Toxic multinodular goitre

Toxic multinodular goitre ; ;
Synonyms	Plummer's disease ;
Specialty	Endocrinology
Symptoms	Hyperthyroidism, goitre, weight loss, tremors, palpitations
Complications	Thyroid storm, atrial fibrillation, osteoporosis ; ; ;
Causes	Iodine deficiency, genetic factors ;
Diagnosis	Thyroid function tests, ultrasound, radioactive iodine uptake test
Differential diagnosis	Graves' disease, thyroiditis ;
Treatment	Antithyroid medication, radioactive iodine therapy, thyroidectomy
Medication	Methimazole, propylthiouracil ; ; ;

Toxic multinodular goitre (TMNG), also known as Plummer's disease, is a condition characterized by an enlarged thyroid gland with multiple nodules that produce excess thyroid hormone, leading to hyperthyroidism. This condition is more common in older adults and in regions with iodine deficiency.

Signs and symptoms[edit]

The symptoms of toxic multinodular goitre are primarily those of hyperthyroidism and may include:

Complications[edit]

If left untreated, toxic multinodular goitre can lead to serious complications such as:

Thyroid storm – a life-threatening exacerbation of hyperthyroidism
Atrial fibrillation – an irregular and often rapid heart rate
Osteoporosis – weakened bones due to excessive thyroid hormone

Causes[edit]

The exact cause of toxic multinodular goitre is not fully understood, but it is believed to be related to:

Diagnosis[edit]

Diagnosis of toxic multinodular goitre typically involves:

Thyroid function tests – to measure levels of thyroid hormones and thyroid-stimulating hormone (TSH)
Ultrasound – to visualize the thyroid gland and detect nodules
Radioactive iodine uptake test – to assess the function of the thyroid nodules

Differential diagnosis[edit]

Conditions that may present similarly and need to be differentiated from toxic multinodular goitre include:

Treatment[edit]

Treatment options for toxic multinodular goitre include:

Antithyroid medication – such as methimazole or propylthiouracil
Radioactive iodine therapy – to reduce the activity of the thyroid gland
Thyroidectomy – surgical removal of part or all of the thyroid gland

References[edit]

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Toxic multinodular goitre
Synonyms	Plummer's disease
Specialty	Endocrinology
Symptoms	Hyperthyroidism, goitre, weight loss, tremors, palpitations
Complications	Thyroid storm, atrial fibrillation, osteoporosis
Causes	Iodine deficiency, genetic factors
Diagnosis	Thyroid function tests, ultrasound, radioactive iodine uptake test
Differential diagnosis	Graves' disease, thyroiditis
Treatment	Antithyroid medication, radioactive iodine therapy, thyroidectomy
Medication	Methimazole, propylthiouracil