Thyrotoxicosis. Clinical guidelines for diagnosis and treatment. Part ІІ

Abstract

Background. Recently they have reported an increased rate of thyrotoxicosis, which is characterized by polyetiology, a variety of clinical manifestations and potential treatment. Appropriate treatment requires an accurate diagnosis and depends on the comorbidities and preferences of the patient. Purpose. To highlight the key points of clinical guidelines for diagnosis and treatment of thyrotpxicosis provided by the American Thyroid Association and the American Association of Clinical Endocrinologists, US Endocrine Society dealing with diagnosis and treatment of thyroid diseases as well as the local clinical protocols of SO «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine». Materials and methods. Based on the search of contributions in the electronic databases over the last 5 years, which are included in the Cochrane Library, PUBMED and MEDLINE databases. Clinical guidelines are based on expert consensus and assessing the significance according to the international guidelines for thyrotoxicosis. Results and discussion. The paper deals with up-to-date guidelines on diagnosis, management and treatment of patients with different forms of thyrotoxicosis. It presents a detailed strategy for those patients depending on etiology of the disease. The therapeutic approaches to treating Graves’ disease, autoimmune ophthalmopathy, thyrotoxic crisis, gravidae as well as the peculiarities of treating patients with subclinical hyperthyroidism and iodine-induced thyrotoxicosis have been substantiated. Conclusions. The treatment of thyrotoxicosis remains a challenging issue of modern internal medicine. Despite the existing numerous clinically proven protocols for the treatment of this pathology, the comorbid background of patients complicates following them. The implementation of the provided protocol elements will make it possible to introduce the principles of a customized approach in thyrotoxicosis patients.