Toxic Adenoma history and symptoms: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
Patients with toxic adenomas typically present with signs and symptoms of | Patients with toxic adenomas typically present with signs and symptoms of [[hyperthyroidism]]. Common symptoms include [[fatigue]], unintentional [[weight loss]], [[Heat illness|heat intolerance]], [[diaphoresis]], [[palpitations]], [[anxiety]], and [[nervousness]]. Specific areas of focus when obtaining a history from the patient of toxic adenoma include the possibility of recent iodide exposure in any form that can provoke transient [[thyrotoxicosis]] in a pre-existing toxic nodule such as medication (e.g., [[amiodarone]]), [[radiocontrast]] dye, [[dietary supplements]]. | ||
==History== | ==History== | ||
Specific areas of focus when obtaining a history from the patient of toxic adenoma include: | Specific areas of focus when obtaining a history from the patient of toxic adenoma include:<ref name="pmid12707627">{{cite journal |vauthors=Corvilain B |title=The natural history of thyroid autonomy and hot nodules |journal=Ann. Endocrinol. (Paris) |volume=64 |issue=1 |pages=17–22 |year=2003 |pmid=12707627 |doi= |url=}}</ref> | ||
*Possibility of recent iodide exposure—in the form of (can provoke transient thyrotoxicosis in a pre-existing toxic nodule) | *Possibility of recent [[iodide]] exposure—in the form of (can provoke transient [[thyrotoxicosis]] in a pre-existing toxic [[nodule]]) | ||
**Medication (e.g., amiodarone) | **Medication (e.g., [[amiodarone]]) | ||
**Radiocontrast dye | **[[Radiocontrast agents|Radiocontrast dye]] | ||
**Dietary supplements | **[[Dietary supplements]] | ||
==Symptoms== | ==Symptoms== | ||
Patients with toxic adenomas typically present with signs and symptoms of thyrotoxicosis. | Patients with toxic adenomas typically present with signs and symptoms of [[thyrotoxicosis]]. Common symptoms of toxic adenoma include:<ref name="pmid12707627">{{cite journal |vauthors=Corvilain B |title=The natural history of thyroid autonomy and hot nodules |journal=Ann. Endocrinol. (Paris) |volume=64 |issue=1 |pages=17–22 |year=2003 |pmid=12707627 |doi= |url=}}</ref><ref name="pmid28274949">{{cite journal |vauthors=Carlé A, Andersen SL, Boelaert K, Laurberg P |title=MANAGEMENT OF ENDOCRINE DISEASE: Subclinical thyrotoxicosis: prevalence, causes and choice of therapy |journal=Eur. J. Endocrinol. |volume=176 |issue=6 |pages=R325–R337 |year=2017 |pmid=28274949 |doi=10.1530/EJE-16-0276 |url=}}</ref><ref name="pmid26926973">{{cite journal |vauthors=Kravets I |title=Hyperthyroidism: Diagnosis and Treatment |journal=Am Fam Physician |volume=93 |issue=5 |pages=363–70 |year=2016 |pmid=26926973 |doi= |url=}}</ref><ref name="pmid23165002">{{cite journal |vauthors=Corrias A, Mussa A |title=Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how |journal=J Clin Res Pediatr Endocrinol |volume=5 Suppl 1 |issue= |pages=57–69 |year=2013 |pmid=23165002 |pmc=3608010 |doi=10.4274/jcrpe.853 |url=}}</ref><ref name="pmid19450325">{{cite journal |vauthors=Nygaard B |title=Hyperthyroidism (primary) |journal=BMJ Clin Evid |volume=2008 |issue= |pages= |year=2008 |pmid=19450325 |pmc=2907936 |doi= |url=}}</ref><ref name="pmid16127951">{{cite journal |vauthors=Reid JR, Wheeler SF |title=Hyperthyroidism: diagnosis and treatment |journal=Am Fam Physician |volume=72 |issue=4 |pages=623–30 |year=2005 |pmid=16127951 |doi= |url=}}</ref> | ||
*Fatigue | *[[Fatigue]] | ||
*Unintentional weight loss | *Unintentional [[weight loss]] | ||
*Heat intolerance | *[[Heat illness|Heat intolerance]] | ||
*Diaphoresis | *[[Diaphoresis]] | ||
*Tremor | *[[Tremor]] | ||
*Palpitations | *[[Palpitations]] | ||
* | *[[Diarrhea]] | ||
*Anxiety | *[[Anxiety]] | ||
*Nervousness | *[[Nervousness]] | ||
*Irritability | *[[Irritability]] | ||
*Difficulty with mental concentration | *Difficulty with mental concentration | ||
*Hair loss | *Hair loss | ||
*Women may experience | *Women may experience<ref name="pmid17302862">{{cite journal |vauthors=Poppe K, Velkeniers B, Glinoer D |title=Thyroid disease and female reproduction |journal=Clin. Endocrinol. (Oxf) |volume=66 |issue=3 |pages=309–21 |year=2007 |pmid=17302862 |doi=10.1111/j.1365-2265.2007.02752.x |url=}}</ref> | ||
**Oligomenorrhea | **[[Oligomenorrhea]] | ||
**Amenorrhea | **[[Amenorrhea]] | ||
*Men may complain of | *Men may complain of | ||
**Decrease in libido | **Decrease in [[Libido decreased|libido]] | ||
**Erectile dysfunction | **[[Erectile dysfunction]] | ||
**Gynecomastia | **[[Gynecomastia]] | ||
===Less common=== | |||
Rarely patients with a toxic adenoma may experience symptoms due to mass effect of adenoma itself. | |||
*Neck discomfort | |||
*Mild [[dysphagia]] | |||
*[[Odynophagia]] | |||
===Signs of thyrotoxicosis=== | ===Signs of thyrotoxicosis=== | ||
*Tachycardia | *[[Tachycardia]] | ||
*Systolic hypertension | *[[Systolic hypertension]] | ||
*Hyperactive or fatigued demeanor | *Hyperactive or fatigued demeanor | ||
*Staring gaze and lag | *Staring gaze and lag | ||
*Brisk carotid upstrokes | *Brisk carotid upstrokes | ||
*Hyperdynamic point of maximal impulse | *[[Hyperdynamic precordium|Hyperdynamic]] point of maximal impulse | ||
*Systolic flow murmur | *[[Murmur|Systolic flow murmur]] | ||
*Proximal muscle weakness | *[[Muscle weakness|Proximal muscle weakness]] | ||
*Fine hand tremor | *[[Tremor|Fine hand tremor]] | ||
*Velvety or oily skin | *Velvety or oily skin | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 19:38, 20 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Patients with toxic adenomas typically present with signs and symptoms of hyperthyroidism. Common symptoms include fatigue, unintentional weight loss, heat intolerance, diaphoresis, palpitations, anxiety, and nervousness. Specific areas of focus when obtaining a history from the patient of toxic adenoma include the possibility of recent iodide exposure in any form that can provoke transient thyrotoxicosis in a pre-existing toxic nodule such as medication (e.g., amiodarone), radiocontrast dye, dietary supplements.
History
Specific areas of focus when obtaining a history from the patient of toxic adenoma include:[1]
- Possibility of recent iodide exposure—in the form of (can provoke transient thyrotoxicosis in a pre-existing toxic nodule)
- Medication (e.g., amiodarone)
- Radiocontrast dye
- Dietary supplements
Symptoms
Patients with toxic adenomas typically present with signs and symptoms of thyrotoxicosis. Common symptoms of toxic adenoma include:[1][2][3][4][5][6]
- Fatigue
- Unintentional weight loss
- Heat intolerance
- Diaphoresis
- Tremor
- Palpitations
- Diarrhea
- Anxiety
- Nervousness
- Irritability
- Difficulty with mental concentration
- Hair loss
- Women may experience[7]
- Men may complain of
- Decrease in libido
- Erectile dysfunction
- Gynecomastia
Less common
Rarely patients with a toxic adenoma may experience symptoms due to mass effect of adenoma itself.
- Neck discomfort
- Mild dysphagia
- Odynophagia
Signs of thyrotoxicosis
- Tachycardia
- Systolic hypertension
- Hyperactive or fatigued demeanor
- Staring gaze and lag
- Brisk carotid upstrokes
- Hyperdynamic point of maximal impulse
- Systolic flow murmur
- Proximal muscle weakness
- Fine hand tremor
- Velvety or oily skin
References
- ↑ 1.0 1.1 Corvilain B (2003). "The natural history of thyroid autonomy and hot nodules". Ann. Endocrinol. (Paris). 64 (1): 17–22. PMID 12707627.
- ↑ Carlé A, Andersen SL, Boelaert K, Laurberg P (2017). "MANAGEMENT OF ENDOCRINE DISEASE: Subclinical thyrotoxicosis: prevalence, causes and choice of therapy". Eur. J. Endocrinol. 176 (6): R325–R337. doi:10.1530/EJE-16-0276. PMID 28274949.
- ↑ Kravets I (2016). "Hyperthyroidism: Diagnosis and Treatment". Am Fam Physician. 93 (5): 363–70. PMID 26926973.
- ↑ Corrias A, Mussa A (2013). "Thyroid nodules in pediatrics: which ones can be left alone, which ones must be investigated, when and how". J Clin Res Pediatr Endocrinol. 5 Suppl 1: 57–69. doi:10.4274/jcrpe.853. PMC 3608010. PMID 23165002.
- ↑ Nygaard B (2008). "Hyperthyroidism (primary)". BMJ Clin Evid. 2008. PMC 2907936. PMID 19450325.
- ↑ Reid JR, Wheeler SF (2005). "Hyperthyroidism: diagnosis and treatment". Am Fam Physician. 72 (4): 623–30. PMID 16127951.
- ↑ Poppe K, Velkeniers B, Glinoer D (2007). "Thyroid disease and female reproduction". Clin. Endocrinol. (Oxf). 66 (3): 309–21. doi:10.1111/j.1365-2265.2007.02752.x. PMID 17302862.