Toxic multinodular goiter causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The progression to Toxic multinodular goiter usually involves the somatic gain-of-function mutations in the TSH receptor gene.

The causes of toxic multinodular goiter as follows:^[1]^[2]^[3]^[4]

The development of multi-nodular goiter is the result of multiple genetic base substitution mutations on exon 10 of chromosome 14q31.

Common mutations

Methionine replacing an isoleucine (I486M) in the first extracellular loop of TSH-R G-protien^[17]
Threonine in position 632 (T632I) sixth transmembrane segment of TSH-R G-protien^[18]

Less common mutations

(TSHr gene codon) 486 (base substitution)ATC/ATG (amino acid change) Ile/Met

(TSHr gene codon)619 (base substitution)GAT/GGT (amino acid change)Asp/Gly

(TSHr gene codon)623 (base substitution)GCC/GTC (amino acid change)Ala/Val

(TSHr gene codon)629 (base substitution)TTG/TTT (amino acid change)Leu/Phe

(TSHr gene codon)630 (base substitution)ATC/CTC (amino acid change)Ile/Leu

(TSHr gene codon)632 (base substitution)ACC/ATC (amino acid change)Thr/Ile

(TSHr gene codon)633 (base substitution)GAC/GAG (amino acid change)Asp/Glu

(TSHr gene codon)639 (base substitution)CCA/TCA (amino acid change) Pro/Ser

Cardiovascular	No underlying causes
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	The development of multi-nodular goiter is the result of multiple genetic base substitution mutations on exon 10 of chromosome 14q31.
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

List the causes of the disease in alphabetical order.

3