Hyperthyroidism

•MONTE de RAMOS , URI P.

Hyperthyroidism is the second most prevalent endocrine disorder, after diabetes mellitus.

A common cause is Grave’s disease, also known as diffuse goiter. Incidence is higher in females, below 40 yrs. of age. The clinical manifestations of hyperthyroidism are based on 3 Basic Concept:

• Increased Metabolic Rate• Increased body heat production• Hypocalcemia

It may appear after an emotional shock , stress , or an infection , but the exact significance of these relationships is not understood.

Other common causes of hyperthyroidism include thyroiditis and excessive ingestion of thyroid hormone

• Grave’s Disease ( diffuse toxic goiter )

• Toxic Nodular Goiter (multinodular goiter)

• Thyroiditis

Grave’s Disease Graves' disease is

caused by an antibody which stimulates the thyroid too much, in turn causing the excess production of thyroid hormone.

The disease is most common in young to middle-aged women and tends to run in families.

The three additional symptoms include:

goiter (enlarged thyroid which may cause a bulge in the neck)

bulging eyes (exophthalmos)

thickened skin over the shin area

Toxic Nodular Goiter

Hyperthyroidism caused by toxic nodular goiter is a condition in which one or more nodules of the thyroid becomes overactive. The overactive nodules actually act as benign thyroid tumors.

Symptoms of toxic nodular goiter do not include bulging eyes or skin problems, as in Graves' disease. The cause of toxic nodular goiter is not known.

Thyroiditis

Thyroiditis causes temporary hyperthyroidism, usually followed with hypothyroidism (an underactive thyroid). Thyroiditis is an inflammation of the thyroid gland. There are three types of thyroiditis:

Hashimoto's thyroiditis

subacute granulomatous thyroiditis

silent lymphocytic thyroiditis

RISK FACTORS :

Medical Conditions

Age

Gender

Genetic Factors

Symptoms:

• Difficulty concentrating• Fatigue• Frequent bowel movements• Goiter (visibly enlarged thyroid gland) or thyroid nodules• Heat intolerance• Increased appetite• Increased sweating• Irregular menstrual periods in women• Nervousness• Restlessness• Weight loss (rarely, weight gain)

Other symptoms that can occur with this disease:•Breast development in men•Clammy skin•Diarrhea•Hair loss•Hand tremor•Weakness•High blood pressure•Itching - overall•Lack of menstrual periods in women•Nausea and vomiting•Pounding, rapid, or irregular pulse•Protruding eyes (exophthalmos)•Rapid, forceful, or irregular heartbeat (palpitations )•Skin blushing or flushing•Sleeping difficulty

Radioactive Iodine Therapy

Antithyroid Medication

Surgery

GENERIC NAME Brand Name

methimazole Tapazole

propylthiouracil Propyl-Thyracil or PTU

Heart-related complications including: • Rapid heart rate• Congestive heart failure• Atrial fibrillation

Increased risk for osteoporosis

Surgery-related complications, including: • Scarring of the neck• Hoarseness due to nerve damage to

the voice box• Low calcium level due to damage to

the parathyroid glands (located near the thyroid gland)

Treatments for hypothyroidism, such as radioactive iodine, surgery, and medications to replace thyroid hormones can have complications.

PREV

ENTIO

NThere are no known ways to prevent HYPERTHYROIDISM.

Toxic Multinodular Goiter (TMG)

MNG and Graves

Huge Toxic MNG Diffuse Graves Thyroid

Higher grades of Goiter

Toxic MNG (Diffuse) Graves

Grade IV Toxic MNG

Huge Toxic MNG Huge Toxic MNG

Proptosis

Lid lag

Thyroid Ophthalmopathy

Ophthalmopathy in Graves

Periorbital edema and chemosis

Ophthalmopathy in Graves

Occular muscle palsy Laka Laka Laka

Severe Exophthalmia

Thyroid Dermopathy

Pink and skin coloured papules, plaques on the shin

Graves with Acropathy

Graves Goiter Acropathy

Clubbing and

Osteoarthropathy

Thyroid Acropathy

Onycholysis