Thyroid

Goiter

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Goiter, Simple Goiter, Endemic Goiter, Colloid Goiter, Enlarged Thyroid Gland, Thyroid Goiter

  • Epidemiology
  1. Endemic in areas distant from sea (e.g. mountains)
    1. Common sites: Alps, Andes, and Himalayas
    2. Related to deficient Iodine intake
    3. Often occurs before Puberty
  2. Sporadic form much more common in women (8:1)
    1. Adolescent girls
    2. Pregnant, Lactating or Menopausal women
  • Criteria
  1. Diffuse Thyroid enlargement without nodularity
  2. Euthyroid function
  • Causes
  1. Idiopathic (Sporadic)
  2. Iodine Deficiency (Endemic Goiter)
  3. Goitrogens (Thyroid suppressants)
    1. Calcium and fluorides in water
    2. Cabbage
    3. Cassava
    4. Cauliflower
    5. Brussels sprouts
    6. Turnips
  • Symptoms
  1. Often asymptomatic
  2. Thyroid sensitive to touch
  3. Dyspnea
  4. Dysphagia
  5. Cough with large glands
  • Signs
  1. Palpable diffuse Thyroid enlargement
  2. No Thyroid nodularity
  • Management
  1. Early Goiter
    1. Iodine replacement results in Goiter regression
  2. Late Goiter
    1. Thyroid Replacement required
  • Prevention
  1. Iodized Salt in diet
  • Course
  1. If untreated, develops into Multinodular Goiter
  • References
  1. Rifat (1994) Am Fam Physician 50(4):785-90 [PubMed]
  2. Siminoski (1995) JAMA 273(10):813-7 [PubMed]