Diffuse toxic goiter

diffuse toxic goiter( diffuse thyrotoxic goiter, Graves' disease, Grave's disease) - an autoimmune disease characterized by excessive production of thyroid hormones, thereby violated all energy and metabolism, as well as there are failures in the adequate functioning of the various systems and

bodies Causes

The main cause leading to the development of diffuse toxic goiter is the presence of a genetic defect not established at the moment by scienceIn the regulatory system for producing antibodies by the immune system. Due to the violation of regulation, antibodies against the tissues of the human thyroid gland are being developed. The immune system, whose main task is to fight against all foreign agents( tumor cells, protozoa, bacteria, viruses), begins to "fight" with the tissues of its own thyroid gland, mistaking its specific components as alien. To date, diffuse toxic goiter is perhaps the only known modern science of autoimmune disease, when there is an increase in the function of the organ, attacked by the immune system.

The presence of a genetic defect is also confirmed by the fact that often enough diffuse toxic goiter occurs in children. As a consequence, it is possible to clearly judge the family predisposition to the development of this disease. However, if Graves' disease is present in one of the parents, it does not give grounds to speak with confidence about what Graves' disease can also occur in children

Symptoms

Not all patients suffering from this disease, there is a classic Graves' triad( the presence of increased eyeAnd goitre, thyrotoxicosis).In most cases, patients with diffuse toxic goiter, thyroid volume is perfectly normal and enlarged eyes( ophthalmopathy Graves' disease, endocrine ophthalmopathy, exophthalmos) observed only in 30% of patients.

To the basic complex of symptoms disturbing patients by Basid's disease include:

- Changes in the cardiovascular system( catabolic syndrome): tachycardia and quite pronounced palpitations. Often, patients experience palpitations not only in the chest but also the abdomen, head,

hands - When long-existing hyperthyroidism( more often in elderly patients), there has been the development of expressed dystrophic changes in the myocardium, frequent manifestation is flickering( fibrillation) Atrial. In most cases, this complication of thyrotoxicosis develops in patients under 50 years of age. Because of further progression myocardiodystrophy develop changes ventricular infarction and congestive heart failure

- Catabolic syndrome usually manifested by progressive weight loss( 10 kg or more.) Due to increased appetite and increasing weakness. The temperature of the skin is significantly increased, in some cases, pronounced hyperhidrosis is observed. Patients feel a constant feeling of heat, so that even at a low enough temperature they do not freeze. In the elderly, patients can identify the evening subfebrile condition

. From the nervous system side, the changes are characterized by mental lability: periods of excitement and aggressiveness are replaced by tearfulness and asthenia. A frequent, but non-specific symptom is a small tremor( slight trembling of the fingers of elongated arms).In severe thyrotoxicosis, tremor may spread throughout the body and is even able to impede it patient

- At the time of detection of diffuse toxic goiter, a significant number of patients have certain disorders of the eye: there is a "sand in the eyes", increased lacrimation, the feeling of "Pressure "in the eyeballs. With the development of endocrine ophthalmopathy, the symptomatology is already more pronounced: there is no possibility of complete closure of the eyelids, eyeballs typically protrude, the upper eyelid is raised, the skin around the eyes noticeably reddens, the eyelids swell.

Treatment of

Treatment of diffuse toxic goiter can be both medicamentous( using radioactive iodine), And surgical( with severe forms of the disease).It must be carried out in a calm environment with mandatory normalization of the patient's sleep. Patients need a high-grade, high-quality diet, with a high content of vitamins and proteins in food.

Antithyroid medications are shown for medicamentous treatment: derivatives of imidazole and thiouracil, iodine preparations, sedatives and potassium preparations.

Radioiodine therapy is used exactly the same as with hyperthyroidism .

Indicator for surgical treatment( surgery on the thyroid gland), pronounced symptoms of cardiovascular failure, large goiter( increased thyroid gland above the third degree), allergic reactions.

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