Central hypothyroidism in adults: better understanding for better care.

摘要: Central hypothyroidism (CH) is a rare cause of generally related to hypothalamic–pituitary disorder or arising as an iatrogenic complication. In adults, CH may be secondary quantitative and/or qualitative alterations in thyroid-stimulating hormone (TSH) secretion. The disease difficult diagnose clinically because it lacks specific clinical signs and these masked by other anterior pituitary secretion deficiencies. patients with long-standing marked CH, diagnosis made based on low free T4 levels normal, moderately increased TSH levels. early-stage moderate exploration the circadian cycle, determination response after TRH test recombinant injection, estimation index, evaluation peripheral indexes thyroid metabolism required establish diagnosis. Regarding treatment, should receive levothyroxine replacement therapy, but objectives during follow-up need precisely determined order reduce cardiovascular risks improve quality life patients.