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Hyperthyroidism Speaker : Dr Priya Tiwari Preceptors : Prof. A.C. Ammini/Dr.R. Goswami Prof. Rita Sood
Content Introduction Causes Clinical manifestations Graves’ disease Toxic multinodular goiter & toxic adenoma Amiodarone induced thyrotoxicosis Subacute thyroiditis Subclinical hyperthyroidism Approach to thyrotoxicosis Thyroid storm
Introduction Hyperthyroidism reserved for disorders resulting from overproduction of hormone by thyroid gland Biochemical & physiologic manifestations of excessive quantities of thyroid hormones Overall incidence of between 0.05 to 1.3%¹ Prevalence of hyperthyroidism is approx. 5-10 times less than hypothyroidism 1. N Engl J Med 2008;358:2594-605
Etiology Sustained Hormone Overproduction Graves' disease Toxic multinodular goiter(Plummer ‘s disease) Toxic adenoma Iodine-induced (Jod-Basedow) Trophoblastic tumor Activating mutation of the TSH receptor Activating mutation of Gsa (McCune-Albright syndrome) Increased TSH secretion Transient thyrotoxicosis Thyrotoxicosis factitia Subacute thyroiditis Other forms of thyroiditis: Painless thyroiditis silent thyroiditis, postpartum thyroiditis Drug induced : Amiodarone, Lithium, GMCSF, IL-2, INF alpha, Leuprolide, Sunitinib Ectopic thyroid tissue (struma ovarii, functioning metastatic thyroid cancer) HiGH RAIU except iodine induced Low RAIU

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