Toxic nodular goitre

Toxic nodular goitre (TNG), also known as Plummer's disease, is a type of thyroid disease characterized by an enlarged thyroid gland with autonomously functioning thyroid nodules. This condition is a common cause of hyperthyroidism, a state of overactive thyroid gland.

Etiology

The exact cause of TNG is unknown, but it is often associated with long-standing goitre. The condition is more common in older adults, particularly women, and in regions with iodine deficiency. Genetic factors may also play a role in the development of TNG.

Pathophysiology

In TNG, the thyroid gland is enlarged due to the growth of one or more nodules. These nodules function independently of the rest of the gland, producing thyroid hormones without the usual regulatory control by thyroid-stimulating hormone (TSH). This leads to an overproduction of thyroid hormones, resulting in hyperthyroidism.

Clinical Features

Patients with TNG typically present with symptoms of hyperthyroidism, which may include weight loss, heat intolerance, palpitations, and nervousness. In addition, the enlarged thyroid gland may cause local symptoms such as difficulty swallowing or breathing.

Diagnosis

The diagnosis of TNG is usually based on clinical features, blood tests showing elevated levels of thyroid hormones and suppressed TSH, and imaging studies such as thyroid ultrasound or radioiodine uptake test. Fine-needle aspiration biopsy may be performed to rule out thyroid cancer.

Treatment

The treatment of TNG typically involves reducing the overproduction of thyroid hormones. This can be achieved with antithyroid drugs, radioactive iodine therapy, or surgery. The choice of treatment depends on the patient's age, overall health, and the size and number of nodules.

Prognosis

With appropriate treatment, the prognosis for TNG is generally good. However, untreated or inadequately treated TNG can lead to serious complications, including thyroid storm, a life-threatening condition characterized by severe hyperthyroidism.

See Also

• Thyroid disease
• Hyperthyroidism
• Goitre
• Thyroid nodule
• Thyroid-stimulating hormone
• Thyroid ultrasound
• Radioiodine uptake
• Fine-needle aspiration biopsy
• Antithyroid drugs
• Thyroid storm