidiuretic (ADH sau vasopresina)

ocitocina (oxitocina)

Reglarea hipofizei[modificare|modificare surs]

1. Hormoni hipotalamici stimulatori:

TRH - hormon eliberator de tirotropin - tireostimulina

CRH - corticoliberina - hormon eliberator de ACTH

GH-RH - hormon eliberator de hormon somatotrop

Gn-RH - hormon eliberator de gonadotropi -gonadoliberine

PRH - hormon eliberator de PRL

RH - hormon eliberator de MSH.

2. Hormoni inhibitori:

SRIF sau somatostatin - inhib eliberarea GH

PIF - inhib eliberarea de PRL

MIF - inhib eliberarea de melatonin.

Hormonii hipofizei[modificare|modificare

surs]

https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=3https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=3https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=3https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=4https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=4https://ro.wikipedia.org/wiki/Oxitocin%C4%83https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=5https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=5https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=5https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=6https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=6https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=6https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=3https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=3https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=4https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=4https://ro.wikipedia.org/wiki/Oxitocin%C4%83https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=5https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=5https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=6https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=6https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=6

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Hormonul somatotrop (STH sau hormonul de crestere).Prin intermediul factorilor insulinici de cretere areaciune asupra cartilajelor de cretere, anabolismuluimuscular i creterii celulare. UP = acromegalie, LOW =hipopituitarism.

Prolactina (LTH, hormonul luteotrop sau mamotrop).Stimuleaz secreia lactat a glandei mamare, este uninhibitor al activitii gonaotrope i este capabil sprevin ovulaia. UP = hiperprolactinemii.

Hormonul adrenocorticotrop (ACTH). Stimuleazproducia de hormoni a corticosuprarenalei, crescndconcentraia sangvin a glucocorticoizilor i a hormonilorsexuali. Are efecte reduse asupra secreiei demineralocorticoizi. UP = boala Cushing

Hormonul foliculostimulant (FSH). Rol n recrutareafoliculilor primordiali la femeie, iar la brbat rol nspermatogenez. UP = menopauza.

Hormonul luteinizant (LH). Rol major n steroidogenez.Declaneaz ovulaia. Stimuleaz producia detestosteron din celulele Leydig testiculare. LOW =insuficiena gonadic secundar.

Hormonul tireotrop (TSH). Rol n asigurarea secreieiadecvate de T3 i T4. Proliferarea i hipertrofia celulelortiroidiene. LOW = hipertiroidism i hipotiroidismsecundar (hipofizar) UP = hipotiroidismul primar.

Hormonul melanozitostimulant (MSH). Rol n stimulareapigmentogenezei.

Acromegalia[modificare|modificare surs]

Definiie - totalitatea modificrilor somatice i metaboliceaprute ca urmare a creterii secreiei de hormon decretere (GH/STH) dup pubertate.

Cauze: tumorale- 95%, prin hiperplazie 2-5%.

Tablou clinic[modificare|modificare surs]

1. Sindrom endocrin:

Tegumente groase, transpiraie excesiv, hipertrichoz,frunte ngust, arcade i sprncene proeminente, nas i buze

groase, macroglosie, prognatism, mini i picioare late,cifoz dorsal, lordoz, voce ngroat, gu, cardiomegalie,

https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=7https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=7https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=8https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=8https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=7https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=7https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=8https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=8

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splenomegalie, hepatomegalie, gastrit hipertrofic,megacolon, cancere i polipi intestinali, nefromegalie, etc.

2. Sindrom tumoral

Cefalee dat de tumorile intraelare, rezistent la antialgiceobinuite; hemianopsie bitemporal frecvent.

Diagnostic

paraclinic[modificare|modificare surs]

1. Biologic

Proba hiperglicemiei provocate poer oral (HGPO) de tipdiabet zaharat sau diabet zaharat tipic, calcemia N,calciuria=UP, fosfatemiea=UP, fosfataza alcalin=UP.

2. Hormonal

GH-static-valori crescute cu anularea ritmului nictemeral desecreie. GH - teste dinamice: stimularea cu GH-RH sauTRH; inhibiie cu HGPO: testul cu L-DOPA sau bromocriptin- la acromegalici produce o reducere paradoxal a GH; Testulla TRH - la sntos TRH nu stimuleaz secreia de TRH, dar

n acromegalie da. PRL = N/UP. Somatomedinele (IGF1) =UP

3. Radiologic

Se face Rx Craniu profil pentru aua turceasc, CT i IRM.

Tratament[modificare|modificaresurs]

Chirurgical

Extirparea tumorii prin abord transsfenoidal dac tumora nuare extensie mare suprastelar.

Medicamentos

Analogi de somatostatine - OCTREOTID sau agonitidopaminergici BROMOCRIPTIN n doz mare.

Adenomul secretantdePRL[modificare|modificare surs]

Tablou

clinic[modificare|modificare surs]

La femei sn bine pregtitestrogenic, galactoree,oligomenoree sau amenoree,

https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=9https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=9https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=9https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=9https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=10https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=11https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=12https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=12

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infertilitate, hirsutism. La brbaiapar tulburri de dinamicsexual pn la impoten,oligospermie, reducereavolumului seminal, infertilitate,scderea pilozitii faciale.

Diagnostic

paraclinic[modificare|modificare surs]

1.1. Hormonal. DozareaPRL serice. Prin treiprobe de sngerecoltate pe un catetervenos la interval de 15min. Dozarea se faceprin metodeELISA/RIA/electrochemiluminescen. Valoripeste 100 ng/mlcertific prezenatumorii.

2.2. Imagistic. CT/IRMidentific tumora.

3.3. Consult oftalmologici neurologic

Tratament[modificare|modificare surs]

1.1. Bromocriptina -blocheaz secreia dePRL.

2.2. Cabergolina

3.3. Extirpareachirurgical aadenomului.

4.4. Radioterapia.

Adenomul secretant

ACTH[modificare|modificare surs]

https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=15https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=15https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=15https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=13https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=14https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&veaction=edit&vesection=15https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=15https://ro.wikipedia.org/w/index.php?title=Hipofiz%C4%83&action=edit&section=15

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Adenom care secret ACTH, decele mai multe orimicroadenom, care prin efectulstimulator asupra ambelorsuprarenale produce hipertrofiabilateral a acestora.

Tablou clinic. Facies rotund delun plin, cu venectazii, tenseboreic, obezitate facio-truncular, hiperpigmentaretegumentar, hirsutism, HTA,hiperglicemie, vergeturi roiiviolacee pe abdomen icoapse, dereglri ale cicluluimenstrual.

Dg paraclinic.

1. Analize nespecifice:hiperglicemie, cretereaNatremiei, scdereapotasemiei.

2. Hormonal. Dozareacortizolului plasmatic la ora 8 i16, constatdu-se pierderearitmului nictemeral; dozarea

cortizolului plasmatic urinar;dozarea ACTH plasmatic; testedinamice - testul de inhibiie cudexametazoa, testul destimulare cu CRH, testul cuMetopiron.

3. Imagistica. Eco desuprarenale identific numaitumorile. CT-IRM de hipofiz

identific i msoar tumorile.Scintigrafie suprarenalian cucolesterol marcat cu iodradioactiv.

Tratament.

1. Hipofizectomietranssfenoidal

2. Radioterapie convenional

3. Alternativ -suprarenalectomie +radioterapie hipofizar.

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4. Blocant ale steroizilorsuprarenalieni: Metopiron,Ketoconazol

5. Blocant ale receptorilor decortizol.

Diabetul Insipid

Este un sindrom cliniccaracterizat prin poliurie ipolidipsie, densitate multsczut ca urmare a deficituluide ADH.

Forme clinice: DI cranial - prindeficit total/parial de ADH printumori, infecii la nivel

hipotalamo-hipofizar, autoimun,ereditar, posthipofizectomie. DInefroge - lipsa de rspuns areceptorilor la aciunea ADH. DIgestatioal.

Tablou clinic. Poliurie, nicturie,sete (polidipsie).

Paraclinic. Diurez peste 5-6l/24h, densitate urinar sub

1010g/l, osmolaritate urinarsub 300 mOsm/l, ADH sericredus, teste dinamice, glicemiai glicozuria pt dg dif cu Dz,uree i electroliti, imagistic.

Teste dinamice. Proba dedeshidratare. Proba cu ADH

Tiroida

Este format din doi lobi uniiprintr-o poriune centraldenumit istm. Are 15-25 g.

Reglarea tiroidei. Neurogena:prin act TRH. Feedbacknegativ: efectul inhibitor al T3 iT4 asupra secreiei de TSH.Autoreglare - excesul de iodscade efectul TSH asuprareceptorilor.

Efectele hormonilor tiroidieni.Calorigen, diferenierea iproliferarea esuturilor, rol

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metabolic - tendina lahiperglicemie, stimuleazlipoliza, cresc catabolismulproteic, hipersudoraie, crescviteza de conducere la nivelulmuchilor netezi i striai iviteza de conducere nervoas,accelereaz tranzitul intestinal.

Explorarea tiroidei.

1. Dozri hormonale. Statice.Dozarea T3 i T4 din serulobinut prin centrifugarea probeide snge venos prin metode:radioimunologice RIA,imunoenzimatice ELISA,electrochemiluminescena ILA.Dozarea TSH prin aceleaimetode. Dozarea calcitononeila fel.

Teste dinamice. Testul cu TRH -dozarea TSH nainte, la 30 min,la 60 min dup adm a 200microg de TRH iv. nhipertiroidism stimularea este

ineficient, TSH nu crete; nhipotiroidie se nregistreaz ocetere exploziv a TSH.Dozarea iodemiei i a ioduriei.Dozarea tireoglobulinei dinserul obinut prin centrifugareasngelui venos prin metodeRIA, ELISA, ILA,imunofluorescena IFA. Normaleste de 30-40 ng/ml. Crete n

cancerul tiroidian.Markerii autoimunitiitiroidiene: anticorpiiantiperoxidazici (TPO) crescui

n hashimoto, aantitireoglobulinici (atc Tg) UP

n tir Hasimoto, a antireceptoriTSH (TRAb) UP n b Basedow.

Explorarea morfologic a

tiroidei. Ecografia.Tireoscintigrma TC/IRM.

Gua endemic

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Orice cretere n volum aglandei tiroide.

Necesarul de iod: Perioadaprepubertar, adolesceni iaduli = 150 microg/zi, gravide

i luze = 200 microni/zi.Tablou clinic. Tumefierearegiunii cervicale anterioare,senzaie de constricie la nivelulgtului, senzaie de nod ngt, tulburri de memorie,

ntrziere de cretere la copii iadolesceni.

Dg pozitiv. Tablou clinic, eco de

tiroid, scintigrafia,radioiodocaptarea, ioduria,dozarea T3 i T4 normal saucrescut, Tsh normal saucrescut, dozarea atcTPO ptexcluderea etiologieiautoimune.

Tratament. Medicamentos.Profilactic: cu iodur de potasiu,sare iodat, ulei iodat. Curativ:

hormoni tiroidieni n doz mare,antitiroidiene de sintez(Thyrozol) pentru guilehipertiroizate. Chirurgical cuscop de decomproimare sauestetic.

Hipertiroidismul (Tireotoxicoza)

Sindrom determinat de excesulde hormoni tiroidieni circulani,

fie prin producie tiroidianexcesiv, fie TSH crescut.

Etiologie: Boal autoimun,cauze genetice, infecii, tumorihipofizare, adenoametiroidiene.

Tablou clinic. Palpitaii,transpiraii, agitaie i anxietate,tremor fin al extremitilor,

dispnee, astenie, scdereponderal, apetit alimentarcrescut, tranzit intestinal

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accelerat, cretere a TA,prezena guii i a freamtuluitiroidian, fibrilaie atrial, flutteratrial, axtrasistole, piele fin,cald, epilat, traspirat.

Dg paraclinic. T3, T4, FT4crescute n ser, TSH sczut,colesterol sczut, RIC crescutla 2, 24 h cu o reducere uoarala 48 h, ecografia poatesemnala eventuale formaiuninodulare.

Tratament. Evitareasuprasolicitrii fizice i psihice,a stresului, tutunului, cafelei, ia preparatelor cu iod, dietbogat n proteine i CH,tratament medical: antitiroidienede sintez Thyrozol,betablocante, sedative.Tratament chirurgical -tiroidectomie subtotal larg.RADIOTERAPIE.

Forme clinice de Hipertiroidism

1. Boala Basedow. Etiologieautoimun. tablou clinic: maniflinice de hipertiroidism, gudifuz i omogen, exoftalmie,mixedem pretibial. Paraclinic:t3, t4, ft4 = UP.

Tratament. Specifichipertiroidismului: medical ichirurgical

Bibliografie[modificare|modificare surs]

1.Biologie. Anatomia sifiziologia omului,Editura Didactica siPedagogica, R.A. -Bucuresti, 1993, Prof.univ. dr. I. Teodorescu

ExarcuCategorii:

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