aetiology

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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

Last reviewed 01/2018

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