Hyperthyroidism

Question 1

Definition

Answer 1

Condition where the thyroid gland is overactive and produces too much thyroid hormone

Question 2

Aetiology

Answer 2

3 most common causes:
– Graves’ disease (most common):
—- result of IgG antibodies binding to the TSH receptor and stimulating thyroid hormone production

– Toxic adenoma:
—- responsible for about 5% of cases.
—- prolonged remission rarely induced by drugs
—- where a single lump (adenoma) grows on the thyroid gland and produces excess thyroid hormone

– Toxic multi nodular goitre:
—- Commonly occurs in older women, and drug therapy is rarely successful in inducing a prolonged remission
—- enlarged thyroid gland. Areas of the thyroid gland grow too big and form nodules, these nodules will then produce too much thyroid hormone

Other causes:
– De Quervains thyroiditis:
—- transient hyperthyroidism sometimes occurs from acute inflammation of the gland, probably as a result of a viral infections
—- usually accompanied by fever, malaise and pain in the neck
—- treatment is with aspirin

– Post-partum thyroiditis

Question 3

Epidemiology

Answer 3

Common condition, affecting 2-5% of all women at some time

Mainly between the ages of 20 and 40

Question 4

Clinical presentation

Answer 4

Clinical features can vary with age and underlying aetiology of the hyperthyroidism

MC symptoms:
– irritability
– heat intolerance

MC signs:
– tremor
– hyperkinesis
– tachycardia or atrial fibrillation
– full pulse
– warm vasodilator peripheries
– goitre, bruit

General symptoms:
– weight loss
– restlessness
– malaise
– breathlessness
– stiffness
– muscle weakness
– thirst
– vomiting
– loss of libido

Graves’ disease only symptoms:
– eye complaints
– exophthalmos

De quervains thyroiditis- usually accompanied with:
– fever
– malaise
– pain in the neck