Diffuse toxic goiter (Graves 'disease, Graves' disease) - a disease accompanied by an increase in the size of the thyroid gland and excessive production of hormones,
resulting in a violation of all kinds of energy and metabolism in the body, as well as the functions of various organs and systems.
Causes of diffuse toxic goiter
The cause of Graves' disease is unknown. The main role for immune system disorders.
Most frequently the disease develops as a result of autoimmune process in the body when, in addition to normal healthy cells of the organism's immune system synthesizes a specific antibody damaging healthy cells. For example, in Graves' disease is a synthesis of an abnormal protein that stimulates the thyroid gland to work intensively.
The disease is accompanied by a syndrome of hyperthyroidism caused by prolonged and persistent excessive amount in the body hormones thyroxine and triiodothyronine.
Most can be found Graves' disease in women, about 8 times more often than men. Mostly the disease develops in middle age (30-50 years), but also occurs in adolescents and young adults during pregnancy and menopause.
The degree of diffuse toxic goiter
According to the severity of hyperthyroidism are three degrees of diffuse toxic goiter: mild, moderate and severe. And according to the degree of increase in thyroid disease is divided into 5 stages:
- Stage 1 - the thyroid gland is almost palpable;
- Stage 2 - swallowing the thyroid gland is clearly visible;
- Stage 3 - goiter visible to the naked eye;
- Stage 4 - pronounced goiter;
- Stage 5 - very large goiter.
Symptoms of Graves' disease
Mild diffuse toxic goiter observed increased nervous irritability, decreased performance, tachycardia (100 beats per minute), weight loss (10-15% of the original).
When the disease of moderate severity to the characteristic symptoms of diffuse toxic goiter refers substantially increased nervous irritability, tachycardia up to 120 beats per minute, almost lost performance, the person loses weight by 20% or more of initial body weight.
Severe hyperthyroidism is characterized by a strong weight loss (50% of body weight), a strong tachycardia (120 beats per minute), severe nervous excitability. For patients with severe thyrotoxicosis also characterized by atrial fibrillation, psychosis, heart failure, liver tireotoksicski.
Furthermore, symptoms of toxic diffuse goiter expressed by the following symptoms which are classified as:
- Eye symptoms. When Graves' disease can often see eye uniform expansion slot that gives the impression the surprised look (bulging eyes). In severe forms of the disease possible inflammation of the cornea, corneal ulcers, which threaten vision.
- Cardiovascular symptoms. The most common symptom - tachycardia. Heart rate can range from 90 to 120 or more beats per minute. For Graves' disease is characterized by the development of cardiovascular disease, which is accompanied by severe swelling of the extremities, swelling of the skin, ascites.
- Dermatological symptoms. When Graves' disease there is increased sweating, erythema, destruction of the nails, swelling in the legs.
- Symptoms of the digestive system. There is a significant increase in appetite. This is due to the acceleration of metabolism. Due to the increase of intestinal motility in patients with diarrhea often occur. There is a malfunction in the liver, until the development of cirrhosis.
- Endocrine symptoms. A decline in the function of the adrenal cortex and gonads, may develop diabetes. In women of childbearing age a decrease in the frequency and amount of menstruation.
- Neurological symptoms. The most common symptoms are diffuse toxic goiter increased fussiness, reactivity, irritability, general restlessness. For patients characterized by trembling fingers, muscle weakness, headache.
- Dental symptoms. Often the disease is accompanied by multiple dental caries, periodontal disease sometimes.
Complications of diffuse toxic goiter
serious complication of the disease is thyrotoxic crisis. His emergence is facilitated by the following factors:
- lack of adequate treatment for Graves' disease over a long period of time;
- enhanced physical activity;
- difficult situation, which caused a lot of stress or trauma;
- any surgery;
- goiter treatment using radioactive iodine, as well as surgical treatment of goiter without prior medical compensation;
- infectious diseases.
When tireotoksicheskom Stroke in the blood to an excessive amount of thyroid hormones, which causes very severe lesions of the cardiovascular and nervous systems, liver and adrenal glands.
Diagnosis of diffuse toxic goiter
Determine the disease is not present any particular difficulties. Confirms the diagnosis by means of laboratory tests on blood levels of thyroid hormones. Also, there is high blood concentration of iodine and a reduced amount of cholesterol.
If you have symptoms of hyperthyroidism the thyroid gland is not palpable, it is probably an atypical location. However, be aware that the symptoms of hyperthyroidism may occur in other diseases: mixed and nodular goiter, thyroiditis, cancer and tumors of the thyroid gland.
Treatment of diffuse toxic goiter
For an effective treatment is extremely important to ensure the patient calm conditions and establish a healthy sleep. Power must be complete, with a high content of vitamins and protein. Treatment of Graves' disease may be medication or using radioactive iodine. In severe forms of the disease preferred surgical treatment.
Drug treatment of diffuse toxic goiter is usually long enough. Doctor prescribes antithyroid drugs, drugs potassium thiouracil derivatives and imidazole, iodine, sedatives. The minimum duration of treatment is six months. Basically patient takes medication during 1 - 1, 5 years. If drug therapy does not give positive results, you should consider other treatments.
Radioiodine therapy - a fairly effective method of treatment, which has, however, a number of contraindications, which include peptic ulcer, tuberculosis, mental disorders, pregnancy and lactation.
Surgical treatment of diffuse toxic goiter, preferably in the presence of allergic reactions, too much increase crop (Grade 3 or higher), as well as too severe symptoms of cardiovascular disease.