www.Primo.com: Did You Know About Goitre.

Goitre is the definition of the term for enlargement of the thyroid gland / godok (Dr.Hendra T.Laksman) goitre Goitre is the Nodusa without hyperthyroidism. Non-toxic struma nodosa is an enlarged thyroid gland that clinically palpable nodules without one or more signs hypertiroidisme. Nodusa or goitre adenomathosa is found in mountainous areas due to iodine deficiency.

Etiology.

The cause of this abnormality wide - range, can be found at the ready the future because the need for thyroxine increases, especially during puberty, growth, menstruation, pregnancy, lactation, monepouse, infection or other stress. In those carp can be found hyperplasia and involution of the thyroid gland. These changes can cause thyroid nodularity and architectural abnormalities that may continue with reduced blood flow in the area resulting in ischemia.

Classification Struma.

According to the American Society for the Study of Goiter divide:

* Non Toxic Struma diffusa.

* Non Toxic Goitre Nodusa.

* Toxic Stuma diffusa.

* Toxic Goitre Nodusa.

Toxic and Non-Toxic term used due to a change in terms of physiological functions such as hyperthyroidism and thyroid gland hipotyroid, while the term nodusa and diffusa more to changes in anatomical shape.

The classification in detail as follows:

1. Nodusa non-toxic goitre.

Enlargement of the thyroid gland is bounded clear without symptoms of hyperthyroidism. Etiology: The cause of most non-toxic goitre is iodine deficiency. However, patients with sporadic goitre formation, the cause is unknown. Non-toxic goitre caused by several things, namely:

** Iodine deficiency : Formation of goitre occurs in moderate iodine difesiensi less than 50 mcg / d. While severe iodine deficiency is less than 25 mcg / d associated with hypothyroidism and cretinism.

** Excess iodine: Rare and generally occur on preexisting autoimmune thyroid disease

** Goitrogen:

** Drugs: Propylthiouracil, lithium, phenylbutazone, aminoglutethimide, expectorants containing iodine

** Agent: environment: Phenolic and phthalate esters and resorcinol derivatives derived from rock and coal mines.

** Food, types of Brassica vegetables (eg, cabbage, Chinese radish, brussels sprouts), grain millet, cassava, and goitrin in the weeds. Dishormonogenesis: Damage in the biosynthetic pathway of thyroid gland hormones history of head and neck radiation:

History ** radiation during childhood resulted in benign and malignant nodules.

2. Non Toxic Struma diffusa.

Causes of Non-Toxic Struma diffusa by Mulinda, 2005: Iodine deficiency autoimmune thyroiditis: Hashimoto's thyroiditis postpartum oatau Excess iodine (Wolff-Chaikoff effect) or ingestion of lithium, with a decrease in the release of thyroid hormones. TSH receptor stimulation by TSH from the pituitary tumors, pituitary resistance to thyroid hormonal, gonadotropins, and / or thyroid-stimulating immunoglobulin inborn errors of metabolism that cause damage in the biosynthesis of thyroid hormone. Radiation exposure to the thyroid hormone resistance deposition disease Subacute thyroiditis (de Quervain's thyroiditis) Silent thyroiditis agents Acute suppurative infection: Chronic bacterial: mycobacteria, fungal, and parasitic granulomatous disease Thyroid Malignancy.

3. Toxic goitre.

Causes of Toxic Goitre Nodusa Nodusa by Davis, 2005: Iodine deficiency resulting in decreased levels of T4 TSH receptor activation of somatic mutation of TSH receptor and Ga protein mediators of growth include: Endothelin-1 (ET-1), insulin-like growth factor-1, epidermal growth factor and fibroblast growth factor.

4. Toxic Struma diffusa.

Included in difusa toxic goitre is grave desease, which is an autoimmune disease in which the exact cause is still unknown.

Pathophysiology in general, people do not have complaints nodusa goiter due to hypo or hyperthyroidism no. Nodusa single but most probably evolved into a multi-nodular that does not work. Goitre can be great without symptoms, except running the neck. Most patients with Struma his nodusa can live with it without complaint, because it does not interfere with breathing and bulging fore. Others can cause breathing problems occur eventually dyspnea. Goitre usually benign adenomas, although likely not cause neurological, musculoskeletal, swallowing because of pressure or encouragement. Another abnormality is heaviness in the neck when swallowing food. Rose to close the trachea and larynx thyroid epiglostis so heavy because fixed to the trachea.

Clinical Manifestations Due to the recurrence of hyperplasia and involution may occur sabagai various forms of cystic degeneration, necrosis, classification, cyst formation and bleeding into the cyst. In general, the disorder can show up as goitre nodusa is Edenoma, cyst hemorrhage thyroiditis and carcinoma. (Mansjoer, 199; 589) While the clinical manifestations of patients with manifest hypothyroidism, such as lack of energy, hair loss, cold intolerance, weight gain, constipation, dry skin and cold, hoarseness, and slow in thinking. In hypothyroidism, the thyroid gland is often not palpable. Likely to occur due to atrophy of the gland due to radioactive iodine treatment of hyperthyroidism wear before or after tiroditiditis autoimmune.

Complications of thyroidectomy complications that may occur: bleeding. Problems opening a large vein and cause air embolism. Trauma to nerve laryngeus recurrens. Forcing the gland secretion of abnormal amounts into circulation with pressure. Sepsis that extends into the mediastinum. Postoperative hypothyroidism due to the lifting of the thyroid gland. Trakeumalasia (softening of the trachea).

Struma carrying on:

Strumektomi. Performed on a large goitre and cause mechanical complaints.

Thyroxine for 4-5 months. This preparation is given when there is a warm nodules and thyroid examination re-prints.

Fine needle aspiration biopsies. How this is done so that the nodules on the thyroid cysts less than 10 mm.

Fingerprint examination of the thyroid. The results of examination with radio isotopes is the impression of the size, shape location, and the main thing is the function of a part - part of the thyroid.

Ultrasound examination (USG). With ultrasound examination can distinguish between solid, liquid and some form of abnormality, but have not been able to distinguish with certainty whether a nodule is malignant or benign.

Fine needle aspiration biopsies. A biopsy was done specifically in suspicious circumstances of a malignancy.

Thermography. Inspection method is based on a measurement of skin temperature using Dynamic Telethermographi place.

Tumor marker. In this examination is measured elevation tiroglobin (TG) levels.

Thank you for reading this article. Written and posted by Bambang Sunarno. sunarnobambang86@gmail.com
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DatePublished: March 06, 2014 at 16:04