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Myxedema

Rheumatologic:

Polyarthritis,

polysynovitisт, progressive polyarthrosis

Masks of hypothyroidism

Gastroenterologic

Constipation, gall ducts dyskynesia gall stones, chronic hepatitis

Neurologic: Tunnel

syndromes

Depression

Cardiologic:

Diastolic hypertension, dyslipidemia, pericardial effusion, heart failure

Hematologic Anemia

Laboratory findings

•High TSH

•Low T3 and T4

•Anemia

•High TC and TG

•Possible presence of autoantibodies: anti-TPO and anti-TSH-receptor antibody

Screening for hypothyroidism is recommended in all patients > 60 years old

Treatment

•Levothyroxine (synthetic T4)

•Dose depends on the clinical presentation and the level of TSH and free T4

•Hormones control after 4-8 weeks of treatment

•Control of TSH and fT4 every 6-12 months in stable dose

Syndrome of hypercorticism (Cushing`s syndrome)

•Cushing`s disease: primary increase of ACTH secretion by pituitary gland

•Tumors of adrenal cortex: adenomatosis, adenoma, adenocarcinoma

•ACTH-ectopic syndrome

•Treatment-induced

Иценко Николай Михайлович

Harvey Williams Cushing

1889-1954

1869-1939

Minnie G., 23 years old, first patient with the disease, described by Cushing

Clinical presentation of Cushing`s syndrome

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