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Hypothyroidism B9402037 陳名揚
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1.Iodine defficiecy 2.Autoantibody (Hashimoto disease) or iatragenic
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Primary Autoimmune hypothyroidism: – Hashimoto's thyroiditis, atrophic thyroiditis Iatrogenic: – 131 I treatment, subtotal or total thyroidectomy, external irradiation of neck for lymphoma or cancer Drugs: – iodine excess (including iodine-containing contrast media and amiodarone), lithium, antithyroid drugs, p-aminosalicyclic acid, interferon- and other cytokines, aminoglutethimide Congenital hypothyroidism: – absent or ectopic thyroid gland, dyshormonogenesis, TSH-R mutation Iodine deficiency Infiltrative disorders: – amyloidosis, sarcoidosis, hemochromatosis, scleroderma, cystinosis, Riedel's thyroiditis Overexpression of type 3 deoiodinase in infantile hemangioma
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Transient Silent thyroiditis, including postpartum thyroiditis (autoimmune?) Subacute thyroiditis (Flu infection thyroid hormone 先昇後降 ) Withdrawal of thyroxine treatment in individuals with an intact thyroid After 131 I treatment or subtotal thyroidectomy for Graves' disease
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Secondary Hypopituitarism: tumors, pituitary surgery or irradiation, infiltrative disorders, Sheehan's syndrome, trauma, genetic forms of combined pituitary hormone deficiencies Isolated TSH deficiency or inactivity Bexarotene treatment Hypothalamic disease: tumors, trauma, infiltrative disorders, idiopathic
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Symptom & Sign
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Reference Harrison’s principles of internal medicine, 17 th edition 馬偕醫院家醫科 - 認識甲狀腺腫 http://www.mmh.org.tw/taitam/famme/fam me05_9_9.asp
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