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Răspunsuri la întrebări (435)
March 24, 2011
Adriana:
Stimate domnule doctor,
Am 35 de ani si am nascut in iunie anul trecut. Acum o luna, medicul de familie a observat o crestere a dimensiunii glandei tiroide, fapt pentru care am facut câteva analize de laborator. Rezultatele sunt:
Anti-TPO = 863,7 IU/mL (valori normale 0.0 – 12.0)
Free_T4 = 0.95 ng/dL (valori normale 0.71 – 1.85)
hTSH = 14.749 uIU/mL (valori normale 0.490 -4.700)
Ulterior, medicul endocrinolog mi-a prescris Euthyrox 50 mg/zi si mi-a recomandat eco abia peste 3 luni la urmatorul control.Diagnosticul pus este de tiroidita cr.ai.DLP.
Va rog sa-mi spuneti opinia dumneavoastra cu privire la analizele de laborator si la tratamentul indicat.
Va multumesc mult.
Raspuns:
– testele de laborator arata intr-adevar prezenta unei tiroidite cronice (autoimune); tratamentul cu Euthyrox este in mod clar recomandat, iar obiectivul este de a readuce TSH-ul in limite normale; o valoare normala al TSH este cel mai bun indicator al unor nivele optime de hormoni tiroidieni;
– in ceea ce priveste doza: personal, as fi recomandat direct 75 micrograme/zi la acea valoare a TSH; este posibil totusi ca si 50 mcg/zi sa se dovedeasca, cel putin initial, adecvat; de asemenea, as considera necesar sa repetati TSH si FreeT4 peste 6-8 saptamani, pentru o mai buna monitorizare a bolii si tratamentului;
– probabil ca sarcina relativ recenta a avut un rol in declansarea acestei afectiuni autoimune; este stiut ca perioda de 3-6 luni dupa o nastere presupune reactivarea intensa a sistemului imun, fapt care poate provoca debutul sau agravarea bolilor cu substrat autoimun;
– ecografia nu este obligatoriu indicata in cazurile clare de tiroidita cronica; ea este utila in diagnosticul diferential al gusii, de exemplu cu prezenta de noduli tiroidieni;
Dr. Cristian-Claudiu Ţupea – Click aici pentru consultaţii
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