Details Descriptions About :: Simple Goiter

 Simple (or nontoxic) goiter is a thyroid gland enlargement that isn’t caused by inflammation or a neoplasm, and is commonly classified as endemic or sporadic. Inherited defects may be responsible for insufficient thyroxine (T4) synthesis or impaired iodine metabolism. Because families tend to congregate in a single geographic area, this familial factor may contribute to the incidence of both endemic and sporadic goiters.

Causes for Simple Goiter

Causes Endemic goiter Inadequate dietary iodine Sporadic goiter Large amounts of foods containing agents that inhibit T4 production, such as rutabagas, cabbage, soybeans, peanuts, peaches, peas, strawberries, spinach, radishes Drugs, such as propylthiouracil, iodides, phenylbutazone, para-aminosalicylic acid, cobalt, lithium; may cross placenta and affect fetus

Pathophysiology Simple Goiter

Pathophysiology Goiters can occur in the presence of hypothyroidism, hyperthyroidism, or normal levels of thyroid hormone. In the presence of a severe underlying disorder, compensatory responses may cause both thyroid enlargement (goiter) and hypothyroidism. Simple goiter occurs when the thyroid gland can’t secrete enough thyroid hormone to meet metabolic requirements. As a result, the thyroid gland enlarges to compensate for inadequate hormone synthesis, a compensation that usually overcomes mild to moderate hormonal impairment.

Signs and symptoms Simple Goiter

Signs and symptoms Enlarged thyroid Respiratory distress Dysphagia Venous engorgement; development of collateral venous circulation in the chest Dizziness or syncope (Pemberton’s sign) when the patient raises her arms above her head

Diagnostic Lab Test results

Diagnostic test results Laboratory tests reveal: normal serum thyroid levels high or normal thyroid-stimulating hormone (TSH) levels low-normal or normal T4 concentrations normal or increased radioactive iodine uptake.

Treatment for Simple Goiter

Treatment Exogenous thyroid hormone replacement with levothyroxine (treatment of choice)—inhibits TSH secretion and allows gland to rest Small doses of iodide (Lugol’s iodine or potassium iodide solution)—commonly relieves goiter due to iodine deficiency Avoidance of known goitrogenic drugs and foods For large goiter that’s unresponsive to treatment—subtotal thyroidectomy

 

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