Una revisión sistemática de la literatura sobre la enfermedad tiroidea oculardermatolaringologica
Palabras clave:
Enfermedad tiroidea, exoftalmos, enoftalmos, colágeno, hipertiroidismo e hipotiroidismo.Resumen
La enfermedad tiroidea subclínica (ETS) es una condición asintomática de alta
prevalencia que incluye el hipertiroidismo subclínico (HiperSC) y el hipotiroidismo
subclínico (HipoSC). Ambas formas no tienen síntomas ni signos específicos y
solamente pueden ser detectados mediante exámenes hormonales. Las causas más
frecuentes de HiperSC son la enfermedad de Graves y el bocio multinodular.
De HipoSC la causa más frecuente es la tiroiditis crónica autoinmune (enfermedad
de Hashimoto). El criterio diagnóstico para HiperSC es TSH sérica de ≤0.4mU/L y
valores normales deT4 total o libre. El criterio diagnóstico para HipoSC es TSH sérica
de 4.5-10mU/L junto con valores normales de T4 total o libre. Ambas se consideran
más severas cuando los valores de TSH se alejan del valor normal: <0.1mU/L HiperSC
y >10mU/L en HipoSC.
En la ETS las alteraciones cardiovasculares son frecuentes, pero de distinta índole,
así en el HiperSC hay mayor riesgo de arritmias supraventriculares mientras en el
HipoSC hay un riesgo aumentado de dislipidemia y ateroesclerosis. En este artículo
se analizan los aspectos diagnósticos de la ETS, sus complicaciones y se propone un
plan de manejo desde una perspectiva clínica. (1).
Durante el actual apartado se expondrán las afecciones patológicas que
pueden ocasionar las alteraciones de la tiroides a nivel dermatológico, ocular y
otorrinolaringológico, en este último caso particular hace referencia a las lesiones
en gran mayoría asociadas con cáncer intervenido de la tiroides. Así como el papel
de la ayuda diagnostica en el abordaje del paciente.
Citas
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