Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop
J Clin Endocrinol Metab. 2014; 99: 3561-9 PMID:25162665
・Ca濃度が上限より1.0mg/dl以上の上昇
・T-score＜-2.5(腰椎/大腿骨近位部/頸部/橈骨遠位1/3)
・椎体骨折
・Ccr<60cc/min
・24時間尿中排泄量＞400mg
・尿路結石
・50歳未満
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer
Thyroid. 2016; 26: 1-133 PMID:26462967
悪性をどれほど疑うか
・High suspicion 1cm以上でFNA
Solid hypoechonic nodule or solid hypoechoic component of a partially cystic nodule
＋(one or more)
辺縁不整/微細石灰化/taller than wide shape/rim状石灰化/ETE
・Intermediate suspicion 1cm以上でFNA
Hypoechonic solid nodule with smooth margins
微細石灰化/ETE/taller than wide shapeがない
・Low suspicion 1.5cm以上でFNA
Isoechonic or heperechonic solid nodule or partially cystic nodule with eccentric solid areas
微細石灰化/辺縁不整/ETE/taller than wide shapeがない
・Very low suspicion 2cm以上でFNA(経過観察も選択肢)
Spongiform or partially cystic nodules
・Benign 生検の必要なし
Purely cystic nodules
TRUST study
Thyroid Hormone Therapy for Lower Adults With Subclinical Hypothyroidism
N Eng J Med. 2017; 376: 2534-2544 PMID:28402245
P：65歳以上 Thyrotropin 4.60-19.99 mIU per liter/free thyroxine level within the reference range
I：levothyroxine投与
C：プラセボ投与
O：症状の改善
潜在性甲状腺機能低下症の治療の有用性についての RCT。Hypothyroid Symptoms socreとTiredness scoreに関して統計学的な有意差は見出されなかった。
