Hyperthyroidism cancer Follicular CA, papillary CA, medullary CA

Hyperthyroidism is
actually a state of toxicity caused by excessive levels of thyroid hormones
circulating in blood. It is also referred as thyrotoxicosis.

Causes

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The main causes of hyperthyroidism
are mentioned below:

·       
Autoimmune

o  
Graves Disease (76%)

o  
F>M, age 20-40

o  
IgG auto antibodies bind TSH
receptors    T3 & T4

o  
Leads to gland hyper function

 

·       
Solitary Nodule

A
single nodule in thyroid gland which is usually euthyroid and rest of the gland
is not palpable.

·       
Toxic adenoma

A
solitary nodule when becomes hyper functioning leads to formation of toxic
adenoma and it is autonomous functioning nodule.

·       
Dominant Thyroid Swelling

A
swelling in thyroid when the rest of the thyroid gland is also enlarged and
palpable.

·       
Multinodular Goitre

Multiple
nodules or swelling formation in thyroid gland is MNG. It is irreversible state
and is cured by surgery ( sub-total thyroidectomy )

·       
Viral Thyroiditis

It
results after the viral illness (CMV usually). The antibodies against viral
antigens or the antigens itself cross react with thyroid gland leading to
transient state of hyperthyroidism.

·       
Excessive Iodine Intake

Excessive
iodine intake leads to increased uptake of iodine in colloid follicles and thus
increased formation of thyroid hormones.

·       
Drugs- Amiodarone

It
is an antiarrhythmic drug which has a structure analogous to T4

·       
Thyroid cancer

Follicular
CA, papillary CA, medullary CA and anaplastic CA are four types of CA which
results in hyperthyroidism.

·       
TSH secreting pituitary adenoma (rare)

TSH
secreting pituitary adenoma is a rare state in which there is a pituitary tumor
which secrete excessive TSH. This TSH in turn stimulates thyroid gland way too
much leading to hyperthyroidism.

 

Symptoms:

·        
Hyperactivity

·        
Irritability

·        
Dysphoria

·        
Heat intolerance

·        
Increased sweating

·        
Palpitations

·        
Fatigue

·        
weakness

·        
Weight loss with increased appetite

·        
Diarrhea

·        
Polyuria

·        
Sexual dysfunction

 

Signs:

·        
Sinus tachycardia

·        
Atrial fibrillation

·        
Tremor

·        
Goitre

·        
Palmer erythema

·        
Warm, moist skin

·        
Muscle weakness, myopathy

·        
Pigmentation

·        
Lid retraction or lag

·        
Gynaecomastia

·        
Exophtalmus

·        
Pretibial myxedema

 

Hyperthyroidism – Eye Disease

Graves Disease

It is an autoimmune
disorder in which there is diffuse enlargement of the thyroid gland. In this
disease there are antibodies against thyroid stimulating hormone receptors
which results in hyper activation of the thyroid gland even in the absence of
TSH stimulus. It is the most common cause of hyperthyroidism and the patient
usually presents in middle age

The signs and symptoms
of Graves Disease are almost same as the other hyperthyroid states. In addition
to that eye symtoms are a common manifestation too i.e, lid lag and lid
retraction due to sympathetic over supply of the levator palpabrae superioris.

Other signs and
symptoms include are following :

·        
Ophthalmoplegia

·        
Exaphthalmos

·        
Pretibial myxedema

·        
Corneal Ulceration

·        
Thyroid acropachy

The patient usually
depicts positive Naffziger Mobius Joeffroy’s signs.