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2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism.

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cam.issuedOnline2018-07-19
dc.contributor.authorPersani, Luca
dc.contributor.authorBrabant, Georg
dc.contributor.authorDattani, Mehul
dc.contributor.authorBonomi, Marco
dc.contributor.authorFeldt-Rasmussen, Ulla
dc.contributor.authorFliers, Eric
dc.contributor.authorGruters, Annette
dc.contributor.authorMaiter, Dominique
dc.contributor.authorSchoenmakers, Nadia
dc.contributor.authorvan Trotsenburg, AS Paul
dc.contributor.orcidSchoenmakers, Nadia [0000-0002-0847-2884]
dc.date.accessioned2018-12-01T00:30:32Z
dc.date.available2018-12-01T00:30:32Z
dc.date.issued2018-10
dc.description.abstractOBJECTIVES: Central hypothyroidism (CeH) is a rare form of hypothyroidism characterized by insufficient thyroid stimulation due to disturbed pituitary and/or hypothalamic functioning. Due to its origin and the whole clinical context, CeH represents a challenging condition in clinical practice as it is characterized by suboptimal accuracy of clinical and biochemical parameters for diagnosis and management. Since no expert consensus or guidance for this condition is currently available, a task force of experts received the commitment from the European Thyroid Association (ETA) to prepare this document based on the principles of clinical evidence. STUDY DESIGN: The task force started to work in February 2017 and after a careful selection of appropriate references (cohort studies, case reports, expert opinions), a preliminary presentation and live discussion during the 2017 ETA meeting, and several revision rounds, has prepared a list of recommendations to support the diagnosis and management of patients with CeH. RESULTS: Due to the particular challenges of this rare condition in the different ages, the target users of this guidance are pediatric and adult endocrinologists. Experts agreed on the need to recognize and treat overt CeH at all ages, whereas treatment of milder forms may be dispensable in the elderly (> 75 years). CONCLUSIONS: Despite the lack of randomized controlled clinical trials, the experts provide 34 recommendations supported by variable levels of strength that should improve the quality of life of the affected patients and reduce the metabolic and hormonal consequences of inadequate management.
dc.description.sponsorshipThis is a guidelines article so funding sources are not acknowledged. However, my personal grant is from the Wellcome Trust
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.33504
dc.identifier.eissn2235-0802
dc.identifier.issn2235-0640
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286192
dc.languageeng
dc.language.isoeng
dc.publisherBioscientifica
dc.publisher.urlhttp://dx.doi.org/10.1159/000491388
dc.subjectCentral hypothyroidism
dc.subjectGuidelines
dc.subjectHormone replacement therapy
dc.subjectPituitary
dc.subjectSubclinical hypothyroidism
dc.subjectTRH
dc.subjectThyroid
dc.subjectThyrotropin
dc.subjectThyroxine
dc.title2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism.
dc.typeArticle
dcterms.dateAccepted2018-08-22
prism.endingPage237
prism.issueIdentifier5
prism.publicationDate2018
prism.publicationNameEur Thyroid J
prism.startingPage225
prism.volume7
pubs.funder-project-idWellcome Trust (100574/Z/12/Z)
pubs.funder-project-idWellcome Trust (100585/Z/12/Z)
pubs.funder-project-idMedical Research Council (MC_UU_12012/5)
pubs.funder-project-idMedical Research Council (MC_PC_12012)
rioxxterms.licenseref.startdate2018-10
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1159/000491388

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