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Vol. 34. Issue 9.
Pages 429-432 (October 1998)
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Vol. 34. Issue 9.
Pages 429-432 (October 1998)
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Función tiroidea y asma de difícil control
Thyroid function and difficult-to-manage asthma
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F.R. Jerez, V. Plaza**, J. Tárrega, P. Casan
Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau. Barcelona
J. Rodríguez*
* Servei de Bioquímica. Hospital de la Santa Creu i Sant Pau. Barcelona
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El hipertiroidismo puede ocasionar un deterioro del paciente asmático, por lo que se ha recomendado investigar la función tiroidea en los asmáticos que presentan una evolución clínica desfavorable.

El objetivo de este estudio ha sido establecer si es útil determinar sistemáticamente la función tiroidea en todos los pacientes con asma de difícil control (ADC).

Prospectivamente, se incluyeron en el estudio 48 asmáticos que presentaban un deterioro de su enfermedad de causa desconocida. A todos ellos se les practicó: a) determinación de tirotropina (TSH) y, si ésta resultó alterada, de tiroxina libre (FT4), y b) anamnesis dirigida a descartar la existencia de enfermedad tiroidea activa.

En 9 pacientes (19%) había sospecha de enfermedad tiroidea. Se constató una alteración en las concentraciones de TSH únicamente en 5 pacientes (10%) que pertenecían a este grupo, en cuatro estaba disminuida y en uno elevada. Finalmente, en sólo 3 pacientes (6%) se confirmó un hipertiroidismo tras detectarse una FT4 elevada.

Aunque la frecuencia de hipertiroidismo en la muestra estudiada es superior a la descrita en la población general, el escrutinio bioquímico sistemático de disfunción tiroidea en todos los enfermos con ADC clínico no parece justificado, pues sólo se demostró su presencia en algunos casos en los que existía sospecha clínica de enfermedad tiroidea.

Palabras clave:
Asma
Asma de difícil control
Hipertiroidismo

Hyperthyroidism can cause asthma to worsen, such that analysis of thyroid function has been recommended when the course of asthma is unfavorable.

The aim of this study was to determine whether systematic analysis of thyroid function is useful for all patients with difficult-to-manage asthma.

For prospective study, we enrolled 48 asthmatics whose condition had deteriorated due to no known cause. All patients were studied as follows: a) all were assessed for thyrotropin (TSH) levéis and, if alterations were detected, we ordered analysis of free thyroxin (FT4), and b) case histories were taken to rule out the existence of active thryoid disease.

Nine patients (19%) were suspected of thyroid disease. TSH levéis were abnormal in oniy 5 (10%) patients in this group (low in four and high in one). Hyperthyroidism was confirmed in oniy 3 patients (6%) after high FT4 leveis were detected.

Although the frequency of hyperthyroidism in the sample studied is higher than that described for the general population, the systematic investigation of thyroid dysfunction in all patients with difficult-to-manage asthma does not appear justified given that disease couid be demostrated in oniy some of those who were clinically suspected of thyroid disease.

Key words:
Asthma
Difficult-to-manage asthma
Hyperthyroidism
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Copyright © 1998. Sociedad Española de Neumología y Cirugía Torácica
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