Introducere: În cazul hipertiroidiei subclinice (HS), spre deosebire de hipertiroidia manifestă (HM), opiniile sunt divergente referitor la manifestările clinice. Scopul lucrării a fost studierea particularităţilor clinice şi hormonale la pacienţii cu guşă difuză toxică (GDT) depistată primar în dependenţă de gradul de exprimare a hipertiroidiei. Materiale şi metode: Studiul a cuprins 130 pacienţi (20 bărbaţi şi 110 femei) cu GDT, cu vârsta între 18 şi 54 ani (vârsta medie 38,23±10,52 ani) şi durata medie a maladiei de 6,88±3,26 luni, precum şi 20 persoane sănătoase. Pacienţii au fost divizaţi în 4 grupe: cu hipertiroidie (tireotoxicoză) subclinică (15,38% pacienţi), uşoară (16,15%), medie (29,23%) şi gravă (39,23%). Pacienţii au fost examinaţi clinic complex, funcţia glandei tiroide fiind apreciată prin dozarea hormonilor tiroidieni. Rezultate: La pacienţii cu HM au fost prezente manifestări clinice caracteristice GDT, cu predominarea celor cardiovasculare şi neuropsihice. În HS endogenă, similar HM, cele mai frecvente manifestări clinice sunt fatigabilitatea, palpitaţiile, nervozitatea şi scăderea ponderală. Nivelul hormonilor tiroidieni la toţi pacienţii, inclusiv cu HS, a fost semnificativ mai mare comparativ cu persoanele sănătoase. Concluzii: Manifestările clinice în HS endogenă sunt mai puţin pronunţate şi mai puţin specifice comparativ cu HM. Tahicardia sinusală este cel mai frecvent şi constant semn clinic caracteristic pentru hipertiroidie şi reflectă gradul de severitate al tireotoxicozei. În HM nivelul crescut al hormonilor tiroidieni reflectă severitatea tireotoxicozei.
Unlike overt hyperthyroidism (OH), in subclinical hyperthyroidism (SH) opinions are divergent on clinical manifestations. Objective of paper was to study the clinical and hormonal particularity in patients with primary detected Grave’s disease depending on the degree of expression of hyperthyroidism. Subjects and methods: The study included 130 patients (20 men and 110 women) with Grave’s disease, aged 18 and 54 years (mean age 38,23±10,52 years) and average disease duration of 6,88±3,26 months and 20 healthy people. Patients were divided into 4 groups: with subclinical (15,38% patients), mild (16,15%), medium (29,23%) and severe (39,23%) hyperthyroidism (thyrotoxicosis). Patients were examined clinically, thyroid function was assessed by determining serum levels of thyroid hormones. Results: In patients with OH were present characteristic clinical manifestations for Grave’s disease, the cardiovascular and neuropsychological signs and symptoms were prevail. The most common clinical manifestations of endogenous subclinical hyperthyroidism, like to over hyperthyroidism, are fatigue, palpitation, nervousness and lose weight. The serum levels of thyroid hormones in all patients, including those with SH, was significantly higher compared with healthy individuals. Conclusions: In patients with subclinical hyperthyroidism, the symptoms and signs are much less severe and not as specific as they are in OH. Sinus tachycardia is the most frequent and consistent clinical sign caracteristic for hyperthyroidism and reflects the degree of severity of thyrotoxicosis. The increased levels of thyroid hormone in over hyperthyroidism reflect the severity of thyrotoxicosis.
