Toxic multinodular goiter screening
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Toxic multinodular goiter Microchapters |
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Differentiating Toxic multinodular goiter from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
Toxic multinodular goiter is diagnosed by a physical examination which reveals nodules in the throat, rapid heart rate, diaphoresis, and tremors. Screening includes testing for elevated T3 and T4 hormone levels that indicate hyperthyroidism. TSH assays are the best initial screening tool for hyperthyroidism.
Screening
The screening for toxic multinodular goiter are as follows:[1][2][3][4]
- Toxic multinodular goiter is diagnosed by a physical examination which reveals nodules in the throat, rapid heart rate, diaphoresis, and tremors.
- Screening includes testing for elevated T3 and T4 hormone levels that indicate hyperthyroidism.
- TSH assays are the best initial screening tool for hyperthyroidism. Patients with TNG will have suppressed TSH levels.
- Low levels of thyroid-stimulating hormone (TSH) are suggestive of hyperthyroidism
- An isolated increase in T4 is observed in iodine-induced hyperthyroidism or patients taking propranolol, corticosteroids, radiocontrast agents, amiodarone.
- 5-46% of patients with toxic nodules have normal free T4 levels with an elevated T3, this is called T3 toxicosis.
- Overactive nodules are found on ultrasound scans of the thyroid to create images of the thyroid, which can reveal the conjunction with a special radioactive iodine test that involves swallowing a pill prior to special scans.
- The normal range for total T3 and T4 levels may vary for each and every individual; especially in case of people with nonthyroidal illness with decreased T3 levels.
References
- ↑ "Toxic multinodular goitre. Personal case histories and literature review. - PubMed - NCBI".
- ↑ "Hyperfunctioning thyroid nodules. - PubMed - NCBI".
- ↑ "Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine de... - PubMed - NCBI".
- ↑ "Thyroid cancer in toxic and non-toxic multinodular goiter. - PubMed - NCBI".