euthyroid goiter
Introduction
Introduction to goiter with normal thyroid function Thyroid tissue has a strong ability to concentrate iodine. The human thyroid gland needs 60-80 ug of iodine per day to produce physiologically active thyroid hormone. In the body, there is an interdependent and mutually restrictive feedback relationship between the thyroid hormone secreted by the thyroid gland and the thyroid stimulating hormone (TSH) secreted by the pituitary. In the absence of iodine, the thyroid cells cannot synthesize enough thyroid hormone and the concentration of thyroid hormone in the blood. Decreased, the inhibitory effect of thyroid hormone on pituitary secretion (TSH) is weakened, the secretion of pituitary TSH is increased, and the level of TSH in the blood is increased, causing hypertrophy of thyroid hypertrophy. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious Complications: thyroid hemangioma
Cause
Causes of goiter with normal thyroid function
Goiter with normal thyroid function is the most common cause of goiter. It is more common in adolescence, pregnancy and menopause. Many other causes include thyroid hormone deficiency and eating thyroid-prone food in under-developed countries with iodine deficiency. These foods contain anti-thyroid substances that inhibit hormone synthesis. Many drugs, including aminosalicylic acid, lithium, and even large doses of iodine, can reduce thyroid hormone synthesis.
There is no iodine deficiency in North America, but iodine deficiency is still the most common cause of goiter in the world. It can have mild compensatory TSH, so it is free from hypothyroidism, but TSH is excited to cause goiter. Repeated stimulation and degeneration Can cause non-toxic nodular goiter. However, the real cause of most non-toxic goiters in non-iodine-deficient areas remains unclear.
Prevention
Goiter prevention for normal thyroid function
In areas lacking iodine, eating iodized salt or oral or intramuscular injection of lipiodol, drinking iodized water, iodized crops or animal feed can prevent iodine-deficient goiter. If you eat goiter, you should stop taking it. To measure the weight and make decisions.
Complication
Goiter with normal thyroid function Complications thyroid hemangioma
In severe cases, the retrosternal goiter may occur. Some or all of the enlarged thyroid gland is below the level of the sternum. Because the enlarged thyroid gland compresses the surrounding organs, it may cause difficulty in breathing, swallowing discomfort and superior vena cava compression syndrome. Once swollen, it should be immediately operated, even for asymptomatic patients, in order to avoid malignant changes, or bleeding to produce a sudden increase in the volume of complications.
Symptom
Symptoms of thyroid function with normal thyroid function Common symptoms Pulsating mass thyroid enlargement Goiter sacral eyelid relaxation and upper lip thickening cystic mass
In the early stage, the diagnosis relies on the presence of a soft and smooth goiter, which may have a history of low iodine intake or eating a thyroid-producing substance, but this is not the case in North America. The thyroid radioactive iodine intake can be normal or high, accompanied by Normal thyroid scan. The results of the thyroid test are usually normal. Later, there may be multiple nodules or cystic masses. The thyroid antibody should be determined to exclude Hashimoto's thyroiditis as the cause of normal thyroid function goiter. Endemic goiter, serum TSH can Mild increase, serum T4 normal low or slight decrease, serum T3 normal or slightly increased.
Examine
Examination of thyroid function with normal thyroid function
1. Thyroid test: The result is usually normal. Later, there may be multiple nodules or cystic masses.
2. Determination of thyroid antibodies: Exclude Hashimoto's thyroiditis.
3, determination of serum TSH, T3, T4: serum TSH can be slightly increased, serum T4 normal low or slight decrease, serum T3 normal or slightly increased.
Diagnosis
Diagnosis and diagnosis of goiter with normal thyroid function
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
The disease needs to be differentiated from hyperthyroidism: hyperthyroidism is characterized by high metabolism and high serum free thyroid hormone.
Common symptoms and signs are goiter; tachycardia; pulse pressure widening; hot, fine, moist skin; tremor; eye sign; atrial fibrillation; increased neuroticism and activity; hyperhidrosis; fear of heat; palpitations; Increased appetite; insomnia; weakness and hyperactivity of the intestines (occasionally diarrhea). Serum TSH can help identify.
