Scintigraphy of thyroid gland
Syndrome of hyperthyroidism
Condition that occurs due to excessive production of thyroid hormone by the thyroid gland
Causes |
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Laboratory findings |
• Primary |
• |
Low TSH |
• Grave`s disease (diffuse toxic goiter) |
• |
High T3 and T4 |
•Toxic multinodular goiter
•Independent or solitary toxic adenoma
•Thyroiditis
•Iodine-induced thyrotoxicosis
Thyrotoxicosis
•All conditions associated with increased serum levels of thyroid hormone regardless the etiology
•Reflect the negative influence of constant elevation of thyroid hormones on the organism
Causes of thyrotoxicosis
Sustained thyrotoxicosis
•Primary: overactivity of thyroid gland (the most common)
•Secondary: excessive TSH production (e.g. pituitary adenoma)
•Tertiary: hypotalamic disorders
•Exogenous: treatment-induced
Transient (temporary) thyrotoxicosis
Thyroiditis
Subacute granulomatous Subacute lymphocytic
Autoimmune (early in clinical course)
Causes of primary thyrotoxicosis
•Prymary hyperthyroidism
•Graves disease (diffuse toxic goiter)
•Toxic multinodular goiter
•Toxic adenoma (Plummer`s)
•Excessive iodine ingestion
•Neonatal hyperthyroid disease
•Subacute thyroiditis
•Classic painful (de Quervain`s)
•Silent subacute
•Postpartum
•Nonthyroidal disease
•Struma ovarii
•Metastatic thyroid cancer
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Clinical manifestations of thyrotoxicosis |
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Organ system |
Symptoms and signs |
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Constitutional |
Weight loss, heat intolerance |
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Cardiovascular |
Palpitations, atrial arrhythmias, CHF, systolic hypertension |
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Respiratory |
Dyspnea |
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Gastrointestinal |
Diarrhea, increased appetite, nausea |
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Musculoskeletal |
Proximal muscle weakness, osteopenia, hypercalciuria, hypercalcemia, extraocular |
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muscle weakness*, myasthenia gravis* |
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Neuropsychiatric |
Nervousness, anxiety, tremor, insomnia, impaired mentation, delirium, psychosis |
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Endocrine |
Hypomenorrhea, amenorrhea, gynecomastia, decreased libido |
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Hematologic |
Splenomegaly*, lymphadenopathy, neutropenia* |
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Ophthalmologic |
Stare, lid lag*, proptosis*, diplopia*, visual loss* |
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Dermatologic |
Warm, moist, velvety skin, palmar erythema, onycholysis, thinning hair, pruritus, hives, |
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pretibial myxedema*, vitiligo*, thyroid acropathy* |
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*in Grave`s disease |
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Proptosis (exophthalmos) |
Lid lag and lid retraction |
Palmar erythema
