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Classification[edit | edit source]
They are classified in different ways:
- A "diffuse goitre" is a goitre that has spread through all of the thyroid (and can be a "simple goitre", or a "multinodular goitre").
- "Toxic goitre" refers to goitre with hyperthyroidism. These most commonly due to Graves disease, but can be caused by inflammation or a multinodular goitre.
- "Nontoxic goitre" (associated with normal or low thyroid levels) refers to all other types (such as that caused by lithium or certain other autoimmune diseases).
Other type of classification:
- I - palpation struma -in normal posture of head it cannot be seen. Only found when palpating
- II - struma is palpative and can be easily seen
- III - struma is very big and is retrosternal. Pressure and compression marks.
Causes[edit | edit source]
Other causes are:
- Hashimoto's thyroiditis (E06.3)
- Graves-Basedow disease (E05.0)
- inborn errors of thyroid hormone synthesis, causing congenital hypothyroidism (E03.0)
- Thyroiditis (acute, chronic) (E06)
- Side-effects of pharmacological therapy (E03.2)
- Thyroid cancer
- Iodine deficiency
Occurrence[edit | edit source]
Iodine is necessary for the synthesis of the thyroid hormones triiodothyronine and thyroxine (T3 and T4). In conditions producing endemic goitre, when iodine is not available, these hormones cannot be made. In response to low thyroid hormones, the pituitary gland releases thyroid stimulating hormone (TSH). Thyroid stimulating hormone acts to increase synthesis of T3 and T4, but it also causes the thyroid gland to grow in size by increasing cell division.
Goitre is more common among women, but this includes the many types of goitre caused by autoimmune problems, and not only those caused by simple lack of iodine.
Treatment[edit | edit source]
Treatment for goitre may not be necessary if the goitre is small. Hypothyroidism should be treated, and this treatment often leads to a substantial reduction in the size of the goitre. Removal of the goitre may be necessary if it causes difficulty with breathing or swallowing. There is now an alternative to surgery in large goitres. Radioiodine therapy with or without the pre-injection of a synthetic thyroid stimulating hormone, TSH, can relieve obstruction and reduce the size of the goitre by 30-65%. But removal of a goitre requires removing the thyroid. The complete removal of the thyroid gland removes the body's ability to produce thyroid hormone. In this case, oral thyroxine supplements are necessary to avoid harm from hypothyroidism.
History and future[edit | edit source]
Paracelsus (born Philippus Aureolus Theophrastus Bombastus von Hohenheim) (1493–1541) was the first to describe the connection between goitre and the consumption of minerals, specifically lead in drinking water.
Goitre was previously common in many areas that were deficient in iodine in the soil. For example, in the English Midlands, the condition was known as Derbyshire Neck. In the United States, goitre was found in the Great Lakes, Midwest, and Intermountain regions. The condition now is practically absent in affluent nations, where table salt is supplemented with iodine. However, it is still prevalent in India, Central Asia and Central Africa.
Some health workers fear that a resurgence of goitre might occur because of the trend to use rock salt and/or sea salt, which has not been fortified with iodine.
New research indicates that there may in fact be a tendency to inherit an increased vulnerability to goitre.
See also[edit | edit source]
References[edit | edit source]
- "Paracelsus" entry in Dictionary.com, retrieved October 9, 2007
- Aguilera, A., & Meza, J. M. (1991). Immunological aspects in psychotic patients: Acta Psiquiatrica y Psicologica de America Latina Vol 37(1) Mar 1991, 53-56.
- Bauer, M., Blumentritt, H., Finke, R., Schlattmann, P., Adli, M., Baethge, C., et al. (2007). Using ultrasonography to determine thyroid size and prevalence of goiter in lithium-treated patients with affective disorders: Journal of Affective Disorders Vol 104(1-3) Dec 2007, 45-51.
- Caparevic, Z. V., Diligenski, V. M., Stojanovic, D. M., & Bojkovic, G. D. (2005). Psychological Evaluation of Patients with a Nodular Goiter Before and After Surgical Treatment. Hauppauge, NY: Nova Science Publishers.
- Cerletti, U., Costa, A., Marocco, F., Masini, A., & Mortara, M. (1963). The endemicity of goitre-cretinism today and sixty years ago: Ricerca Scientifica, Part II-B 3(1) 1963, 5-35.
- Dunn, J. T. (1992). Iodine-deficiency: The next target for elimination? : New England Journal of Medicine Vol 326(4) Jan 1992, 267-268.
- Fialkov, M. J., & Robins, A. H. (1978). An unusual case of the Capgras syndrome: British Journal of Psychiatry Vol 132 Apr 1978, 403-404.
- Gong, J., Chen, F., Jiang, Z., Chen, M., & Guo, X. (2000). Investigation of goiter incidence and intelligence level in children in light-iodine-deficient areas: Chinese Journal of Clinical Psychology Vol 8(2) May 2000, 107-108, 110.
- Hervas-Abad, E., Paramo-Fernandez, C., Gil-Gil, P., Casteras-Roman, A., Alvarez-Vazquez, P., & Garcia-Mayor, R. V. (2006). Surgical treatment of endothoracic goiter producing compressive syndromes in elderly patients with multiple comorbidities: Revista Espanola de Geriatria y Gerontologia Vol 41(3) May-Jun 2006, 190-192.
- Jie, Z., Yi, J., & Jianmin, R. (2004). Anxiety and the Risk Factors in Graves' Disease: Chinese Mental Health Journal Vol 18(7) Jul 2004, 495-497.
- Kolsch, D. (2006). Singultus-A case report: Nervenheilkunde: Zeitschrift fur interdisziplinaere Fortbildung Vol 25(12) 2006, 1059-1061.
- Lamberg, B.-A. (1991). Endemic goitre: Iodine deficiency disorders: Annals of Medicine Vol 23(4) Oct 1991, 367-372.
- Lazarus, J. H., & et al. (1981). Lithium therapy and thyroid function: A long-term study: Psychological Medicine Vol 11(1) Feb 1981, 85-92.
- Ledesma Jimeno, A. (1971). Psychiatric aspects of endemic goiter: Archivos de Psiquiatria Vol 34(5) Sep 1971, 365-374.
- Lubart, J. M. (1964). Implicit personality disorder in patients with toxic and nontoxic goiter: Journal of Nervous and Mental Disease 138(3) 1964, 255-267.
- Navarro Despaigne, D., Speck Garzon, P., & Alvarez, M. A. (1986). Emotional stimulus and thyroid function in relatives of patients with diffuse toxic goiter: Revista del Hospital Psiquiatrico de La Habana Vol 27(4) Oct-Dec 1986, 609-615.
- Rockwell, J. G. (1928). The thyroid gland: Psychological Bulletin Vol 25(6) Jun 1928, 341-360.
- Sharghi, S., Haghpanah, V., Heshmat, R., Fard-Esfahani, A., Hadizadeh, H., Lashkari, A., et al. (2007). Comparison of MRI findings with traditional criteria in diagnosis of Pendred syndrome: International Journal of Audiology Vol 46(2) Feb 2007, 69-74.
- Soysal, A. S., Seven, D. K., Cinaz, P., Bideci, A., & Ayvali, E. (2006). An Assessment of the Intelligence Functions of the Primary Education Level Children Aged 6-12 in an Endemic Goitre Region: Klinik Psikiyatri Dergisi Vol 9(2) 2006, 61-69.
- Tajdine, M. T., Lamrani, M., Serhane, K., Achour, A., Benariba, F., & Daali, M. (2005). Multinodular diving goiters: 100 cases in Morocco: Cahiers D'Etudes et De Recherche Francophone/ Sante Vol 15(4) Oct-Dec 2005, 247-252.
- Thould, A. K., & Scowen, E. F. (1964). Genetic studies of the syndrome of congenital deafness and simple goitre: Annals of Human Genetics 27(3) 1964, 283-293.
- Venier, N. (1963). Intellectual and characteriological functioning in endemic thyroid dysfunctions: Difesa Sociale 42(3) 1963, 149-161.
- Wachter, W., & et al. (1985). Iodine deficiency, hypothyroidism, and endemic goitre in southern Tanzania: A survey showing the positive effects of iodised oil injections by TSH determination in dried blood spots: Journal of Epidemiology & Community Health Vol 39(3) Sep 1985, 263-270.
- Wile, I. S. (1940). Body-mind unity: American Journal of Orthopsychiatry 10 1940, 532-548.
- Zisselman, M., Kim, E., & Rovner, B. W. (1995). Depression and anxiety in an 85-year-old woman with toxic nodular goiter: General Hospital Psychiatry Vol 17(2) Mar 1995, 144-147.
[edit | edit source]
- National Health Services, UK
- Network for Sustained Elimination of Iodine Deficiency
- Network for Sustained Elimination of Iodine Deficiency - alternate site at Emory University's School of Public Health
Endocrine pathology of psychological interest (E00-35)
thyroid Hypothyroidism (Iodine deficiency, Cretinism, Congenital hypothyroidism, Goitre) - Hyperthyroidism (Graves-Basedow disease, Toxic multinodular goitre) - Thyroiditis (De Quervain's thyroiditis, Hashimoto's thyroiditis)
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