Toxic multinodular goiter

Toxic Multinodular Goiter
Other names	Plummer's disease, Multinodular toxic goiter
Specialty	Endocrinology

Toxic multinodular goiter (TMNG), also known as Plummer's disease, is a type of hyperthyroidism characterized by a thyroid gland that has multiple nodules which produce excessive amounts of thyroid hormones. This condition is more common in older adults and typically develops gradually.

Causes

The exact cause of toxic multinodular goiter is not fully understood, but it is believed to result from a combination of genetic and environmental factors. The development of nodules, which are lumps or growths within the thyroid, can lead to the overproduction of thyroid hormones. These nodules may be benign or, less commonly, malignant.

Symptoms

Symptoms of toxic multinodular goiter include:

• Hyperthyroidism symptoms such as rapid heartbeat, weight loss, tremors, and increased anxiety
• Enlargement of the thyroid gland, known as a goiter
• Difficulty swallowing or breathing if the goiter is large enough to press on the windpipe or esophagus

Diagnosis

Diagnosis of toxic multinodular goiter typically involves:

• Physical examination
• Blood tests to measure levels of thyroid hormones and thyroid-stimulating hormone (TSH)
• Ultrasound of the thyroid to identify nodules and assess their characteristics
• Radioactive iodine uptake test to evaluate the function of the thyroid gland and the activity of the nodules

Treatment

Treatment options for toxic multinodular goiter may include:

• Antithyroid drugs to reduce thyroid hormone production
• Radioactive iodine therapy to shrink the nodules and decrease hormone production
• Thyroidectomy, which is the surgical removal of part or all of the thyroid gland, in cases where other treatments are not suitable or effective

Prognosis

The prognosis for individuals with toxic multinodular goiter is generally good, especially when the condition is diagnosed early and treated appropriately. Treatment can effectively manage symptoms and prevent complications.

Epidemiology

Toxic multinodular goiter is more common in regions with iodine deficiency, though it can occur anywhere. It is also more prevalent in older adults and affects women more often than men.

See also

• Thyroid
• Goiter
• Hyperthyroidism
• Thyroid nodule