The most common type of goiter is etiologically related to a deficiency of
Nontoxic goiter is a common condition related to deficiency in the iodine intake. Other etiological factors include genetic susceptibility, female gender, age, and tobacco smoking. Since the thyroid tissue has preponderance for nodular degeneration, most goiters harbor nodules of different size and texture. In some patients with long-standing goiter, hyperthyroidism will emerge gradually due to functional autonomy of one or more nodules. Although the risk of malignancy in nodular goiter is low in unselected patients, evaluation by thyroid ultrasonography, and by fine-needle aspiration biopsy of nodules with suspicious features, is crucial for determining the nature of the goiter. Show
In reaching a treatment decision, a range of factors should be taken into account. Asymptomatic patients with a benign goiter most often need no treatment. Thyroid surgery, typically in the form of a hemi- or a total thyroidectomy, can rapidly remove the target tissue and is the treatment of choice if the goiter is very large, if it compromises the upper airways, or if there is suspicion of thyroid malignancy. Specific risks, correlating with goiter size, include vocal cord paralysis and hypoparathyroidism, and these risks increase in cases of reoperation for recurrent goiter. The noninvasive nature is the major advantage of radioiodine (131I) therapy, resulting in a goiter volume reduction of 35–50% within 2 years. However, a low thyroid 131I uptake (RAIU) is a hindrance for 131I therapy efficacy in some patients. In such cases, recombinant human TSH (rhTSH) stimulation can augment the goiter shrinkage, which reduces the need for additional treatment due to goiter recurrence. Alternatively, rhTSH stimulation allows a reduction of the administered 131I, while achieving a goiter reduction comparable to that obtained by 131I therapy given without rhTSH stimulation. In selected patients, noninvasive interventional treatment may be an option in solitary thyroid lesions. Keywords
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Corresponding authorCorrespondence to Steen Joop Bonnema . Editor informationEditors and Affiliations
Rights and permissionsReprints and Permissions Copyright information© 2017 Springer International Publishing AG About this entryCite this entryBonnema, S.J., Hegedüs, L. (2017). Nontoxic Goiter. In: Vitti, P., Hegedus, L. (eds) Thyroid Diseases. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-29195-6_5-1 What is the deficiency of goitre?Iodine deficiency is the most common cause of goiter. The body needs iodine to produce thyroid hormone. If you do not have enough iodine in your diet, the thyroid gets larger to try and capture all the iodine it can, so it can make the right amount of thyroid hormone.
What is the most common type of goiter?Simple goiter (popularly called benign goiter) is the most common goiter, accounting for 80%. This is a swelling of the thyroid gland that is not caused by cancer or inflammation, and there are no signs of an overactive or underactive thyroid. The disease is more common in women than men.
What is the most common aetiology of goiter?The most common cause of goiters worldwide is a lack of iodine in the diet. In the United States, where the use of iodized salt is common, goiters are caused by conditions that change thyroid function or factors that affect thyroid growth.
What is the most common etiology of hypothyroidism?The most common cause of hypothyroidism is an autoimmune disease called Hashimoto's disease. Autoimmune diseases happen when the immune system makes antibodies that attack healthy tissues. Sometimes that process involves the thyroid gland and affects its ability to make hormones.
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