Goiter: enlargement of the thyroid gland, causing a
swelling in the front part of the neck.
Hyperthyroidism: excessive
thyroid gland activity, marked by increased metabolic rate, goiter, and
disturbances in the autonomic nervous system and in creatine metabolism;
sometimes used to refer to Graves’ disease.
This metabolic imbalance results from Excessive thyroid Hormone.
The most common form of hyperthyroidism is Graves’ disease, which increases
T 4 production, enlarges the thyroid gland (goiter), and causes multisystemic
changes. An acute exacerbation of hyperthyroidism is called thyrotoxicosis,
and
is a medical emergency that may lead to cardiac failure.
Cause: Believe to be an autoimmune disease. Antibodies
to thyroglobulin or to thyroid microsomes occur in most patients with this
disorder.
Symptoms:
Enlarged thyroid
Nervousness
Heat intolerance
Weight loss (despite increased appetite)
Sweating
Diarrhea
Tremor
Palpitation
Exophthalmos (abnormal protrusion of the eye)
Thyrotoxicosis symptoms: may include – irritability,
hypertension, tachycardia, vomiting, temperature up to 106 degrees F.,
delirium, and coma
Other sings and symptoms include:
CNS: difficulty concentrating, excitability, nervousness,
fine tremor, shaky handwriting, clumsiness, and mood swings.
Cardiovascular system: tachycardia, full – bounding
pulse, wide pulse pressure, increased cardiac output and blood volume,
cardiomegaly, paroxysmal supraventricular tachycardia and atrial fibrillation
(more so in elderly patients),
Eyes: exophthalmos, inflammation of conjunctivae,
corneas, or eye muscles; increased tearing, lid retraction, the perception
of two images of a single object (diplopia)
GI system: increased appetite, but occasional anorexia,
increased defecation, soft stools or, with severe disease – diarrhea, and
liver enlargement..
Musculoskeletal system: weakness, fatigue, and muscle
atrophy. generalized or localized paralysis associated with hypokalemia;
soft tissue swelling
Reproductive system: in females – oligomenorrhea
(abnormal infrequent menstrual cycle) or amenorrhea (absent or abnormal
stoppage of menstrual cycle); decreased fertility; higher incidence of
spontaneous abortions.
In males: gynecomastia (excessive development of the male mammary
glands, even to the functional state.)
Both sexes: diminished libido
Respiratory system: dyspnea (difficulty breathing)
on exertion and at rest rest
Skin, hair, and nails: smooth, warm, paper thin, flashed
skin; accentuated hair follicles; raised red patches of skin that
are itchy and sometimes painful, with occasional nodule formation; fine,
soft hair: premature graying and increased hair loss in both sexes; friable
nails and distal nail separated from the bed (onycholysis)
Treatment:
Treatment depends on the size of the goiter, the causes, the patient’s
age and parity, and how long surgery (if needed) will be delayed.
Antithyroid drugs
I, beta-adrenergic blockers
Surgery (if needed)