Thyroid gland diseases

Tatyana Golovko

many target tissues, including the brain and skeleton.

As a result,

connected by thyroid isthmus medially. Weight range from 12 to

T3 )

Total Hormone load is influenced by serum binding

metabolic rate;
Inotropic and chronotropic effects on heart;
Stimulates gut motility;
Increase bone

PROCESSES
Benign;
Malignant.
THYROID GLAND DISORDERS DIVIDED INTO:

artifact.

Low TSH usually indicates Thyrotoxicosis

Other causes:
First trimester of pregnancy;
After treatment

or I131 administration (per os or IV). Radioactivity of TG

gland function because is defined as the state of thyroid

TSH receptor;
Struma ovary;
Drugs: Iodine excess.
Causes of Thyrotoxicosis:

destruction:
Amiodarone, radiation, infarction of an adenoma;
Exogenous/Factitious.

Secondary Hyperthyroidism:
TSH-secreting pituitary adenoma;
Thyroid hormone

fatigue;
Weight loss (normal to increased appetite);
Diarrhea;
Tremor, palpitations;
Diaphoresis (sweating);
Lid retraction, thyroid

and results from the transplacental passage of maternal TSH, receptor

or stare;
● Unexplained petechiae, hyperbilirubinemia, or hepatosplenomegaly;
● There is a

with thyrotoxicosis

of antithyroid medication in fetus.
Till nowadays propylthiouracil (PTU) was

follows: either PTU
(5 to10 mg/kg/day) or mercazolilum

3 divided doses) is added if sympathetic overstimulation is severe,

to a germline mutation in the TSH receptor resulting in

of affected infants is frequently difficult to manage medically, and,

have goiter
Common in China and central Africa
Sporadic goitre:
Areas where

with hypo, hyper or euthyroid states;
Graves’:
Due to chronic stimulation of

– goitre isn’t visualized, but it’s size less than distal

has a risk of malignancy of solitary nodules (

progression;

Thyroid suppression therapy:
May be used for progressive growth;
May reduce gland

- 66% in 80% of patients
Improvement of dysphagia or dyspnea

due to complications;
May be used for symptomatic individuals until definitive

elevation T3 and T4 and enlagment of thyroid gland. In

discomfort in the eyes;
Retrobulbar pressure or pain;
Eyelid retraction;
Periorbital edema, chemosis,

discontinued as thyroid function tests normalize;
– Methimazole (mercazolilum): block and

T4 or their acts to target cells.

due
to pathology of thyroid gland.

SECONDARY - decreasing T3, T4

3000 to 4000);
Iodine defficiency;
Infiltrative disorders.

gland) are the most common causes 85%.
Dyshormonogenesis (10%) and a

fontanelles, posterior fontanell > 1cm, cutis marmorata, bradycardia, hypothermia, hoarse

blood spot on 4th day in term and on 7th

Bone age;
TSH level!!!
Free T4 level – if hypothalamic-pituitary hypothyroidism
suspected;
TBG (Thyroid

with evaluated TSH (primary) level;
T3 –normal, T4 ↓- severe or

(ECG);
Increased left ventricular wall thickness, decrease LV chamber size and

B. Epiphyseal dysgenic

add to
5-10 ml of water
or milk
Normal T4
In 2 wks
(upper

Form

Goals

Treatment prevents bone loss, cardiomyopathy, myxedema

Early treatment is crucial to prevent mental and intellectual retardation.
Early

gain weight; his school performance is deteriorating and he is

may have initial thyrotoxicosis or be euthyroid or hypothyroid.
Hashimoto may

low (earlier than T3).
Bone age is delayed.
Treatment is with thyroxine.

Quervain`s);
Goitrogens (iodide, thiouracil, etc.);
Thyroidectomy or ablation following radioactive iodine;
Infiltrative disease

school performance;
Cold Intolerance;
Short stature;

Delayed dentition;
Myxedema or mildly overweight;
Goiter;
Galactorrhea;
Menometrorrhagia.

or cool skin;
Muscle pseudohypertrophy;
Delayed puberty or precocious puberty;
Treatment – same

Toxic thyroiditis;
Hypothyroidism with or without thyromegaly;
Dysphagia, pain or

antibodies to thyroperoxidase, antimicrosomal test.

goiter size;
Surgery treatment if compression or pain take place.

respiratory infection.
FNA may reveal multinuleated giant cells or granulomatous change.
Disease

secondary to:
Pyriform sinus fistulae;
Pharyngeal space infections;
Persistent Thyroglossal Duct Cyst;
Thyroid

decreased in DeQuervain’s);
CT or US if infected Thyroglossal Duct Cyst