Nodular goiter

Nodular goiter - a group of diseases of the thyroid gland, proceeding with the development of her voluminous nodules of different origin and morphology. Nodular goiter may be accompanied by a visible cosmetic defect in the neck, a sense of compression of the neck, symptoms of hyperthyroidism. Diagnosis of nodular goiter is based on data palpation, ultrasound examination of thyroid gland, thyroid hormone parameters synthroid generic name, fine needle biopsy, scintigraphy, esophageal X-ray, CT, or MRI. Treatment of nodular goiter may include suppressive therapy with thyroid hormone, treatment with radioactive iodine, thyroidectomy or hemithyroidectomy.

Hermine "nodular goiter" in endocrinology represent the bulk formation of thyroid, related to various nosological forms. Signs of nodular goiter detected in 40-50% of the population; women nodular goiter occurs 2-4 times more frequently and is often combined with uterine myoma. With palpation, usually identified nodes exceeding 1 cm in diameter; more than half of the nodes are not palpable and only detected during ultrasound of the thyroid gland. About multinodular goiter say that if the thyroid gland are two or more nodules.

The importance of identifying and monitoring patients with nodular goiter due to the need to exclude thyroid cancer, as well as determining the risk of functional autonomy of the thyroid and hyperthyroidism, prevention of cosmetic defect and compression syndrome.

The causes of thyroid nodules is not known until the end. Thus, the appearance of toxic thyroid adenomas associated with mutation of the TSH receptor gene and the a-subunits of G proteins inhibit adenylate cyclase activity. The inherited and somatic mutations are also found in medullary thyroid cancer.

Etiology nodal colloid proliferative goiter is unclear: it is often considered as the age transformation of the thyroid gland. In addition, to the emergence of colloidal goiter iodine deficiency predisposes. In regions with iodine deficiency is not uncommon multinodular goiter with symptoms of hyperthyroidism.

Risk factors contributing to the development of nodular goiter, include genetic disorders (Klinefelter's syndrome, Down syndrome), the harmful effects of the environment (radiation, toxic substances), micronutrient deficiencies, medication, smoking, stress, viral and chronic bacterial and infections, especially chronic tonsillitis.

In most cases, nodular goiter has no clinical manifestations. Large nodules present themselves visible cosmetic defect in the neck area - a marked thickening of the front surface. In nodular goiter of the thyroid gland increase is mainly asymmetrically.

With the proliferation of sites they begin to compress the adjacent organs (esophagus, trachea, nerves and blood vessels), which is accompanied by the development of the motor symptoms of nodular goiter. Compression of the larynx and trachea manifested feeling of "lump" in the throat, persistent hoarseness, progressive shortness of breath, prolonged dry cough, attacks of breathlessness. Compression of the esophagus causes difficulty in swallowing. Signs of vascular compression of may be dizziness, noise in my head, the development of superior vena cava syndrome. Soreness in the assembly area may be associated with a rapid increase in its size, hemorrhage or inflammation.

Typically, nodular goiter thyroid function is not affected, but the deviations can occur in the direction of hyperthyroidism or hypothyroidism. When hypothyroidism is marked tendency to bronchitis, pneumonia, SARS; pain in the heart, hypotension; drowsiness, depression; gastrointestinal disturbances (nausea, loss of appetite, bloating). Characterized by dry skin, hair loss, decreased body temperature. Against the background of hypothyroidism in children may be a delay of growth and mental development; in women - menstrual disorders, spontaneous abortions, infertility; men - decreased libido and potency.

Symptoms of hyperthyroidism in nodular goiter are long low-grade fever, trembling hands, insomnia, irritability, constantly experiencing hunger, weight loss, tachycardia, exophthalmos, and others.