Resection of an unusually large goitre

1977 ◽  
Vol 64 (3) ◽  
pp. 158-159 ◽  
Author(s):  
Adrie E. Manoppo
Keyword(s):  
Large Goitre

DEFECTIVE THYROID HORMONE BIOSYNTHESIS WITH ANOMALOUS REACTION TO THYROID THERAPY: REPORT OF A CASE

1963 ◽  
Vol 42 (3) ◽  
pp. 412-422 ◽  
Author(s):  
J. D. Wiener ◽  
G. A. Lindeboom
Keyword(s):  
Turnover Rate ◽  
Exchange Resin ◽  
Test Dose ◽  
Ion Exchange Resin ◽  
Adsorbed Protein ◽  
Thyroid Hormone Biosynthesis ◽  
Hormone Biosynthesis ◽  
Anomalous Reaction ◽  
Large Goitre ◽  
Inborn Defect

A case is presented of an euthyroid woman with an excessively large goitre, present since childhood. A distinct discrepancy was found between total protein bound iodine and butanol extractable iodine in the serum, and an elevated part of the plasma radioactivity after a test dose of 131I was not adsorbed on ion exchange resin. However, this non-adsorbed (»protein-like«) 131I was at least partly extractable with acid butanol. The fractional turnover rate of radiothyroxine was high. The possibility is raised that the pathological component was brought into the circulation as a result of an inborn defect in the thyroidal synthesis or proteolysis of thyroglobulin, and that it was composed of a number of more or less simple peptides, possibly not without some hormonal activity. The uptake of radioiodine by the thyroid was only partly suppressed by desiccated thyroid therapy, but most of the trapped radioactivity did not appear to be incorporated into organic compounds.

Investigation of Nithsdale Goitre

1969 ◽  
Vol 14 (2) ◽  
pp. 48-50 ◽  
Author(s):  
H. W. Gray ◽  
Anna V. Murphy ◽  
R. W. Logan ◽  
W. R. Greig ◽  
E. M. McGirr
Keyword(s):  
Iodine Deficiency ◽  
Large Majority ◽  
The South ◽  
Normal Range ◽  
Iodine Supplementation ◽  
South West ◽  
High Prevalence ◽  
Low Prevalence ◽  
Large Goitre

As a sequence to a survey which showed that the prevalence of goitre was higher in schoolchildren in Nithsdale (30%) than in Dumfries (16%), a total of 181 adult subjects from these 2 areas were examined and the plasma inorganic iodide concentrations (PII) were determined. The large majority of PII values in subjects from both areas were within the normal range and the overall conclusions are that iodine deficiency severe enough to account for a high prevalence of small goitre or a low prevalence of large goitre does not exist in the South West of Scotland. Since this area is likely to be representative of the U.K. in general, it is also concluded that there is no practical justification for general dietary iodine supplementation meanwhile.

scholarly journals Thyroidal Psychoses [Les psychoses thyroïdiennes]. (Le Prog. Méd., April, 1922.) Laignel-Lavastine

1922 ◽  
Vol 68 (283) ◽  
pp. 418-418
Author(s):  
Norman R. Phillips
Keyword(s):  
Present Article ◽  
Affective Psychoses ◽  
Radio Therapy ◽  
Thyroid Cyst ◽  
Large Goitre ◽  
Thyroid Abnormalities

The present article is chiefly concerned with those thyroid abnormalities which have been found associated with the so-called affective psychoses. The author himself has met with many cases of melancholia, hypomania, and anxiety psychosis, which, at the same time, were goitrous. Thus in a case of agitated melancholia presenting thyroid enlargement with signs of hyperthyroidism, complete mental recovery followed the removal of a thyroid cyst. In another case of melancholia with a large goitre the latter was treated by radio-therapy, with the result that the signs of hyperthyroidism diminished and the melancholia disappeared.

scholarly journals Presentation and Outcome of Severe Graves’ Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A842-A843
Author(s):  
Priya Mohan Babu ◽  
Suhani Bahl ◽  
Florin Capatana ◽  
Khaliq Hamdan ◽  
Ishrat Khan ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Treatment Initiation ◽  
Treatment Regime ◽  
Definitive Treatment ◽  
Dose Titration ◽  
Graves Disease ◽  
Detection Range ◽  
Multisystem Involvement ◽  
Significant Difference ◽  
Large Goitre

Abstract Introduction: Subjects with “severe” Graves’ disease (GD) are known to have adverse outcomes. They have multisystem involvement (orbitopathy, dermopathy), more severe clinical features, large goitres and a higher relapse rate. Also, their response to thionamides is slower. There is a developing consensus that early definitive treatment improves prognosis in them. Methods: We retrospectively analysed the electronic case records and biochemistry databases of all subjects seen in our University Health Board between January 2017 and October 2019 with GD. Severe GD was defined by (1) a thyrotropin receptor antibody (TRAb) value greater than 10U/l (normal range: less than 0.9), (2) with any one of the following - (a) free thyroxine (T4) above 50pmol/l (reference range 9-19.1), (b) a combination of T4 more than 40 pmol/l with triiodothyronine (T3) above the detection range of the assay (46.1 pmol/l), (c) the presence of a large goitre, (d) active Graves’ orbitopathy (GO) or (e) dermopathy. We compared subjects with severe GD to those who did not fulfil the above criteria i.e. non-severe GD. Results: 176 GD subjects were seen during this period - 52 (29.5%) with severe and 124 (70.5%) with non-severe GD. However, 19 severe and 26 non-severe GD subjects were on active thionamide treatment at the time of analysis, and complete details were unavailable in 41 subjects. There was a significant difference in the following features between the severe and non-severe GD groups respectively (1) their median age (39 vs.52 years), (2) median TRAb levels (25.5 vs.18.5 U/l) (3) higher prevalence of GO (38.5 vs.13.3%) and active GO (15.4 vs.0%), (4) the presence of moderate/large goitre (51.3 vs.3.3%), (5) higher number failing to normalize biochemically within the first 6 months after treatment initiation (53.9 vs.39%), (6) the presence of a family history, and (8) a higher number requiring definitive treatment within 12 months of starting treatment (9.6vs.0.81%)(p=0.001-0.026 for the above). There was no difference between the two groups in gender, treatment regime i.e. dose titration regime or block and replacement regime, number biochemically normalizing within 12 months, and those who had more than 18 months of treatment and their relapse rates (55 vs. 59.1%, p=0.84). Conclusions: We have shown that those with severe GD were younger, have higher TRAb concentrations with multisystem involvement, and delayed initial normalization of thyroid hormones. A greater number of them require definitive treatment within 12 months of treatment initiation. However, the majority in both groups normalize thyroid hormones within 12 months irrespective of the treatment regime used. Early definitive treatment is required in a significantly higher percentage of subjects with severe GD and needs to be considered in them.

scholarly journals Large Goitre in a Child of 10

BMJ ◽  
1944 ◽  
Vol 1 (4354) ◽  
pp. 812-812
Author(s):  
E. N. Callum
Keyword(s):  
Large Goitre

Factors influencing the outcome of thyrostatic drug therapy in Graves' disease

1990 ◽  
Vol 122 (6) ◽  
pp. 722-728 ◽  
Author(s):  
Brita Winsa ◽  
Per Anders Dahlberg ◽  
Rolf Jansson ◽  
Hans Ågren ◽  
F. Anders Karlsson
Keyword(s):  
Drug Therapy ◽  
Prognostic Significance ◽  
Fine Needle Biopsy ◽  
Graves Disease ◽  
Unfavourable Outcome ◽  
Tsh Receptor Antibody ◽  
Hla Dr ◽  
Antibody Levels ◽  
Large Goitre

Abstract. In patients with Graves' disease, thyrostatic drug treatment may induce definitive remission without the need of more aggressive measures such as surgery or radioiodine. Following drug therapy, however, relapses often occur. In the present study, a multivariate analysis of pretreatment variables was performed, in order to identify individuals running a high risk of an unfavourable outcome of thyrostatic drug therapy. We studied 109 consecutive patients with a mean age of 38 years, range 20–70, over a mean follow-up period of 5.3 years after cessation of therapy. The analysis showed that goitre size, age, thyroid hormone levels, HLA-DR 3 haplotype, and TSH receptor antibody levels were of prognostic significance, whereas HLA-B8 haplotype, a lymphocytic infiltrate at fine needle biopsy, thyroglobulin, and microsomal antibodies had no such value. In particular, patients characterized by young age, large goitre and high hormone values were found to be associated with an unfavourable course.

Circadian Serum Melatonin Profiles in Patients With Very Large Goitre Before Andafter Surgery

2002 ◽  
pp. 463-465
Author(s):  
Aleksander Stankiewicz ◽  
Krzysztof Kuzdak ◽  
Krystyna Zylinska ◽  
Elzbieta Bandurska-Stankiewicz ◽  
Jacek Swietoslawski ◽  
...  
Keyword(s):  
Large Goitre

Goitre size and outcome of medical treatment of Graves' disease

1986 ◽  
Vol 111 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Peter Laurberg ◽  
Poul Erik Buchholtz Hansen ◽  
Eigil Iversen ◽  
Sigurd Eskjær Jensen ◽  
Jørgen Weeke
Keyword(s):  
Medium Size ◽  
First Year ◽  
Graves Disease ◽  
Newly Diagnosed ◽  
Multinodular Goitre ◽  
Remission Rates ◽  
Table Analysis ◽  
Reasonable Choice ◽  
Large Goitre

Abstract. One hundred and twenty-four patients with newly diagnosed hyperthyroidism received a combined thionamid-thyroxine medical therapy for approximately 2 years. According to the estimated goitre size before therapy and the type of goitre the patients were divided into 4 groups: Graves' disease no goitre (n = 19). Graves' disease small goitre (n = 57), Graves' disease medium or large goitre (n = 23), multinodular goitre (n = 25). The median follow-up period after cessation of medication was 64 (range 11–141) months. The remission rates in the different groups during follow-up were calculated using life table analysis. Graves' patients with no goitre or a small goitre had a significantly better outcome (remission % after 5 years 82.5 ± 15.4 (se) and 71.5 ± 7.8, respectively) than Graves' patients with a medium size or large goitre (remission % after 5 years 37.0 ± 11.1) (P <0.025). Most patients with multinodular goitre had a relapse within the first year after stop of medication (remission % after 5 years 15.5 ± 10.1). Hence patients with Graves' disease having a small thyroid gland should be treated medically while surgery or radioiodine may be a more reasonable choice in Graves' patients with medium size or large goitres. Medically treated patients with toxic multinodular goitres have a very small chance of prolonged remission if medication is stopped.

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