Simple Nodular Goitre causes, diagnosis, complications and treatment

Here is an approach to Simple Nodular Goitre, in which we are going to discuss its definition, causes, complications, diagnosis (clinical picture [symptoms and signs] and investigations) and management of the disease .

Here is an approach to Simple Nodular Goitre, in which we are going to discuss its definition, causes, complications, diagnosis (clinical picture [symptoms and signs] and investigations) and management of the disease .

Definition :

Non inflammatory, non neoplastic & non toxic enlargement of thyroid gland (euthyroid)Endemic goitre .

Causes

Fluctuation of TSH level à area of active follicle, area of inactive follicle.
Most nodules are inactive & active follicles are present in internodular tissues.

Complications of Simple Nodular Goitr

1. Pressure manifestation
2. Infection very rare
3. Carcinoma (0.5 -5%)
4. Hemorrhage
5. Cyst formation & calcification.
6. Secondary thyrotoxicosis

Clinical picture of Simple Nodular Goitre

Age & sex : ♀ 20 & 30 years.

Symptoms

1- Pain: uncommon à felt when hemorrhage occurs or late malignancy.

2- Neck swelling

3- Pressure symptoms :

i) Positional Dyspnea & cough à on trachea .

ii) Change in the voice à on Recurrent laryngeal nerve

iii) Dysphagia especially in retrosternal goitre.

iv) Black out ↑ on leaning foreword.

v) Horner’s syndrome à on sympathetic chain 

Examination

· Asymmetrical thyroid swelling, nodular & firm
· trachea may be displaced.
· May be retrosternal goitre

Investigations

1.      Total T3 & T4
2.      Free T3 & T4
3.      serum T.S.H
4.      free thyroxin index: Free T4 index = total T4 X free binding sites/100
5.    Thyroid scan
·         tracer dose of iodine is given by mouth à Estimate gland uptake 

Treatment :

Sub- total thyroidectomy

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Med2Date: Simple Nodular Goitre causes, diagnosis, complications and treatment
Simple Nodular Goitre causes, diagnosis, complications and treatment
Here is an approach to Simple Nodular Goitre, in which we are going to discuss its definition, causes, complications, diagnosis (clinical picture [symptoms and signs] and investigations) and management of the disease .
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