Thick, brittle and cracked nails
Introduction
Introduction Thick and brittle nails and multiple cracks are clinical manifestations of hypothyroidism.
Cause
Cause
Cause:
First, the primary hypothyroidism, caused by the disease of the thyroid itself, patients with elevated serum TSH. Mainly seen in:
1 congenital thyroid deficiency.
2 thyroid atrophy.
3 diffuse lymphocytic thyroiditis.
4 subacute thyroiditis.
5 thyroid destructive treatment (radioactive iodine, surgery), the only side effect of radioactive iodine 131 nuclides for the treatment of hyperthyroidism is hypothyroidism, hypothyroidism (mainly permanent hypothyroidism, hypothyroidism).
6 thyroid hormone synthesis disorders (congenital enzyme deficiency, iodine deficiency or iodine excess).
7 drug inhibition.
8 invasive damage (lymphatic cancer, amyloidosis, etc.).
Second, secondary hypothyroidism
The patient's serum TSH is reduced. Mainly seen in pituitary disease, pituitary tumor, isolated TSH deficiency; hypothalamic syndrome, hypothalamic tumor, isolated TRH deficiency, inflammation or postpartum pituitary avascular necrosis.
Third, the reduction of peripheral thyroid gland is a family hereditary disease. The peripheral target tissue has a good function of ingesting hormones, but the nucleus has receptor dysfunction or deficiency, so the physiological effect on thyroid hormone is weakened.
4. Thyroid stimulating hormone or thyroid hormone insensitivity syndrome is a hypothyroidism caused by the resistance of the thyroid to TSH.
Examine
an examination
Related inspection
Thyroglobulin endocrine function test
diagnosis:
Adult-type hypothyroidism is more common in middle-aged women, the ratio of male to female is 1:5, the onset is concealed, and the disease develops slowly. Fear of cold, lack of words, lack of expression, apathy, thick lips, dry skin and cold, eyebrows sparse outside 1/3 off. Memory loss, mental retardation. Sinus bradycardia. Anorexia, bloating, constipation. Loss of libido, impotence can occur in male patients, and galactorrhea can occur in female patients. Typical symptoms are as follows:
(1) General performance is cold, dry and sweaty, thick, yellow, cold, thin hair, dry, nails crisp, cracked, fatigue, lethargy, poor memory, mental retardation, slow response, mild anemia. Weight gain.
(2) The special face is pale and sallow, the face is swollen, the eyes are dull, the eyelids are swollen, the expression is indifferent, the words are whispered, the words are vocal, and the words are ambiguous.
(3) The heart rate of the cardiovascular system is slow, the heart sound is weak, the heart is generally enlarged, often accompanied by pericardial effusion, myocardial fiber swelling after long illness, mucinous glycoprotein (PAS staining positive) deposition and interstitial fibrosis. It is called hypothyroidism. Patients may have obvious lipid metabolism disorders, hypercholesterolemia, hypertriglyceridemia and high -lipoproteinemia, often accompanied by atherosclerosis, the incidence of coronary heart disease is higher than the general population, but because of the surrounding The low metabolic rate of the tissue, the reduction of cardiac output, and the reduction of myocardial oxygen consumption, seldom occur angina and heart failure. Sometimes blood pressure is high, but more common in diastolic blood pressure. The electrocardiogram is low voltage, the T wave is inverted, the QRS wave is broadened, and the PR interval is prolonged.
(4) Patients with digestive system have loss of appetite, constipation and bloating, and even paralytic ileus. About half of the patients have complete gastric acid deficiency.
(5) Muscle and joint system muscle contraction and relaxation are slowly delayed, often feeling muscle pain and stiffness. Bone metabolism is slow, bone formation and absorption are reduced. Joint pain, lack of activity, strong sense of straightness, increased after cold, like chronic arthritis. Occasionally, the joint cavity effusion.
(6) Men with endocrine system impotence, women with menorrhagia, long-term illness can also be amenorrhea. The tight glandular cortex is low in function, and blood and urinary cortisol are reduced. Primary hypothyroidism can sometimes be accompanied by autoimmune adrenal insufficiency and/or type 1 diabetes, called Schmidt syndrome.
Diagnosis
Differential diagnosis
Differential diagnosis: should be differentiated from renal edema, anemia, congestive heart failure. According to rT3 and the patient's primary disease manifestations, with low T3 syndrome, hypothyroidism and galactorrhea should be differentiated from prolactinoma.
1. Renal edema: The pathological process in which excessive fluid accumulates in the interstitial space or body cavity is called edema. According to the cause of the disease, edema can be divided into renal edema, hepatic edema, cardiac edema, dystrophic edema, lymphedema and so on.
2, congestive heart failure: refers to the heart can not beat the same venous return and body tissue metabolism required blood supply. Often, the ability of the heart muscle to contract is weakened by various diseases, so that the blood output of the heart is reduced, which is insufficient to meet the needs of the body, and thus a series of symptoms and signs are generated.
