Hyperthyroidism

• Hyperthyroidism refers to thyrotoxicosis:
  • Caused by the overproduction of the thyroid hormones:
    • Thyroxine (T4) and triiodothyronine (T3)
• The most common type of thyrotoxicosis encountered in the United States and worldwide:
  • Is Graves’ disease
• Toxic nodular goiter (TNG):
  • Is the second most common type of thyrotoxicosis
• Goiter:
  • Is enlargement of the thyroid gland:
    • That is commonly encountered in clinical endocrine practice
  • It may be classified as:
    • Diffuse or
    • Nodular
      • May be either:
        • Non-toxic or
        • Toxic
  • Nodular goiter may include:
    • Multiple nodules:
      • Multi-nodular goiter (MNG)or
    • A single nodule
  • Regardless of different possible mechanisms of development:
    • Diffuse thyroid enlargement eventually evolves into a nodular stage
• A TNG is a thyroid gland that contains:
  • Autonomously functioning thyroid nodule(s):
    • With resulting hyperthyroidism
  • Also called Plummer’s disease:
    • TNG was first described by Henry Plummer at Mayo Clinic in 1913
  • TNG is the second most common cause of hyperthyroidism in the Western world, after Graves disease:
    • In elderly individuals and in geographic areas of endemic iodine deficiency:
      • TNG is the most common cause of hyperthyroidism
• Graves’ disease:
  • Is the most common type of thyrotoxicosis encountered in the industrialized world
  • Graves’, disease owes its name to an:
    •  Irish doctor, Robert James Graves’ who described the first case of goiter with exophthalmos in 1835
  • Patients with Graves’ disease usually have:
    • Diffuse, nontender, symmetric enlargement of the thyroid gland

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