Nodular goiter

Nodular goiter is a group of thyroid gland diseases that occur with the development of volumetric nodal formations of various origin and morphology. Nodular goiter may be accompanied by a visible cosmetic defect in the neck, sensation of neck compression, symptoms of thyrotoxicosis. Diagnosis of nodular goiter is based on palpation data, thyroid ultrasound, thyroid hormone indices, fine needle biopsy, scintigraphy, esophageal radiography, CT or MRI. Treatment of nodular goiter may include suppressive therapy with thyroid hormone drugs, radioactive iodine therapy, hemithyroidectomy or thyroidectomy.

The term “nodular goiter” in endocrinology refers to the volume formations of the thyroid gland that refer to various nosological forms. Signs of nodular goiter are revealed in 40-50% of the population; in women, nodular goiter occurs 2-4 times more often and is often combined with uterine myoma. With the help of palpation, as a rule, nodes greater than 1 cm in diameter are detected; more than half of the cases the nodes are not palpable and are found only when carrying out ultrasound of the thyroid gland. A multinodal goiter is spoken of if two or more nodular formations are found in the thyroid gland.
The importance of identifying and monitoring patients with nodular goiter is due to the need to exclude thyroid cancer, as well as to determine the risk of developing functional thyroid autonomy and thyrotoxicosis, to prevent the onset of a cosmetic defect and compression syndrome.

Causes of nodular goiter

The causes of the development of thyroid nodules are not known to the end. Thus, the appearance of toxic adenomas of the thyroid gland is associated with a mutation of the TSH receptor gene and a-subunits of G proteins, which inhibit the activity of adenylate cyclase. Hereditary and somatic mutations are also found in medullary thyroid cancer.
The etiology of nodular colloid proliferating goiter is unclear: it is often considered as an age-related transformation of the thyroid gland. In addition, the occurrence of colloid goiter predisposes iodine deficiency. In regions with iodine deficiency, cases of multinodal goiter with thyrotoxicosis phenomena are not uncommon.
The risk factors contributing to the development of nodular goiter include genetic disorders (Klinefelter syndrome, Down syndrome), harmful environmental effects (radiation, toxic substances), micronutrient deficiencies, medications, smoking, stress, viral and chronic bacterial infections, especially chronic tonsillitis.

local_offerevent_note September 1, 2018

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