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Thyroid Diseases

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Posted by on Wednesday, September 8, 2010, 3:52
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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.

Random Diseases

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