Diagnóstico y estrategias terapéuticas de la Enfermedad de Graves Basedow
Palabras clave:
hipertiroidismo, graves, metimazol, tiroidectomía
Resumen
Introducción: La Enfermedad de Graves (EG) es un trastorno autoinmune a nivel de la glándula tiroides caracterizada por la hipersecreción de hormonas lo que conlleva a su presentación mediante una notable triada de Merserbur, su incidencia es en aproximadamente el 2% de la población siendo mayor en mujeres con respecto a los hombres. Su diagnóstico debe ser de manera oportuna y se puede realizar por medio de cuantificación de los valores del perfil tiroideo y una ecografía tiroidea, el esquema terapéutico debe ser individualizado teniendo como finalidad mantener dentro de los rangos normales los valores de las hormonas tiroideas. Objetivo: Realizar una revisión bibliográfica para describir los métodos diagnósticos y las estrategias terapéuticas para la EG. Metodología: para la presente revisión bibliográfica se accedieron a diferentes bases de datos obteniendo un total de 60 artículos de acuerdo a los criterios de inclusión y exclusión se descartaron 35 artículos obteniendo un total de 25 fuentes de información bibliográfica entre artículos científicos, revisiones sistemáticas, metanalisis. Conclusión: al tratarse de una enfermedad autoinmune lo más importante en esta patología es un diagnóstico oportuno, para establecer un manejo de manera individualizada ya sea con fármacos antitiroideos, una terapia con yodo radioactivo o la realización de una tiroidectomía.
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Antonelli, A., Fallahi, P., Elia, G., Ragusa, F., Paparo, S. R., Ruffilli, I., Patrizio, A., Gonnella, D., Giusti, C., Virili, C., Centanni, M., Shoenfeld, Y., & Ferrari, S. M. (2020). Graves’ disease: Clinical manifestations, immune pathogenesis (cytokines and chemokines) and therapy. Best Practice and Research: Clinical Endocrinology and Metabolism, 34(1), 1–13.
https://doi.org/10.1016/j.beem.2020.101388
Antonelli, A., Ferrari, S. M., Ragusa, F., Elia, G., Paparo, S. R., Ruffilli, I., Patrizio, A., Giusti, C., Gonnella, D., Cristaudo, A., Foddis, R., Shoenfeld, Y., & Fallahi, P. (2020). Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses. Best Practice and Research: Clinical Endocrinology and Metabolism, 34(1). https://doi.org/10.1016/j.beem.2020.101387
Azizi, F., Takyar, M., Madreseh, E., & Amouzegar, A. (2019). Long-term methimazole therapy in Juvenile Graves’ Disease: A randomized trial. Pediatrics, 143(5).
https://doi.org/10.1542/peds.2018-3034
Bandai, S., Okamura, K., Fujikawa, M., Sato, K., Ikenoue, H., & Kitazono, T. (2019). The long-term follow-up of patients with thionamide- treated Graves ’ hyperthyroidism. 66(6), 535–545.
https://www.jstage.jst.go.jp/article/endocrj/66/6/66_EJ18-0418/_article
Bel Lassen, P., Kyrilli, A., Lytrivi, M., & Corvilain, B. (2019). Graves’ disease, multinodular goiter and subclinical hyperthyroidism. Annales d’Endocrinologie, 80(4), 240–249.
https://doi.org/10.1016/j.ando.2018.09.004
Ehlers, M., Schott, M., Allelein, S., Endocrinology, S., & Faculty, M. (2019). Graves ’ disease in clinical perspective 3 . ETIOLOGY AND PATHOGENESIS OF GRAVES ’ DISEASE. 35–47.
George J. Kahaly , a, * Luigi Bartalena , b Lazlo Hegedüs , c Laurence Leenhardt , d Kris Poppe, e y S. H. P. f. (2018). 2018 European Thyroid Association Guideline for the Management of Graves ’ Hyperthyroidism. 167–186. https://doi.org/10.1159/000490384
Goichot, B., Leenhardt, L., Massart, C., Raverot, V., Tramalloni, J., & Iraqi, H. (2018). Diagnostic procedure in suspected Graves’ disease. Annales d’Endocrinologie, 79(6), 608–617.
https://doi.org/10.1016/j.ando.2018.08.002
Hussain, Y. S., Hookham, J. C., Allahabadia, A., & Balasubramanian, S. P. (2017). Epidemiology, management and outcomes of Graves’ disease—real life data. Endocrine, 56(3), 568–578.
https://doi.org/10.1007/s12020-017-1306-5
Kahaly, G. J. (2020). Management of graves thyroidal and extrathyroidal disease: An update. Journal of Clinical Endocrinology and Metabolism, 105(12), 3704–3720.
https://doi.org/10.1210/clinem/dgaa646
Kotwal, A., & Stan, M. (2018). Current and Future Treatments for Graves’ Disease and Graves’ Ophthalmopathy. Hormone and Metabolic Research, 50(12), 871–886.
https://doi.org/10.1055/a-0739-8134
Lane, L. C., & Cheetham, T. (2020). Graves’ disease: developments in first-line antithyroid drugs in the young. Expert Review of Endocrinology and Metabolism, 15(2), 59–69.
https://doi.org/10.1080/17446651.2020.1735359
Lane, L. C., Cheetham, T. D., Perros, P., & Pearce, S. H. S. (2020). New therapeutic horizons for graves’ hyperthyroidism. Endocrine Reviews, 41(6), 873–884.
https://doi.org/10.1210/endrev/bnaa022
Okamura, K., Bandai, S., Fujikawa, M., Sato, K., & Kitazono, T. (2020). Clinical experience of treating Graves ’ hyperthyroidism complicated with malignancy — The possible role of potassium iodide for avoiding the risk of thionamide- associated neutropenia. 67(7), 751–758.
https://www.jstage.jst.go.jp/article/endocrj/67/7/67_EJ20-0016/_article
Okosieme, O. E., Taylor, P. N., Evans, C., Thayer, D., Chai, A., Khan, I., Draman, M. S., Tennant, B., Geen, J., Sayers, A., French, R., Lazarus, J. H., Premawardhana, L. D., & Dayan, C. M. (2019). Articles Primary therapy of Graves ’ disease and cardiovascular morbidity and mortality : a linked-record cohort study. THE LANCET Diabetes & Endocrinology, 8587(19), 1–10. https://doi.org/10.1016/S2213-8587(19)30059-2
Pearce, E. N., Brent, G. A., Alexander, E. K., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., & Peeters, R. P. (2017). 2017 Guidelines of the American Thyroid Association. 27(3). https://doi.org/10.1089/thy.2016.0457
Schneider, D. F., & Sippel, R. S. (2018). disease : Implications for Safety and Operative Difficulty. 163(April 2017), 68–72. https://doi.org/10.1016/j.surg.2017.03.030.The
Sjölin, G., Holmberg, M., Törring, O., Byström, K., Khamisi, S., De Laval, D., Abraham-Nordling, M., Calissendorff, J., Lantz, M., Hallengren, B., Filipsson Nyström, H., & Wallin, G. (2019). The Long-Term Outcome of Treatment for Graves’ Hyperthyroidism. In Thyroid (Vol. 29, Issue 11). https://doi.org/10.1089/thy.2019.0085
Struja, T., Eckart, A., Kutz, A., Huber, A., Neyer, P., Kraenzlin, M., Mueller, B., Meier, C., Bernasconi, L., & Schuetz, P. (2018). Metabolomics for prediction of relapse in Graves’ disease: Observational pilot study. Frontiers in Endocrinology, 9(OCT), 1–6.
https://doi.org/10.3389/fendo.2018.00623
Subekti, I., & Pramono, L. A. (2018). Current Diagnosis and Management of Graves’ Disease. Acta Medica Indonesiana, 50(2), 177–182.
Svensson, J. Ohlsson. Karlsson, M. Lorentzon, M. Lewerin, C. Mellstrom, D. (2021). Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men. 2257–2265. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563553/
Tatulashvili, S., Baudry, C., Sadoul, J. L., & Bihan, H. (2018). New perspectives for the diagnosis and prognosis of Graves’ disease. Annales d’Endocrinologie, 79, S31–S39.
https://doi.org/10.1016/S0003-4266(18)31239-3
Tsai, C., Yang, P., Lee, J., Liu, T., Kuo, C., & Cheng, S. (2019). Effects of Preoperative Iodine Administration on Thyroidectomy for Hyperthyroidism: A Systematic Review and Meta-analysis. https://doi.org/10.1177/0194599819829052
Vejrazkova, D., Vcelak, J., Vaclavikova, E., Vankova, M., Zajickova, K., Duskova, M., Vrbikova, J., Bendlova, B., Endocrinología, D., Checa, R., & Hla, E. (2018). Predictores genéticos del desarrollo y la recurrencia de la enfermedad de Graves ( GD ). 67(Suplemento 3).
https://www.biomed.cas.cz/physiolres/pdf/67/67_S431.pdf
Williams, G. R., & Bassett, J. H. D. (2018). Thyroid diseases and bone health. Journal of Endocrinological Investigation, 41(1), 99–109. https://doi.org/10.1007/s40618-017-0753-4
https://doi.org/10.1016/j.beem.2020.101388
Antonelli, A., Ferrari, S. M., Ragusa, F., Elia, G., Paparo, S. R., Ruffilli, I., Patrizio, A., Giusti, C., Gonnella, D., Cristaudo, A., Foddis, R., Shoenfeld, Y., & Fallahi, P. (2020). Graves’ disease: Epidemiology, genetic and environmental risk factors and viruses. Best Practice and Research: Clinical Endocrinology and Metabolism, 34(1). https://doi.org/10.1016/j.beem.2020.101387
Azizi, F., Takyar, M., Madreseh, E., & Amouzegar, A. (2019). Long-term methimazole therapy in Juvenile Graves’ Disease: A randomized trial. Pediatrics, 143(5).
https://doi.org/10.1542/peds.2018-3034
Bandai, S., Okamura, K., Fujikawa, M., Sato, K., Ikenoue, H., & Kitazono, T. (2019). The long-term follow-up of patients with thionamide- treated Graves ’ hyperthyroidism. 66(6), 535–545.
https://www.jstage.jst.go.jp/article/endocrj/66/6/66_EJ18-0418/_article
Bel Lassen, P., Kyrilli, A., Lytrivi, M., & Corvilain, B. (2019). Graves’ disease, multinodular goiter and subclinical hyperthyroidism. Annales d’Endocrinologie, 80(4), 240–249.
https://doi.org/10.1016/j.ando.2018.09.004
Ehlers, M., Schott, M., Allelein, S., Endocrinology, S., & Faculty, M. (2019). Graves ’ disease in clinical perspective 3 . ETIOLOGY AND PATHOGENESIS OF GRAVES ’ DISEASE. 35–47.
George J. Kahaly , a, * Luigi Bartalena , b Lazlo Hegedüs , c Laurence Leenhardt , d Kris Poppe, e y S. H. P. f. (2018). 2018 European Thyroid Association Guideline for the Management of Graves ’ Hyperthyroidism. 167–186. https://doi.org/10.1159/000490384
Goichot, B., Leenhardt, L., Massart, C., Raverot, V., Tramalloni, J., & Iraqi, H. (2018). Diagnostic procedure in suspected Graves’ disease. Annales d’Endocrinologie, 79(6), 608–617.
https://doi.org/10.1016/j.ando.2018.08.002
Hussain, Y. S., Hookham, J. C., Allahabadia, A., & Balasubramanian, S. P. (2017). Epidemiology, management and outcomes of Graves’ disease—real life data. Endocrine, 56(3), 568–578.
https://doi.org/10.1007/s12020-017-1306-5
Kahaly, G. J. (2020). Management of graves thyroidal and extrathyroidal disease: An update. Journal of Clinical Endocrinology and Metabolism, 105(12), 3704–3720.
https://doi.org/10.1210/clinem/dgaa646
Kotwal, A., & Stan, M. (2018). Current and Future Treatments for Graves’ Disease and Graves’ Ophthalmopathy. Hormone and Metabolic Research, 50(12), 871–886.
https://doi.org/10.1055/a-0739-8134
Lane, L. C., & Cheetham, T. (2020). Graves’ disease: developments in first-line antithyroid drugs in the young. Expert Review of Endocrinology and Metabolism, 15(2), 59–69.
https://doi.org/10.1080/17446651.2020.1735359
Lane, L. C., Cheetham, T. D., Perros, P., & Pearce, S. H. S. (2020). New therapeutic horizons for graves’ hyperthyroidism. Endocrine Reviews, 41(6), 873–884.
https://doi.org/10.1210/endrev/bnaa022
Okamura, K., Bandai, S., Fujikawa, M., Sato, K., & Kitazono, T. (2020). Clinical experience of treating Graves ’ hyperthyroidism complicated with malignancy — The possible role of potassium iodide for avoiding the risk of thionamide- associated neutropenia. 67(7), 751–758.
https://www.jstage.jst.go.jp/article/endocrj/67/7/67_EJ20-0016/_article
Okosieme, O. E., Taylor, P. N., Evans, C., Thayer, D., Chai, A., Khan, I., Draman, M. S., Tennant, B., Geen, J., Sayers, A., French, R., Lazarus, J. H., Premawardhana, L. D., & Dayan, C. M. (2019). Articles Primary therapy of Graves ’ disease and cardiovascular morbidity and mortality : a linked-record cohort study. THE LANCET Diabetes & Endocrinology, 8587(19), 1–10. https://doi.org/10.1016/S2213-8587(19)30059-2
Pearce, E. N., Brent, G. A., Alexander, E. K., Brown, R. S., Chen, H., Dosiou, C., Grobman, W. A., Laurberg, P., Lazarus, J. H., Mandel, S. J., & Peeters, R. P. (2017). 2017 Guidelines of the American Thyroid Association. 27(3). https://doi.org/10.1089/thy.2016.0457
Schneider, D. F., & Sippel, R. S. (2018). disease : Implications for Safety and Operative Difficulty. 163(April 2017), 68–72. https://doi.org/10.1016/j.surg.2017.03.030.The
Sjölin, G., Holmberg, M., Törring, O., Byström, K., Khamisi, S., De Laval, D., Abraham-Nordling, M., Calissendorff, J., Lantz, M., Hallengren, B., Filipsson Nyström, H., & Wallin, G. (2019). The Long-Term Outcome of Treatment for Graves’ Hyperthyroidism. In Thyroid (Vol. 29, Issue 11). https://doi.org/10.1089/thy.2019.0085
Struja, T., Eckart, A., Kutz, A., Huber, A., Neyer, P., Kraenzlin, M., Mueller, B., Meier, C., Bernasconi, L., & Schuetz, P. (2018). Metabolomics for prediction of relapse in Graves’ disease: Observational pilot study. Frontiers in Endocrinology, 9(OCT), 1–6.
https://doi.org/10.3389/fendo.2018.00623
Subekti, I., & Pramono, L. A. (2018). Current Diagnosis and Management of Graves’ Disease. Acta Medica Indonesiana, 50(2), 177–182.
Svensson, J. Ohlsson. Karlsson, M. Lorentzon, M. Lewerin, C. Mellstrom, D. (2021). Subclinical hyperthyroidism is associated with increased risk of vertebral fractures in older men. 2257–2265. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563553/
Tatulashvili, S., Baudry, C., Sadoul, J. L., & Bihan, H. (2018). New perspectives for the diagnosis and prognosis of Graves’ disease. Annales d’Endocrinologie, 79, S31–S39.
https://doi.org/10.1016/S0003-4266(18)31239-3
Tsai, C., Yang, P., Lee, J., Liu, T., Kuo, C., & Cheng, S. (2019). Effects of Preoperative Iodine Administration on Thyroidectomy for Hyperthyroidism: A Systematic Review and Meta-analysis. https://doi.org/10.1177/0194599819829052
Vejrazkova, D., Vcelak, J., Vaclavikova, E., Vankova, M., Zajickova, K., Duskova, M., Vrbikova, J., Bendlova, B., Endocrinología, D., Checa, R., & Hla, E. (2018). Predictores genéticos del desarrollo y la recurrencia de la enfermedad de Graves ( GD ). 67(Suplemento 3).
https://www.biomed.cas.cz/physiolres/pdf/67/67_S431.pdf
Williams, G. R., & Bassett, J. H. D. (2018). Thyroid diseases and bone health. Journal of Endocrinological Investigation, 41(1), 99–109. https://doi.org/10.1007/s40618-017-0753-4
Publicado
2025-01-15
Cómo citar
Sangucho Chicaiza, E. G., & Naranjo Perugachi , J. D. C. (2025). Diagnóstico y estrategias terapéuticas de la Enfermedad de Graves Basedow. Ciencia Latina Revista Científica Multidisciplinar, 7(1), 14441-14456. https://doi.org/10.37811/cl_rcm.v7i1.15478
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Derechos de autor 2025 Estefanía Gissela Sangucho Chicaiza, Jeaneth Del Carmen Naranjo Perugachi
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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