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Goiter (Endemic Goiter)
Published in Charles Theisler, Adjuvant Medical Care, 2023
A goiter is an abnormal enlargement of the thyroid gland. Endemic goiter is an iodine-deficiency disease (IDD). Endemic goiters occur in those areas where the iodine content of the soil is so low that insufficient iodine is obtained through food and water and when no provision is made for supplying iodized salt. In the U.S., where the use of iodized salt is common, a goiter is most often due to Grave’s disease, Hashimoto’s disease, multinodular goiter, solitary thyroid nodules, or thyroid cancer.1
Acquired hypothyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Acquired hypothyroidism in the developed world is primarily caused by autoimmune thyroid disease (AITD). It is the leading cause of thyroid disorders in the pediatric population in the US (1). In the underdeveloped world, iodine deficiency, or endemic goiter, remains an important cause of hypothyroidism, affecting one-third of the world’s population (2). Less common causes of acquired primary hypothyroidism include subacute thyroiditis, acute iodine toxicity, postoperative hypothyroidism, radiation exposure, chromosomal abnormalities, and medication-related hypothyroidism. Secondary and tertiary acquired causes of hypothyroidism are less common and directly related to pituitary and hypothalamic insults (tumor, hypo perfusion, hypophysitis, local radiation, postoperative and brain trauma).
Thyroid cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Gitta Madani, Polly S Richards
The incidence of thyroid carcinoma is higher in iodine-rich areas (Iceland, Hawaii), suggesting a relationship to high iodine consumption (7,10). Endemic goiter, occurring in areas of iodine deficiency, is also a possible risk factor for thyroid carcinomas (possibly due to prolonged stimulation of the gland by thyroid-stimulating hormone). Follicular and anaplastic carcinomas predominate in iodine-deficient areas, whilst in iodine-rich areas, papillary carcinomas are more common (7,11).
Clinical and ultrasound characteristics distinguishing benign and malignant thyroid nodules in Johannesburg, South Africa
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Kershlin Naidu, Victoria Saksenberg, Nasrin Goolam Mahyoodeen
In Southern Africa, endemic goitre is usually associated with iodine deficiency. This was initially described in 1954 in a goitre belt extending from Limpopo province through Swaziland and Lesotho into the Eastern Cape.23 Prevalence rates of endemic goitre in Africa range between 1% and 90% depending on the study region.24 Mandatory iodinisation of table salt in South Africa was introduced on 1 December 1995 and the Iodine Global Network now classifies South Africa’s iodine intake as adequate.25 A retrospective review at the endocrine unit of Chris Hani Baragwanath Academic Hospital compared thyroid ultrasound features with FNA and histology results. There was good correlation between the ATA ultrasound classification and cytopathology and histopathology results.26 Non-diagnostic thyroid FNA rates in South African studies range between 9% and 10%.26,27
A New Imaging Technique for the Diagnosis of Thyroid Cancer: Thyroidography
Published in Journal of Investigative Surgery, 2021
Erhan Aysan, Ozan Aydin, Merve Ercivan, Direnc Aksoy, Alp Erdem Yavuz
In past, Erazo et al. produced poor success evaluating endemic goiter cases for detection of thyroid cancer with direct neck x-ray [16]. Rahman et al. reviewed 160 goiter cases with chest, thoracic inlet and neck X-ray radiograms and classified them into two groups; those with calcifications and those without calcifications. Calcifications were demonstrable in 17% of the cases. All patients with calcifications had tracheal narrowing, higher occurrence of cervical degeneration and 3-fold incidence of retrosternal extension of their goiters. However, only four out of 13 patients with malignant histology had calcification, while the remaining nine patients had no calcification [17]. Cited studies did not evaluate calcifications into micro and macro sub-groups because they were surgical goiter cases’ with neck, thoracic input and lung X-ray radiograms retrospectively, so with low resolution capacity these imaging modalities of microcalcifications could not be seen. Thus in our study, we could not detect any microcalcifications in the DICOM images.
Prevalence and clinical relevance of thyroid autoantibodies in patients with goitre in Nigeria
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2019
OA Ojo, RT Ikem, BA Kolawole, OE Ojo, MO Ajala
In a study carried out by Olusi et al.8 4.6% of patients with goitre were found to have significantly positive autoantibody titres against thyroglobulin (Tg) while none of the 59 normal controls matched for age and sex had demonstrable autoantibodies. Isichei et al.,9 in a survey of endemic goitre in Jos, showed that goitre is highly endemic in the area with prevalence varying from 1% to 23%. Females showed a markedly higher prevalence of goitre. Though urine samples indicated that iodine excretion was similar to that in iodine-deficient areas of the world, no relationship was observed between the prevalence of goitre and urinary iodine. It could therefore not be concluded that the aetiology of endemic goitre in this area was associated with iodine deficiency. It was thus concluded that endemic goitre may be an interplay of multiple factors of aetiological importance. Okosieme et al.,10 in a study on the prevalence of thyroid antibodies in Nigerian patients, found that TgAb and TPOAb were found in 4% and 7%, respectively, of healthy adult controls, 11.6% and 76.8% of patients with GD, 25% and 12.5% of patients with toxic nodular goitre (TNG) and 9.52% and 14.29% of patients with simple non-toxic goitre (SNTG). The prevalence of thyroid autoantibodies found by Okosieme et al.10 was higher than that reported in previous studies in Africans.11,12 This may be due to the use of agglutination method in previous studies, a less sensitive method compared with enzyme-linked immunosorbent assay (ELISA), which was used by Okosieme et al.