HIPOTIREOIDISMO E HIPERTIREOIDISMO – UMA BREVE REVISÃO
SOBRE AS DISFUNÇÕES TIREOIDIANAS
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DOWHUDo}HVQRRUJDQLVPRKXPDQR(VWHWUDEDOKRWHYHFRPRREMHWLYRUHDOL]DUXPDUHYLVmRGDOLWHUDWXUD
VREUHDVSHFWRVJHUDLVGHVVDVGXDVGLVIXQo}HVWDLVFRPRWLSRVGH¿QLo}HVVLQWRPDVHIHLWRVVREUHR
RUJDQLVPR GLDJQyVWLFRV H WUDWDPHQWR )RL UHDOL]DGD XPD EXVFD GH DUWLJRV FLHQWt¿FRV HP GLIHUHQWHV
EDVHV GH GDGRV FRP WHUPRV DVVRFLDGRV D KLSRWLUHRLGLVPR H KLSHUWLUHRLGLVPR ([LVWH YDVWD OLWHUDWXUD
VREUHRDVVXQWRLQGLFDQGRTXHHVWDVGLVIXQo}HVSRGHPRFRUUHUGHGLIHUHQWHVIRUPDVFRPLPSDFWRV
QRVLVWHPDFDUGLRYDVFXODUSXOPRQDUFpUHEURHWDPEpPGXUDQWHDJHVWDomR2GLDJQyVWLFRpIHLWRDWUD
YpVGDGRVDJHPGRVKRUP{QLRV76+7H74XDQWRjTXHVWmRQXWULFLRQDOSRXFRVWUDEDOKRVIRUDP
HQFRQWUDGRVVREUHRSDSHOGDDOLPHQWDomRWDQWRQRVXUJLPHQWRFRPRQRFRQWUROHGHVWDVGLVIXQo}HV
PALAVRAS-CHAVE+LSRWHLURLGLVPRKLSHUWLUHRLGLVPRGRHQoDGH*UDYHVVLVWHPDFDUGLRYDVFXODUDWL
YLGDGHItVLFD
ABSTRACT: +\SRWK\URLGLVPDQGK\SHUWK\URLGLVPDUHGLVRUGHUVRIWK\URLGJODQGZKLFKFDXVHVHYHUDO
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KEYWORDS: +\SRWK\URLGLVPK\SHUWK\URLGLVP*UDYHVGLVHDVHFDUGLRYDVFXODUV\VWHPSK\VLFDODFWLYLW\
1. INTRODUÇÃO
+LSRWLUHRLGLVPR H KLSHUWLUHRLGLVPR
VmR GXDV GLVIXQo}HV GD JOkQGXOD WLUHRLGH
TXH FDXVDP XPD VpULH GH DOWHUDo}HV QR
RUJDQLVPR KXPDQR 2 KLSRWLUHRLGLVPR p
GH¿QLGRFRPRXPHVWDGRFOtQLFRUHVXOWDQWH
GH TXDQWLGDGH LQVX¿FLHQWH RX DXVrQFLD GH
KRUP{QLRVFLUFXODQWHVGDJOkQGXODWLUHRLGH
GHQRPLQDGRV 7 WLUR[LQD H 7 WULLRGR
WLURQLQD SDUD VXSULU XPD IXQomR RUJkQLFD
QRUPDO (QTXDQWR TXH R KLSHUWLUHRLGLVPR
FRQVLVWH HP XP HVWDGR KLSHUPHWDEyOLFR
FDXVDGR SHOR DXPHQWR QD IXQomR GD JOkQ
dula tireoide e, consequente, aumento dos
QtYHLVFLUFXODQWHVGRVKRUP{QLRV7H7OL
YUHV$VFDXVDVPDLVFRPXQVVmRKLSHUSOD
36
VLDGLIXVDGDWLUHRLGHDVVRFLDGDjGRHQoDGH
*UDYHVEyFLRPXOWLQRGXODUKLSHUIXQFLRQDQ
WHHDGHQRPDKLSHUIXQFLRQDQWHGDWLUHRLGH
2. HIPOTIREOIDISMO
+LSRWLUHRLGLVPR p GH¿QLGR
FRPRXPHVWDGRFOtQLFRUHVXOWDQWHGHTXDQ
WLGDGH LQVX¿FLHQWH RX DXVrQFLD GH KRUP{
QLRVFLUFXODQWHVGDJOkQGXODWLUHRLGHGHQR
PLQDGRV7WLUR[LQDH7WULLRGRWLURQLQD
SDUD VXSULU XPD IXQomR RUJkQLFD QRUPDO
$ IRUPD PDLV SUHYDOHQWH p D GRHQoD WL
UHRLGLDQD SULPiULD GHQRPLQDGD GH KLSRWL
UHRLGLVPR SULPiULR TXH p XPD GH¿FLrQFLD
KRUPRQDO FDXVDGD GHYLGR j LQFDSDFLGDGH
SDUFLDORXWRWDOGDJOkQGXODWLUHRLGHGHSUR
Interciência
& Sociedade
,QWHUFLrQFLD6RFLHGDGH,6619RO1
GX]LU RV KRUP{QLRV WLUHRLGLDQRV 0h//(5
HWDO1RHQWDQWRRKLSRWLUHRLGLVPR
SRGHVHDSUHVHQWDUGHRXWUDVPDQHLUDVWDLV
FRPR KLSRWLUHRLGLVPR FRQJrQLWR FHQWUDO H
VXEFOtQLFR
2 KLSRWLUHRLGLVPR FRQJrQLWR +&
p D FDXVD PDLV FRPXP GH UHWDUGR PHQWDO
SDVVtYHO GH SUHYHQomR (OH UHVXOWD GD GH
¿FLrQFLD GRV KRUP{QLRV WLUHRLGLDQRV IXQ
damentais na organogênese do sistema
QHUYRVR FHQWUDO DWp RV GRLV DQRV GH YLGD
quando estimulam o crescimento dos den
GULWRVHD[{QLRVDOpPGHFRQWULEXtUHPSDUD
D IRUPDomR GR FyUWH[ FHUHEUDO DQWHULRU KL
SRFDPSR FyUWH[ DXGLWLYR H FHUHEHOR %(
1(9,'(6HWDO
*HUDOPHQWH HVWH WLSR GH KLSHUWL
UHRLGLVPR p GHFRUUHQWH GH GHIHLWRV QD IRU
mação glandular durante a embriogênese e
HYLGrQFLDV VXJHUHP TXH PXWDo}HV QRV ID
WRUHVGHWUDQVFULomR77)77)H3$;
PXLWDVYH]HVVmRRVUHVSRQViYHLVSHODGR
HQoD$IDOWDGHHVWtPXORGR76+KRUP{QLR
HVWLPXODGRUGDWLUHRLGHQDJOkQGXODWLUHRLGH
OHYDDRFRUUrQFLDGDGRHQoDPRWLYDGDSRU
PiIRUPDomRRXGLVIXQomRKLSRIiVLFDRXKL
SRWDOkPLFD2FRUUHJHUDOPHQWHSRUGLVKRU
PRJrQHVHGDJOkQGXODWLUHRLGHSRUGHIHLWR
QR WUDQVSRUWDGRU GH LRGHWR QD PHPEUDQD
EDVDO HRX DSLFDO GHIHLWRV QD VtQWHVH GD
7* RX GHIHLWRV QD RUJDQL¿FDomR GR LRGHWR
3(5521(HWDO$ELRVVtQWHVHGRV
KRUP{QLRV GD WLUHRLGH WHP QD HQ]LPD WLUH
RSHUR[LGDVH 732 XPD IXQomR FKDYH GH
FDWDOLVDULPSRUWDQWHVUHDo}HV0XWDo}HVQR
gene relacionado a esta enzima são consi
GHUDGRVDSULQFLSDOFDXVDGH+&SRUGLVRU
PRQRJrQHVH628=$
'RHQoDV QHXURSVLTXLiWULFDV SR
GHPDSUHVHQWDUP~OWLSORVHQIRTXHVGHQWUH
HOHVUHODomRFRPRVKRUP{QLRVGDWLUHRLGH
Pesquisa realizada com um menino de cin
FRDQRVGHLGDGHFRPKLSRWLUHRLGLVPRFRQ
JrQLWRDVVRFLDGRDSUREOHPDVGRGHVHQYRO
YLPHQWRGHRUGHPLQVWUXPHQWDOHHVWUXWXUDO
UHODWDUHWDUGRQRGHVHQYROYLPHQWRSVLFRPR
WRU SULQFLSDOPHQWH QD IDOD KLSRWRQLD PXV
FXODU H KLSRDFXVLD ELODWHUDO$ HYROXomR GR
FDVRUHODWDGRDSRQWRXPHOKRUDGDVLQWRPD
WRORJLD DVVLP TXH VH REWHYH FRQWUROH GRV
KRUP{QLRV WLUHRLGRV %UDJDWWL:LQFNOHU 5RWWD
3UREOHPDV IRQRXGLROyJLFRV WDP
37
EpP VmR UHODWDGRV HP FULDQoDV TXH DSUH
VHQWDPKLSRWLUHRLGLVPRFRQJrQLWR7UDEDOKR
UHDOL]DGR FRP FULDQoDV GH D DQRV QR
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IDOD LQLQWHOLJtYHO FRPSRUWDPHQWR DJLWDGR H
FRPSRUWDPHQWR QHUYRVR 9HUL¿FRXVH DOWH
UDomRQDIDODHPGRJUXSRDYDOLDGRH
DOWHUDomR DXGLWLYD HP 3DUD DTXHOHV
TXHWLYHUDPGLDJQyVWLFRHWUDWDPHQWRPDLV
WDUGLRGRKLSRWLUHRLGLVPRRtQGLFHGHTXHL
[DVIRLPDLRUGRTXHSDUDDTXHOHVFRPGLDJ
QyVWLFR H WUDWDPHQWR PDLV SUHFRFH )(5
5(,5$ HW DO $ LQFLGrQFLD GR +& p
YDULiYHOVHQGRTXHQR%UDVLOHODpGHDSUR
[LPDGDPHQWHFDVRSDUDFDGDQDVFL
GRVYLYRV'(&$59$/+2HWDO
2 KLSRWLUHRLGLVPR SULPiULR +3
SRGH VHU SHUPDQHQWH RX WUDQVLWyULR &HUFD
GHGR+3SHUPDQHQWHpGHFRUUHQWHGH
defeitos na formação glandular durante a
HPEULRJrQHVH H p GHQRPLQDGR GLVJHQHVLD
WLUHRLGLDQD ./(77 3RU RXWUR ODGR
GHIHLWRV JHQpWLFRV QR GHVHQYROYLPHQWR H
IXQomR GD KLSy¿VH SRGHP UHVXOWDU HP Yi
ULDVIRUPDVGHGH¿FLrQFLDFDUDFWHUtVWLFDVGR
KLSRWLUHRLGLVPR FHQWUDO 3(5521( HW DO
2KLSRWLUHRLGLVPRFHQWUDORFRUUHSRU
GH¿FLrQFLD GH KRUP{QLRV WLUHRLGLDQRV SRU
IDOWD GH HVWtPXOR GR76+ KLSR¿ViULR RX GR
75+KRUP{QLROLEHUDGRUGDWLUHRWUR¿QDKL
SRWDOkPLFR
(QTXDQWR LVVR R KLSRWLUHRLGLV
PR VXEFOtQLFR +6 RX GRHQoD WLUHRGLDQD
PtQLPD p GH¿QLGR SHOD HOHYDomR GR QtYHO
VpULFRGR76+DFLPDGROLPLWHVXSHULRUGD
QRUPDOLGDGHDVVRFLDGDDQtYHLVQRUPDLVGH
WLUR[LQDOLYUH7/3,0(17(/+$16(1
7(,;(,5$HWDO2XWURWUDED
OKR UHODWD TXH R KLSRWLUHRLGLVPR VXEFOtQLFR
6+7 p XPD GLVIXQomR FDUDFWHUL]DGD SRU
YDORU VpULFR DXPHQWDGR GR 76+ FRP FRQ
FHQWUDo}HVQRUPDLVGH7H7QDDXVrQ
FLD GH VLQWRPDV FOtQLFRV PDQLIHVWRV (VWD
HQWLGDGH Mi IRL GHQRPLQDGD GH KLSRWLUHRL
GLVPRSUpFOtQLFRGLPLQXLomRGDUHVHUYDGD
WLUHRLGHRXPL[HGHPDSUpFOtQLFR520$/
',1, 6*$5%, )$5$+ $ SUHYD
OrQFLDGR6+7YDULDFRPDLGDGHHRVH[R
GD SRSXODomR VHOHFLRQDGD GH D HTXDQGRDFRPSDQKDGRGHYDORUHVHOHYD
GRVGHDQWLFRUSRVDQWLWLURLGHDQRVRULVFRGH
SURJUHVVmRSDUDKLSRWLUHRLGLVPRFOtQLFDDX
Interciência
& Sociedade
,QWHUFLrQFLD6RFLHGDGH,6619RO1
PHQWDHPDRDQR,QFLGHPDLVQRVH[R
IHPLQLQR H SULQFLSDOPHQWH HP SDFLHQWHV
FRPPDLVGHDQRVGHLGDGHSRGHQGRDO
FDQoDUtQGLFHVGH
2 KLSRWLUHRLGLVPR VXEFOtQLFR SD
UHFH VHU R SULPHLUR VLQDO GH GLVIXQomR GD
WLUHRLGH H SDUHFH HVWDU UHODFLRQDGR FRP
HYHQWRVFDUGLRYDVFXODUHVPRUWDOLGDGHGLV
OLSHGPLDGHSUHVVmRHGp¿FLWFRJQLWLYR(V
WXGRV UHFHQWHV VXJHUHP SRUpP TXH HVWD
VHMD XPD SRVVtYHO FRQGLomR LQHUHQWH DR
HQYHOKHFLPHQWR DWXDQGR FRPR XPD DGDS
WDomR¿VLROyJLFDGHSURWHomRjVH[LJrQFLDV
GH FRQVXPR H[DJHUDGR RX FDWDEROLVPR$
DYDOLDomR GRV KRUP{QLRV WLUHRLGLDQRV HP
LGRVRV p FRPSOH[D GHYLGR j SUHVHQoD GH
doenças concomitantes e uso frequente de
PHGLFDo}HVTXHSRGHPLQÀXHQFLDUDGRVD
JHP GHVWHV KRUP{QLRV H D VLQWRPDWRORJLD
WDPEpP p GLIHUHQWH FRP R DYDQoR GHVWD
LGDGH GH IRUPD TXH WDQWR RV QtYHLV GH UH
IHUrQFLD GRV KRUP{QLRV WLUHRLGLDQRV FRPR
R WUDWDPHQWR DSOLFDGR GHYHP VHU GLIHUHQ
FLDGRV HP IDL[DV HWiULDV PDLV DYDQoDGDV
5$8(1HWDO
8PGRVLPSDFWRVUHODFLRQDGRV DR
6+7GL]UHVSHLWRjSUHVFULomRGHH[HUFtFLRV
ItVLFRV 2V KRUP{QLRV GD WLUHRLGH DWXDP
VREUH R VLVWHPD FDUGLRYDVFXODU UHJXODQGR
D FRQWUDomR H R UHOD[DPHQWR GR P~VFXOR
FDUGtDFRDOpPGHUHJXODURW{QXVYDVFXODU
1R KLSRWLUHRLGLVPR VXEFOtQLFR TXDQGR Ki
QtYHLV DOWHUDGRV GH 7 H 7 RFRUUHP GLV
IXQo}HVFRPRSRUH[HPSORGLPLQXLomRGD
FRQWUDWLOLGDGHHGDIUHTXrQFLDFDUGtDFDGL
PLQXLomRGRGpELWRFDUGtDFRGLPLQXLomRGD
SUHVVmRDUWHULDOHGDYDULDELOLGDGHGDIUHTX
rQFLDFDUGtDFDDOpPGHDXPHQWRQRVQtYHLV
GHFROHVWHUROVpULFRHGLPLQXLomRGDVHQVLEL
OLGDGHjLQVXOLQD8PGRVWUDWDPHQWRVSDUD
UHYHUWHU RV FRPSURPHWLPHQWRV FDUGLRYDV
FXODUHV FDXVDGRV SHOR KLSRWLUHRLGLVPR p D
UHSRVLomRKRUPRQDOFRPOHYRWLUR[LQD$LQGD
KiSRVVLELOLGDGHGDSUiWLFDGHH[HUFtFLRVIt
VLFRV SDUD DMXGDU WDQWR QD SDUWH UHVSLUDWy
ULDTXDQWRQDSDUWHYDVFXODUFDUGLRYDVFXODU
&2(/+2HWDO
9iULRVHVWXGRVDVVRFLDPR6+7D
IDWRUHVGHULVFRGHGRHQoDDUWHURVFOHUyWLFD
PDVSRXFRVFRUUHODFLRQDPHVVHGLVW~UELRj
GLPLQXLomR GD WROHUkQFLD DR HVIRUoR ItVLFR
$UHSRVLomRKRUPRQDOFRP/WLUR[LQDQRWUD
WDPHQWRGRVGRHQWHVSHUPDQHFHFRQWURYHU
38
VD0XOKHUHVSRUWDGRUDVGH6+7QDIDL[DGH
DDQRVFRP76+DFLPDGHP8/
7 OLYUH H 7 QRUPDLV IRUDP DYDOLDGDV HP
WHVWH GH HVIRUoR SURJUHVVLYR FRP DQiOLVH
GDFRQFHQWUDomRGHODFWDWRVDQJXtQHRQRV
SHUtRGRV SUp H SyVWUDWDPHQWR FRP /WLUR
[LQDHREVHUYRXVHPHOKRUDVLJQL¿FDWLYDQD
WROHUkQFLDDRODFWDWRHFRQVHTXHQWHPHQWH
WROHUkQFLD DR HVIRUoR DSyV R WUDWDPHQWR
PRVWUDQGR R SRWHQFLDO GD /WLUR[LQD VyGLFD
SDUDDXPHQWDUDWROHUkQFLDDRHVIRUoRItVLFR
SURJUHVVLYR HP SRUWDGRUDV GH 6+7 GON
d$/9(6HWDO
Em outro trabalho foi feito um le
YDQWDPHQWR GH HVWXGRV SXEOLFDGRV HQWUH
H QD EDVH GH GDGRV 3XE0HG
FRQVLGHUDQGR DUWLJRV TXH DYDOLDUDP D IXQ
omRFDUGLRYDVFXODUGHKLSRWLUHRLGHRVVXEFOt
QLFRV H FOtQLFRV H D LQÀXrQFLD GR H[HUFtFLR
ItVLFR VREUH DV IXQo}HV FDUGLRYDVFXODUHV
DIHWDGDV QHVWD GRHQoD 9HUL¿FRXVH TXH D
FDSDFLGDGH DHUyELD GH KLSRWLUHRLGHRV VXE
FOtQLFRV H FOtQLFRV HVWi UHGX]LGD H TXH D
IXQomR HQGRWHOLDO R HVWUHVVH R[LGDWLYR H D
IXQomRDXWRQ{PLFDHVWmRSUHMXGLFDGRVQHV
WHVVXMHLWRV$SHVDUGHVHUXPDHQIHUPLGD
GH WmR SUHYDOHQWH TXDQWR R GLDEHWHV QmR
H[LVWH XPD UHFRPHQGDomR SDUD SUHVFULomR
GH DWLYLGDGH ItVLFD SDUD RV KLSRWLUHRLGHRV
WDOFRPRKiSDUDREHVRVFDUGLRSDWDVHGLD
EpWLFRV628=$HWDO
8P HVWXGR UHDOL]DGR FRP SDFLHQ
WHVSRUWDGRUHVGHKLSRWLUHRLGLVPRVXEFOtQLFR
DYDOLRX GXUDQWH VHLV PHVHV R WUHLQDPHQWR
DHUyELRVHQGRTXHRVSDFLHQWHVDSUHVHQWD
ram melhoras da função endotelial. O estu
GRDSRQWRXFDUDFWHUtVWLFDVHFRPSRUWDPHQ
WRVIXQFLRQDLVVHPHOKDQWHVDRGHSDFLHQWHV
FDUGtDFRV H SXOPRQDUHV 6HQGR DVVLP D
SUHVFULomR GH H[HUFtFLRV ItVLFRV GHYH OHYDU
HPFRQVLGHUDomRRWLSRDIUHTXrQFLDDGX
UDomR H QtYHO GH KLGUDWDomR GRV SDFLHQWHV
;,$1*HWDO
2XWUD TXHVWmR TXH WHP OHYDQWD
GR LQWHUHVVH p D VLPLODULGDGH GH VLQWRPDV
HQWUH R KLSRWLUHRLGLVPR H D ¿EULRPLDOJLD
$ ¿EURPLDOJLD p GH¿QLGD FRPR XPD VtQ
GURPH GRORURVD P~VFXORHVTXHOpWLFD não
LQÀDPDWyULD GH FDUiWHU FU{QLFR VHQGR DV
SULQFLSDLV PDQLIHVWDo}HV FOtQLFDV DV GH
TXHL[DV iOJLFDV GLVWULEXtGDV GLIXVDPHQWH
SHORFRUSRVHQVDomRGHIDGLJDHGLVW~UELRV
do sono. Por outro lado, os sintomas P~V
Interciência
& Sociedade
,QWHUFLrQFLD6RFLHGDGH,6619RO1
FXORHVTXHOpWLFRV WDPEpP WHP VLGR UHODWD
GRV QR KLSRWLUHRLGLVPR QD SURSRUomR HQWUH
HGRVFDVRV)5(,5(HWDO
2XWUR HVWXGR WDPEpP DSUHVHQWD FRQFRPL
WkQFLD GH ¿EURPLDOJLD HP SDFLHQWHV SRUWD
GRUHV GH KLSRUWLUHRLGLVPR H DOWHUDo}HV WL
UHRLGLDQDV HP SDFLHQWHV FRP ¿EURPLDOJLD
)RUDPDYDOLDGRVSDFLHQWHVVHQGRTXH
SRVVXtDPKLSRWLUHRLGLVPR2VSDFLHQWHV
IRUDP VXEPHWLGRV jV GRVDJHQV VpULFDV GR
KRUP{QLRHVWLPXODGRUGDWLUHRLGH76+WL
UR[LQD OLYUH 7 OLYUH H DQWLFRUSR DQWLWLUHR
SHUR[LGDVHD732SRUPpWRGRGHTXLPLR
OXPLQHVFrQFLD'HVVHJUXSRSDFLHQWHV
HUDPSRUWDGRUHVGH¿EURPLDOJLDVHQGRTXH
R KLSRWLUHRLGLVPR VXEFOtQLFR IRL HQFRQWUDGR
HPLQGLYtGXRVVHQGRFRPKLSRWLUHRL
GLVPR VXEFOtQLFR FRP SURYiYHO FDXVD GH
WLUHRLGLWH FU{QLFD DXWRLPXQH 76+ HOHYDGR
7 OLYUH QRUPDO H D732 HOHYDGR FRP
KLSRWLUHRLGLVPR VXEFOtQLFR LGLRSiWLFR 76+
GLVFUHWDPHQWHHOHYDGR7OLYUHQRUPDOHD
732QRUPDOFRPKLSRWLUHRLGLVPRFOtQLFR
SRUWLUHRLGLWHFU{QLFDDXWRLPXQH76+HOHYD
GR7OLYUHGLPLQXtGRHD732HOHYDGRH
FRPKLSRWLUHRLGLVPRSRUFDXVDQmRGH¿QLGD
76+ HOHYDGR 7 OLYUH GLPLQXtGR H D732
QRUPDO1RVSDFLHQWHVFRPKLSRWLUHRLGLVPR
SUHYLDPHQWHGLDJQRVWLFDGRDIDGLJDRVRQR
QmRUHVWDXUDGRUHDFHIDOHLDFU{QLFDIRUDP
estatisticamente mais frequentes naqueles
HPTXHIRLIHLWRRGLDJQyVWLFRGH¿EURPLDO
JLD&81+$6È%$5&(/26
(PRXWUDiUHDpLPSRUWDQWHDFRP
SDQKDURIXQFLRQDPHQWRGDJOkQGXODWLUHRLGH
durante a gestação. $JHVWDomRLQGX]GLYHU
VDVDOWHUDo}HV¿VLROyJLFDVPDWHUQDVVHQGR
uma delas a função tireoidiana. Quando há
D SUHVHQoD GH DQWLFRUSRV DQWLWLUHRLGLDQRV
RX LQJHVWmR GH¿FLHQWH GH LRGR DV DOWHUD
o}HVDXPHQWDPDLQGDPDLVUHVXOWDQGRHP
KLSRWLUHRLGLVPR PDWHUQR HRX IHWDO RFDVLR
QDQGR FRPSOLFDo}HV SDUD D PmH H SDUD R
IHWR GXUDQWH D JUDYLGH] (VWXGRV UHODWDP
TXH¿OKRVGHPmHVKLSRWLUHRLGLDQDVQmRWUD
WDGDVGXUDQWHDJUDYLGH]SRGHPDSUHVHQWDU
GH¿FLrQFLDV QR GHVHQYROYLPHQWR GR VLVWH
PDQHUYRVRFHQWUDO61&eDFRQVHOKiYHO
TXHPXOKHUHVTXHSRVVXHPKLSRWLUHRLGLVPR
estabilizem a doença antes da gestação
SDUDDSUHYHQomRGHPDLRUHVFRPSOLFDo}HV
%$57+HWDO
2GLDJQyVWLFRSDVVDQRUPDOPHQWH
39
SHODV GRVDJHQV GR 76+ 2 76+ p R H[D
me de escolha utilizado no rastreamento
SDUD GLVIXQomR WLUHRLGLDQD e SRVVtYHO GH
WHFWDU DOWHUDo}HV PtQLPDV RX VXEFOtQLFDV
GD GH¿FLrQFLD GH KRUP{QLRV WLUHRLGLDQRV
FRP GRVDJHP VpULFD GR 76+ ([LVWHP GL
IHUHQWHV HQVDLRV SDUD GRVDJHP GH 76+
com diferentes sensibilidades, no entanto,
QmRVHGHYHFHQWUDUHVWUDWpJLDGLDJQyVWLFD
DSHQDVQDGRVDJHPGH76+SRUTXHQHVWH
FDVRRHL[RKLSRWiODPRKLSy¿VHWLUHRLGHWH
ULDTXHHVWDUVHPSUHLQWDFWR$UHODomRORJ
OLQHDUHQWUH76+H7OLYUHFRPSURYDTXHR
76+pRPHOKRUH[DPHSDUDGHWHFWDUKLSR
IXQomRWLUHRLGLDQD2PpWRGRXWLOL]DGRDWX
DOPHQWHSDUDGRVDU76+pRLPXQRPpWULFR
QmRLVRWySLFR,0$HGHYHWHUVHQVLELOLGDGH
IXQFLRQDO GH SHOR PHQRV P8/ 12
*8(,5$ HW DO 2V YDORUHV GH UHIH
UrQFLDGH76+SDUDHXWLUHRLGHRVVmRD
P8,/SDUDKLSRWLUHRLGLVPRP8,/
HSDUDKLSHUWLUHRLGLVPRGHDP8,/
0,/+$5$16$62$5(6
3. HIPERTIREOIDISMO
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