Aetiology

Causes of goitre include:

• physiological:
  • puberty - increased metabolic demand
  • pregnancy - increased demand; increased TBG
  • physiologic stress of any kind
    
• autoimmune:
  • Graves' disease
  • Hashimoto's thyroiditis
    
• thyroiditis:
  • subacute granulomatous / de Quervain's
  • subacute lymphocytic / silent
  • Riedel's thyroiditis - uncommon; gland usually shrinks
  • acute infective - transient
  • infiltrative e.g. sarcoidosis, tuberculosis
    
• iodine deficiency - simple, endemic goitre
• idiopathic - simple, sporadic goitre
• multinodular goitre - develops from simple goitre
  
• dyshormogenesis - including Pendred's syndrome:
  • inability to use trapped iodine
  • deficiency of peroxidase and dehalogenase
  • abnormal protein binding in the plasma
    
• goitrogens
• thyroid cysts - rare
• thyroid tumours

Note:

• a new area of enlargement within a goitre may indicate haemorrhage into a cyst, or a thyroid carcinoma

References

1. Yildirim Simsir I, Cetinkalp S, Kabalak T. Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma. Med Princ Pract. 2020;29(1):1-5
2. Bel Lassen P, Kyrilli A, Lytrivi M, Corvilain B. Graves' disease, multinodular goiter and subclinical hyperthyroidism. Ann Endocrinol (Paris). 2019 Sep;80(4):240-249