Hyperthyroidism, hyperthyroidism:Autoimmune thyroid disease (I):1, autoimmune hyperthyroidism: due to thyroid stimulating antibody (TSI) in
Autoimmune thyroid disease (I):
1, autoimmune hyperthyroidism: due to thyroid stimulating antibody (TSI) in the role of the thyroid cell membrane TSH receptor, caused by hyperthyroidism. Known as Graves Graves disease, hyperthyroidism, diffuse toxic goiter and diffuse goiter with hyperthyroidism, goiter and Basedow disease.
The "Graves disease" and "diffuse toxic goiter" name is widely used but not. Because of Graves's disease including thyroid function hyperfunction and normal thyroid function of two types of exophthalmos only, the former is called "Graves hyperthyroidism, which is referred to as the" Graves eye disease "is appropriate.
Toxic diffuse goiter, toxic inappropriate, because the thyroid gland is not toxic, often misunderstood by clinical patients, increase the burden of thinking. Graves hyperthyroidism is not diffuse, but also some manifestations of nodular goiter.
2, multinodular goiter with hyperthyroidism: nodular non autonomy is autoimmune hyperthyroidism in a multi nodular basis, should belong to Graves hyperthyroidism, and there is a difference between "toxic multinodular goiter".
3, Hashimoto Shiko: should belong to Hashimoto's thyroiditis with autoimmune hyperthyroidism, Hashimoto's thyroiditis and non induced hyperthyroidism, and the essential difference between Hashimoto's thyroiditis and early clinical manifestations of hyperthyroidism, often misunderstood.
4, neonatal hyperthyroidism: neonatal hyperthyroidism has two kinds, one is from the maternal TRAb through the placenta to the fetus can cause transient neonatal hyperthyroidism, another is caused by an autoimmune reaction to the neonatal hyperthyroidism, both not distinguish the observation if it is a transient, should belong to the former.
5, pregnancy, lactation hyperthyroidism: can be a history of hyperthyroidism before pregnancy, pregnancy or lactation relapse, can also be a continuation of the treatment of hyperthyroidism before pregnancy or early hyperthyroidism.
6, eye type Graves disease and normal thyroid function: only exophthalmos, autoimmune and Graves can develop into clinical hyperthyroidism, hyperthyroidism, also can maintain the normal thyroid function over a long period of time.
(two) non autoimmune hyperthyroidism:
1, high iodine: iodine caused by high iodine or iodine deficiency area, the literature that may have their own thyroid tissue is a potential independent function, high iodine activation caused by hyperthyroidism.
2, pituitary hyperthyroidism: due to excessive secretion of pituitary TSH, causing hyperthyroidism. Such as the autonomy of pituitary TSH secreting adenoma (chromophobe adenoma), was also seen in the pituitary thyroid hormone resistance of negative feedback, which is called the central thyroid hormone should not.
The sensitivity of the pituitary gland to the negative feedback of thyroid hormones is reduced, which is the "central thyroid hormone resistance syndrome", and the blood TSH can be increased.
According to the clinical findings: unexplained increased TSH (subclinical hypothyroidism) or decreased TSH (subclinical hyperthyroidism) whether pituitary thyroid hormone abnormal reaction? Worth exploring.
3, hypothalamic hyperthyroidism due to hypothalamic lesion or dysfunction caused by thyrotropin releasing hormone (TRH) release of excessive, indirectly caused by hyperthyroidism.
4, autonomous high functioning thyroid adenoma (Plummer disease): adenoma for autonomous high function, secretion of excessive thyroid hormone cause hyperthyroidism.
5, toxic nodular goiter: nodules for autonomy, there are literature included in Plummer disease.
6, heterologous TSH syndrome: Women's chorionic epithelial carcinoma, male testicular villous cancer, lung cancer and gastrointestinal cancer can secrete TSH like substances, stimulate the thyroid. In addition, the high level of HCG gravidarum, the thyroid gland has a TSH like stimulation, can cause hyperthyroidism hyperthyroidism.
7, polyostotic fibrous dysplasia with hyperthyroidism: very rare.
8, non autoimmune autosomal dominant hyperthyroidism: a genetic disease, caused by the activation of thyroid TSH receptor tissue.
9, subclinical hyperthyroidism: only TSH decreased and T3, T4 normal, no significant clinical manifestations of hyperthyroidism, its mechanism is not clear.
Two, hyperthyroidism hyperthyroidism hyperthyroidism:
The thyroid gland itself has no function hyperfunction, because the thyroid gland outside factor or the thyroid gland destruction causes the thyroid hormone to increase, appears the hyperthyroidism clinical manifestation.
1, follicular thyroid carcinoma (including metastasis): functional thyroid cancer thyroid hormone production, can cause clinical hyperthyroidism, thyroid itself has no autoimmune reactions, sometimes functional thyroid cancer and autoimmune hyperthyroidism can be combined with. There is no contradiction between the two treatment options, because in the process of dealing with thyroid cancer, hyperthyroidism can be alleviated.
2, ovarian goiter (ovarian toxic adenoma): ovarian teratoma, ectopic thyroid gland secretion of thyroid hormones, causing hyperthyroidism.
3, drug-induced thyrotoxicosis: thyroid hormone treatment process, such as excessive doses, can cause hyperthyroidism.
4, due to inflammatory thyroiditis: the destruction of thyroid tissue, thyroid hormone release into the blood. In acute thyroiditis, subacute thyroiditis, painless thyroiditis, postpartum thyroiditis, radioactive thyroiditis, Hashimoto's thyroiditis (early).
5, thyroid adenoma necrosis.
(a), primary hypothyroidism due to thyroid dysfunction itself, resulting in the loss of thyroid function.
In 1, idiopathic hypothyroidism (autoimmune) due to thyroid stimulating blocking antibody (TBAb) exists, blocking TSH normal stimulation of the thyroid, resulting in hypothyroidism.
2, thyroid abnormalities in hypothyroidism:
1), thyroid agenesis or hypoplasia: congenital hypothyroidism in newborn.
2), ectopic thyroid gland: the case of congenital hypothyroidism neonates, visible, paratracheal thyroid, lingual thyroid substernal thyroid.
3, thyroid hormone synthesis disorder: due to thyroid hormone synthesis process of a certain enzyme function defects, leading to reduced thyroid hormone, is a hereditary disease.
4, the fetus exposed to excessive effects of antithyroid drugs or iodine can cause neonatal hypothyroidism.
5, neonatal transient hypothyroidism: fetal maternal thyroid antibody blocking effect after birth showed hypothyroidism, when the antibody disappeared after hypothyroidism can relieve.
6. Down's syndrome: a hereditary chromosomal abnormality.
7, local Kading disease: due to maternal or fetal iodine deficiency.
(two), pituitary hypothyroidism due to pituitary lesions, reduce the secretion of TSH induced hypothyroidism.
(three), hypothalamic hypothyroidism: the decrease of TRH secretion caused by hypothalamic lesions caused by hypothyroidism.
(four), Hashimoto's thyroiditis with hypothyroidism caused by thyroid autoimmunity.
(five), and 131 iodine in the treatment of hypothyroidism after surgery.
(six) and thyroid hormone resistance syndrome: in the peripheral thyroid hormone resistance, target tissue of thyroid hormone on the thyroid hormone sensitivity decreased, serum thyroid hormone concentration is not low even increased, while the performance of hypothyroidism.
(a), acute thyroiditis: caused by bacterial infection, due to thyroid cell destruction, thyroid hormone release into the blood, causing symptoms of hyperthyroidism.
(two), subacute thyroiditis: common caused by viral infection in clinical, easily confused with Graves hyperthyroidism.
(three), Hashimoto's thyroiditis is also called chronic lymphocytic thyroiditis, caused by autoimmune reaction.
(four), postpartum thyroiditis: the case of autoimmune thyroiditis.
(five), painless thyroiditis: similar to autoimmune thyroiditis.
(six), painless subacute thyroiditis and subacute thyroiditis: similar.
Five, thyroid morphology, abnormal location:
(a), a thyroid absence or dysplasia: normal thyroid function, thyroid radionuclide imaging is an effective method for diagnosis of thyroid surgery, in any should be clear or except in the presence of the disease, in order to guide the operation plan, is expected to avoid or hypothyroidism after surgery.
(two), ectopic thyroid: visible at the base of the tongue, paratracheal, sternum, etc., is one of the causes of neonatal congenital hypothyroidism, early diagnosis.
Six, thyroid dysfunction syndrome":
Clinical hyperthyroidism and hypothyroidism sometimes see each other repeatedly into case, may be converted in the nature of thyroid antibody. As a result of the treatment of hypothyroidism in the process of drug withdrawal in hyperthyroidism, hypothyroidism after a period of time, still exist, this disease should be considered, and vice versa. Should be properly handled according to circumstances.
According to: the name of the disease was not included in the specification, the author comments.
Seven, simple goiter:
The thyroid gland with normal thyroid function can be divided into local and sporadic goiter, diffuse and nodular goiter.
Eight, thyroid nodules:
Including the nodules found by palpation and ultrasound findings of nodules, the latter is more common. Benign nodules are the majority, and the preoperative diagnosis of benign and malignant nodules is still one of the clinical difficulties.
Nine, thyroid adenoma:
Benign tumor of thyroid nails, can be divided into functional independence and autonomy, sometimes manifested as cystadenoma.
Ten, thyroid cyst:
More benign lesions, B ultrasound can be found early.
Eleven, thyroid cancer:
Including functional thyroid cancer (papillary carcinoma, cellular carcinoma), poorly differentiated carcinoma, medullary carcinoma, etc..
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