NHG-Standaard
M31
3.0
Onlangs herzien
maart 2025
maart 2025
T. Endocriene klieren / voeding / metabolisme

Richtlijnen diagnostiek

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Lichamelijk onderzoek

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Aanvullend onderzoek

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Richtlijnen beleid bij hypothyreoïdie

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Medicamenteuze behandeling

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Consultatie en verwijzing

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Richtlijnen beleid bij subklinische hypothyreoïdie

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Medicamenteuze behandeling

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Richtlijnen beleid bij hyperthyreoïdie

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Consultatie en verwijzing

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Richtlijnen beleid bij subklinische hyperthyreoïdie

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Consultatie en verwijzing

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Richtlijnen beleid bij zwelling of palpabele afwijkingen in de schildklier

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Schildklieraandoeningen tijdens zwangerschap, zwangerschapswens en postpartumperiode

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Hypothyreoïdie

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Belangrijkste wijzigingen

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Kernboodschappen

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Inleiding

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Samenwerking en afstemming

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Achtergronden

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Vrije T4 (fT4 )

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Euthyreoïdie

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Hypothyreoïdie

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Hyperthyreoïdie

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Subklinische schildklierfunctiestoornis

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Thyreotoxicose

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Thyreotoxische crisis

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Hypothyreotische crisis

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TSH-R-antistoffen

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Oftalmopathie

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Schildkliernodus

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Epidemiologie

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Pathofysiologie

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Hypothyreoïdie

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Ziekte van Hashimoto
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Stille of pijnloze lymfocytaire thyreoïditis
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Iatrogene oorzaken van hypothyreoïdie
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Hyperthyreoïdie

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Ziekte van Graves
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Hyperthyreotisch (multi)nodulair struma
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Toxisch adenoom
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(Sub)acute thyreoïditis van De Quervain
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Iatrogene oorzaken van hyperthyreoïdie
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Thyreotoxicose
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Subklinische schildklierafwijkingen

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Subklinische hypothyreoïdie
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Subklinische hyperthyreoïdie
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Factoren die de kans op een schildklierfunctiestoornis vergroten

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Hypothyreoïdie tijdens zwangerschap

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Hyperthyreoïdie tijdens zwangerschap

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Postpartumthyreoïditis

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Richtlijnen diagnostiek

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Lichamelijk onderzoek

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Palpatie van de schildklier

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Aanvullend onderzoek

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Laboratoriumonderzoek

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Leeftijdsspecifieke referentie-intervallen
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Overig laboratoriumonderzoek
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Schildklierscintigrafie
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Hypothyreoïdie

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Hyperthyreoïdie

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Richtlijnen beleid bij hypothyreoïdie

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Voorlichting

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Medicamenteuze behandeling

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Levothyroxine

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Starten met levothyroxine
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Opbouwschema
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Instructies aan de patiënt

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Persisterende klachten

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Consultatie en verwijzing

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Richtlijnen beleid bij subklinische hypothyreoïdie

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Voorlichting

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Medicamenteuze behandeling

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Geen proefbehandeling

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Richtlijnen beleid bij hyperthyreoïdie

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Voorlichting

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Consultatie en verwijzing

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Richtlijnen beleid bij subklinische hyperthyreoïdie

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Voorlichting

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Consultatie en verwijzing

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Richtlijnen beleid bij zwelling of palpabele afwijkingen in de schildklier

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Voorlichting

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Consultatie en verwijzing

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Schildklieraandoeningen tijdens zwangerschap, zwangerschapswens en postpartumperiode

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Richtlijnen diagnostiek

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Richtlijnen beleid

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Hypothyreoïdie

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Subklinische hypothyreoïdie

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Hyperthyreoïdie

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Subklinische hyperthyreoïdie

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Postpartumthyreoïditis

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Referenties

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NHG-werkgroep
Bloem E, Bouma M, Elshout G, Te Grotenhuis R, Minnaard MC, Schep-Akkerman A, Van der Spruit R, Ursem SR, Verlaan-Snieders MN, Wiersma T
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