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Diagnostica del nodulo tiroideo autonomo: è sufficiente misurare il TSH?

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L'Endocrinologo Aims and scope

Sommario

La diagnostica del gozzo (multi) nodulare, una volta esclusa la natura neoplastica o autoimmune, è generalmente basata sull’ecografia e sulla determinazione degli ormoni tiroidei liberi e del TSH circolante. L’esecuzione della scintigrafia tiroidea è infatti limitata ai casi con TSH soppresso o semi-soppresso, nel sospetto di un’autonomia funzionale con possibile evoluzione verso la tossicità. Scopo di questa rassegna è richiamare l’attenzione sul fatto che basare esclusivamente sui livelli del TSH il sospetto di autonomizzazione di uno o più noduli sia non di rado inappropriato e che pertanto, in talune situazioni cliniche, la scintigrafia tiroidea sia l’unico esame capace di rivelare l’autonomia funzionale di uno o più noduli, pur in presenza di TSH dosabile.

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Authors and Affiliations

  1. Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini morfo-funzionali, Università di Messina, Messina, Italia

    Alfredo Campennì

  2. Unità di Medicina Nucleare, AOU Policlinico “G. Martino”, Messina, Italia

    Alfredo Campennì & Massimiliano Siracusa

  3. Thyroid Committee, European Association of Nuclear Medicine, Vienna, Austria

    Alfredo Campennì & Luca Giovanella

  4. Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italia

    Francesco Trimarchi & Rosaria Maddalena Ruggeri

  5. Accademia Peloritana dei Pericolanti, Messina, Italia

    Francesco Trimarchi

  6. Unità di Medicina Interna e Endocrinologia, ICS Maugeri, Pavia, Italia

    Luca Chiovato

  7. Dipartimento di Medicina Interna e Terapia Medica, Università di Pavia, Pavia, Italia

    Luca Chiovato

  8. Unità di Endocrinologia, AOU Policlinico “G. Martino”, Messina, Italia

    Rosaria Maddalena Ruggeri

  9. Clinica di Medicina Nucleare e Imaging Molecolare, Centro Diagnosi e Terapia delle Malattie Tiroidee, Istituto Imaging della Svizzera Italiana, Bellinzona, Svizzera

    Luca Giovanella

  10. Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurigo, Svizzera

    Luca Giovanella

Authors
  1. Alfredo Campennì
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  2. Francesco Trimarchi
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  3. Luca Chiovato
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  4. Massimiliano Siracusa
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  5. Rosaria Maddalena Ruggeri
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  6. Luca Giovanella
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Corresponding author

Correspondence to Alfredo Campennì.

Ethics declarations

Conflitto di interesse

Gli autori Alfredo Campennì, Francesco Trimarchi, Luca Chiovato, Massimiliano Siracusa, Rosaria M. Ruggeri e Luca Giovanella dichiarano di non avere conflitti di interesse.

Consenso informato

Lo studio presentato in questo articolo non ha richiesto sperimentazione umana né consenso per l’utilizzazione delle immagini in anonimato.

Studi sugli animali

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Proposto da Alfredo Campennì.

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Campennì, A., Trimarchi, F., Chiovato, L. et al. Diagnostica del nodulo tiroideo autonomo: è sufficiente misurare il TSH?. L'Endocrinologo 22, 528–532 (2021). https://doi.org/10.1007/s40619-021-00982-6

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  • DOI: https://doi.org/10.1007/s40619-021-00982-6

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