-IBIS-1.5.0-
tx
endocrine system
hyperthyroidism
diagnoses
definition and etiology
definition: A disease of hyperthyroidism combined with one or more of the following: pretibial myxedema, exophthalmos, and goiter. Also termed "toxic diffuse goiter" and "Grave's Disease".
etiology: Grave's disease: the classic cause of hyperthyroidism: is seen most in women aged 20-40. The cause is unknown although there might be an autoimmune connection, as in about 20-50% of patients there are circulating "long-acting thyroid stimulators" (LATS), which appear to be antibodies to the thyroid tissue.
signs and symptoms
signs and symptoms of general hyperthyroidism:
Goiter.
Tachycardia.
Warm, fine, moist skin.
Tremor.
Atrial fibrillation; widened pulse pressure.
frequent symptoms:
Nervousness and hyperactivity.
Increased perspiration; worse heat.
Palpitations; tachycardia.
Weight loss; increased appetite.
Insomnia; fatigue; weakness.
Increased bowel movements.
Exophthalmos; blurred and double vision.
Myopathy: often involving the shoulder.
Infiltrative dermopathy (aka pretibial myxedema): red and very itchy lesion.
lab findings:
Increased serum T3 and resin uptake.
Serum total thyroxine (T4) increased.
Serum thyroxine-binding globulin is normal.
Increased radioactive iodine uptake.
Decreased serum cholesterol and lipids.
Abnormal liver tests.
Decreased TSH.
Specific antibody testing to differentiate Grave's Disease and thyroiditis.
course and prognosis
Prognosis is variable: conventional treatments include iodine, antithyroid drugs, radioactive iodine, and surgery (which offers a very good prognosis).
differential diagnosis
Thyroid storm.
Toxic adenoma.
Toxic multinodular goiter.
Thyrotoxicosis factitia.
Silent thyroiditis.
T3 toxicosis.
Anxiety states.
Pheochromocytoma.
footnotes