Thyroid Diseases
- Thyroid Diseases
Thyroid Gland: It is the largest endocrine gland. It is found in neck below thyroid cartilage and at approximately the same level as cricoid cartilage. Thyroid hormones are T3 & T4. Thyroid also produces calcitonin which plays a role in calcium homeostasis.
Anatomy: It is a butterfly shaped organ and is composed of two cone like lobus, lobus dexter (right) and lobus sinister (left lobe), connected via isthmus.
Thyroids Diseases:
Grave’s disease
Multinodular Goiter
Adenoma
Sub-acute Thyroiditis
Hashimoto’s Thyroiditis
Atrophic Hypothyroidism
Thyroid diseases in children
(1) Congenital Hypothyroidism: decrease or absent of thyroid function at birth.
Causes:
Digenesis, aplasia of thyroid gland.
Ectopic thyroid gland.
Inborn detect of thyroxin synthesis.
TSH deficiency.
(2) Juvenile Hypo: When symptoms appears first year of life.
Causes:
Ectopic thyroid digenesis.
Defect in thyroid hormone synthesis.
Ingestion of iodine containing medicines.
Thyroidectomy.
Idiopathic.
Common Diseases
a. Hypothyroidism b. Hyperthyroidism
a. Hypothyroidism: Under production of thyroid hormones T3, T4.
Clinical features:
Weight Gain Tiredness Goiter
Hoarseness Arthralgia Cold Intolerance
Myalgia Muscle Cramps Dry Skin
Constipation Infertility Vitiligo
Anemia Macrocytosis Hypertension
Angina
Investigation & Diagnosis:
Serum T4 level is low.
Serum T3 level does not discriminate reliably between euthyroid & hypothyroid patients.
Serum TSH level is high.
Serum LDH is raised.
Serum cholesterol is raised.
Serum sodium is decreased.
Management: Thyroid replacement
b. Hyperthyroidism: A clinical syndrome which results from exposure of body tissues to excess circulating levels of free thyroid hormones.
Sign & Symptoms:
Nervousness Irritability Tremor
Palpitation Dyspnea Angina
Weight loss Diarrhea Increased sweating
Heat intolerance Fatigue
Investigations:
Serum TSH is low.
T3 & T4 & free thyroxin are raised.
TSH receptor antibody levels are usually high.
Serum ANA and DNA are elevated.
Thyroid scan.
Management:
Anti-thyroid drugs.
Carbimazole.
Propylthiouracil.