title: The Brazilian consensus for the diagnosis and treatment of hyperthyroidism: recommendations by the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism.
abstract: BACKGROUND
  Hyperthyroidism is characterized by increased synthesis and release of thyroid hormones by the thyroid gland. Thyrotoxicosis refers to the clinical syndrome resulting from excessive circulating thyroid hormones, secondary to hyperthyroidism or due to other causes. This article describes evidence-based guidelines for the clinical management of thyrotoxicosis.
  
  
  OBJECTIVE
  This consensus, developed by Brazilian experts and sponsored by the Department of Thyroid Brazilian Society of Endocrinology and Metabolism, aims to address the management, diagnosis and treatment of patients with thyrotoxicosis, according to the most recent evidence from the literature and appropriate for the clinical reality of Brazil.
  
  
  METHODS
  After structuring clinical questions, search for evidence was made available in the literature, initially in the database MedLine, PubMed and Embase databases and subsequently in SciELO - Lilacs. The strength of evidence was evaluated by Oxford classification system was established from the study design used, considering the best available evidence for each question.
  
  
  RESULTS
  We have defined 13 questions about the initial clinical approach for the diagnosis and treatment that resulted in 53 recommendations, including the etiology, treatment with antithyroid drugs, radioactive iodine and surgery. We also addressed hyperthyroidism in children, teenagers or pregnant patients, and management of hyperthyroidism in patients with Graves' ophthalmopathy and various other causes of thyrotoxicosis.
  
  
  CONCLUSIONS
  The clinical diagnosis of hyperthyroidism usually offers no difficulty and should be made with measurements of serum TSH and thyroid hormones. The treatment can be performed with antithyroid drugs, surgery or administration of radioactive iodine according to the etiology of thyrotoxicosis, local availability of methods and preferences of the attending physician and patient.
authors.affiliation: Unidade de Tireoide, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil. almaia@ufrgs.br
authors.forename: Ana Luiza
authors.initials: AL
authors.lastname: Maia
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Scheffel
authors.forename: Erika Laurini Souza
authors.initials: EL
authors.lastname: Meyer
authors.forename: Glaucia M F S
authors.initials: GM
authors.lastname: Mazeto
authors.forename: Gisah Amaral de
authors.initials: GA
authors.lastname: Carvalho
authors.forename: Hans
authors.initials: H
authors.lastname: Graf
authors.forename: Mario
authors.initials: M
authors.lastname: Vaisman
authors.forename: Lea M Z
authors.initials: LM
authors.lastname: Maciel
authors.forename: Helton E
authors.initials: HE
authors.lastname: Ramos
authors.forename: Alfio José
authors.initials: AJ
authors.lastname: Tincani
authors.forename: Nathalia Carvalho de
authors.initials: NC
authors.lastname: Andrada
authors.forename: Laura S
authors.initials: LS
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D006042:Goiter / Q000628:therapy*; D006111:Graves Disease / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D006980:Hyperthyroidism / Q000175:diagnosis / Q000628:therapy; D016606:Thyroid Nodule / Q000628:therapy*; D013965:Thyroidectomy / Q000592:standards*; D013966:Thyroiditis / Q000628:therapy; D013971:Thyrotoxicosis / Q000175:diagnosis / Q000628:therapy