Main Article Content
Abstract
Abstract
Abstrak:
Hipertiroid adalah kondisi klinis yang disebabkan peningkatan sintesis dan sekresi hormone oleh kelenjar tiroid, sedangkan tirotoksikosis mengacu pada manifestasi klinis. Penyakit graves merupakan penyebab hipertiroid yang paling sering ditemukan sekitar 60-80% dari semua kasus tirotoksikosis di seluruh dunia. Pada laporan kasus ini akan dibahas pasien Ny. NMS berusia 56 tahun datang dengan keluhan dada berdebar-debar yang dirasakan sejak 3 minggu yang lalu dan pada pemeriksaan fisik didapatkan adanya pembesaran kelenjar tiroid dan indeks Wayne pada kasus ini didapatkan 21. Pada pemeriksaan laboratorium didapatkan kadar Tyroid Stimulating Hormone (TSH) 0,005 uIU/ml, , dan free Tiroksin (fT4) 7,77mg/dl. Penatalaksanaan pada kasus ini yaitu pasien diberikan tyrozol 3x10 mg sehari dan propanolol 3x10mg.
Kata kunci: graves, hipertiroidism, tirotoksikosis
Abstract
Hipertiroidisme is a clinical condition caused by increased synthesis and secretion of hormones by the thyroid gland. Thyrotoxicosis is defined as clinical manifestations related to increased thyroid hormone levels. Graves' disease (GD) persists as the most frequently encountered etiology of hipertiroidisme causing approximately 60-80% of all cases of thyrotoxicosis worldwide. In this case report we will discuss woman patient Mrs.NMS aged 56 years with complaints of palpitations felt since three weeks ago and physical examination found enlargement of the thyroid gland and Wayne index in this case obtained 21. In laboratory tests found levels of TSH 0.005 uIU/ml and T4 7.77 mg/dl. Principle in the treatment of hipertiroidisme is suppressing the production of thyroid hormone by using antithyroid drugs. Management in this case that the patient is given 3x10 mg Thyrozol and propranolol 3x10 mg.
Keywords: graves, hipertiroidisme, thyrotoxicosis
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References
- Kravets, Hipertiroidisme: Diagnosis and Treatment. Stony Brook University School of Medicine, Stony Brook, New York. Volume 93, Number 5. 2016
- The Indonesian Society of Endocrinology Task Force on Thyroid Diseases. Indonesian Clinical Practice Guidelines for Hipertiroidisme. Vol. 27 No. 2012. ISSN 0857-1074
- Simone De Leo, Sun Y Lee, and Lewis E Braverman Published in final edited form as: Lancet. 2016 August 27; 388(10047): 906–918. doi:10.1016/S0140-6736(16)00278-6.
- Kusrini I, Kumorowulan S. Nilai diagnostic indeks wayne dan indeks newcastle untuk penapisan kasus hipertiroid. Jakarta: Balai Penelitian dan Pengembangan GAKI, Kementerian Kesehatan RI; 2010.
- Silva JE, Bianco SD. Thyroid-adrenergic interactions: physiological and clinical implications. Thyroid. 2008;18(2):157-165.
- Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry. 2000;68(6): 750-755.
- Gulseren S, Gulseren L, Hekimsoy Z, Cetinay P, Ozen C, Tokatlioglu B. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Arch Med Res. 2006;37(1):133-139.
- Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ. 2012;345:e7895.
- N J, Francis J. Atrial fibrillation and hipertiroidisme. Indian Pacing Electrophysiol J. 2005;5(4):305-311.
- Siu CW, Yeung CY, Lau CP, Kung AW, Tse HF. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hipertiroidisme. Heart. 2007; 93(4):483-487.
- Dian Ayu Juwita, Suhatri Suhatri, Risa Hestia. Evaluasi Penggunaan Obat Antitiroid Pada Pasien Hipertiroid di RSUP Dr. M. Djamil Padang, Indonesia. Jurnal Sains Farmasi & Klinis . ARTICLE Vol. 5 No. 1, 2018 | pp. 49–54. e-ISSN: 2442-5435
- George J, Luigi B, Lazlo H, Laurence L, Kris P, Simon H. 2018 European Thyroid Association Guideline for the Management of Graves’ Hipertiroidisme. Europe Thyroid Journal. Eur Thyroid J 2018;7:167–186. DOI: 10.1159/000490384
- Kalra S, Khandelwal SK. Clinical scoring scales in thyroidology. India: Indian J of Endocrinology and Metabolism. 2011; 15(6):89-94
- de los Santos ET, Starich GH, Mazzaferri EL. Sensitivity, specifi city,and cost-eff ectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch Intern Med 1989; 149: 526–32.
- Cooper DS: Antithyroid drugs in the management of patients with Graves’ disease: an evidence- based approach to therapeutic controversies. J Clin Endocrinol Metab 2003; 88: 3474–3481
- Nicholas WC, Fischer RG, Stevenson RA, Bass JD 1995 Single daily dose of methimazole compared to every 8 hours propylthiouracil in the treatment of hipertiroidisme. South Med J 88:973–976
References
Kravets, Hipertiroidisme: Diagnosis and Treatment. Stony Brook University School of Medicine, Stony Brook, New York. Volume 93, Number 5. 2016
The Indonesian Society of Endocrinology Task Force on Thyroid Diseases. Indonesian Clinical Practice Guidelines for Hipertiroidisme. Vol. 27 No. 2012. ISSN 0857-1074
Simone De Leo, Sun Y Lee, and Lewis E Braverman Published in final edited form as: Lancet. 2016 August 27; 388(10047): 906–918. doi:10.1016/S0140-6736(16)00278-6.
Kusrini I, Kumorowulan S. Nilai diagnostic indeks wayne dan indeks newcastle untuk penapisan kasus hipertiroid. Jakarta: Balai Penelitian dan Pengembangan GAKI, Kementerian Kesehatan RI; 2010.
Silva JE, Bianco SD. Thyroid-adrenergic interactions: physiological and clinical implications. Thyroid. 2008;18(2):157-165.
Duyff RF, Van den Bosch J, Laman DM, van Loon BJ, Linssen WH. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry. 2000;68(6): 750-755.
Gulseren S, Gulseren L, Hekimsoy Z, Cetinay P, Ozen C, Tokatlioglu B. Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction. Arch Med Res. 2006;37(1):133-139.
Selmer C, Olesen JB, Hansen ML, et al. The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study. BMJ. 2012;345:e7895.
N J, Francis J. Atrial fibrillation and hipertiroidisme. Indian Pacing Electrophysiol J. 2005;5(4):305-311.
Siu CW, Yeung CY, Lau CP, Kung AW, Tse HF. Incidence, clinical characteristics and outcome of congestive heart failure as the initial presentation in patients with primary hipertiroidisme. Heart. 2007; 93(4):483-487.
Dian Ayu Juwita, Suhatri Suhatri, Risa Hestia. Evaluasi Penggunaan Obat Antitiroid Pada Pasien Hipertiroid di RSUP Dr. M. Djamil Padang, Indonesia. Jurnal Sains Farmasi & Klinis . ARTICLE Vol. 5 No. 1, 2018 | pp. 49–54. e-ISSN: 2442-5435
George J, Luigi B, Lazlo H, Laurence L, Kris P, Simon H. 2018 European Thyroid Association Guideline for the Management of Graves’ Hipertiroidisme. Europe Thyroid Journal. Eur Thyroid J 2018;7:167–186. DOI: 10.1159/000490384
Kalra S, Khandelwal SK. Clinical scoring scales in thyroidology. India: Indian J of Endocrinology and Metabolism. 2011; 15(6):89-94
de los Santos ET, Starich GH, Mazzaferri EL. Sensitivity, specifi city,and cost-eff ectiveness of the sensitive thyrotropin assay in the diagnosis of thyroid disease in ambulatory patients. Arch Intern Med 1989; 149: 526–32.
Cooper DS: Antithyroid drugs in the management of patients with Graves’ disease: an evidence- based approach to therapeutic controversies. J Clin Endocrinol Metab 2003; 88: 3474–3481
Nicholas WC, Fischer RG, Stevenson RA, Bass JD 1995 Single daily dose of methimazole compared to every 8 hours propylthiouracil in the treatment of hipertiroidisme. South Med J 88:973–976